Return-Path: <nifl-health@literacy.nifl.gov> Received: from literacy (localhost [127.0.0.1]) by literacy.nifl.gov (8.10.2/8.10.2) with SMTP id e9RBjl919541; Fri, 27 Oct 2000 07:45:47 -0400 (EDT) Date: Fri, 27 Oct 2000 07:45:47 -0400 (EDT) Message-Id: <80256985.003FDCD0.00@smtpgw.nipltd.com> Errors-To: listowner@literacy.nifl.gov Reply-To: nifl-health@literacy.nifl.gov Originator: nifl-health@literacy.nifl.gov Sender: nifl-health@literacy.nifl.gov Precedence: bulk From: "Adam Oliver" <aoliver@ohe.org> To: Multiple recipients of list <nifl-health@literacy.nifl.gov> Subject: [NIFL-HEALTH:2677] [HEN] Collated responses X-Listprocessor-Version: 6.0c -- ListProcessor by Anastasios Kotsikonas Content-type: text/plain; charset=us-ascii Status: OR Dear all, Last week I posted the following request for help: "I was hoping that you may be able to help me. I'm searching the literature for evidence that shows (or does not show) that providing the patient with information improves health outcomes (where information can be any information at all - e.g. health promotion material, information on medical devices/pharmaceuticals etc.). The disease categories that I'm interested in are coronary heart disease and diabetes." I had a great many responses, and many people asked me to share the information with them. I thought the easiest way to do this was to post a collated list of responses to the lists. This I have done below, though I have not included all responses: for example, those containing Word files as I thought these may clog up some people's e-mail systems. Many thanks to everyone who responded. Best wishes, Adam ----------------------------------------- Lorig K, Konkol L & Gonzalez V, 1987, Arthritis patient education: a review of the literature, Patient Education and Counselling, 10, 207-252 The reference above is a well cited article around patient information/education. Although it concerns arthritis, it may provide some info re background issues or be a starting point for you. Unfortunately I have not come across anything for CHD / diabetes (but then I haven't looked). The literature that I've come across has implied that information alone does not have any great impact on health outcomes - patients need to know what to do with the information and believe they can do it for it to have any effect. -------------------------------------------- Check out Greenfield, S, Kaplan S, Ware J. Expanding patient involvement in care: effects on patient outcomes. Annals of Internal Medicine, 1985;102:520-528. Should be just what you're looking for. ------------------------------------------------------------------------------------------- The Centre for Health Information Quality may be able to help. www.hfht.org/chiq chiq@hfht.org tel: 01962 872245 ------------------------------------------------------------------------------------------------ Clenland, J.G. & Van Ginniken, J.K. (1988) Maternal education and child survivalo in developing countries: The search for pathways of influence. Social Science Medicine, 27 (1), 357-368. Grosse, R.N., Auffrey, B. (1989). Literacy and health status in developing countries. Annual Review of Public Health, 10, 281-297. Perrin, B. (1989) Literacy and health project: Phase one. Making the world a healthier and safer place for people who can't read. ERIC Document #ED346357. Smith, C. (1994). Health education and adult literacy (HEAL) project final evaluation report. Boston: World Education. http://www.prenataled.com/newsletters/v3n10/v3n10-3.htm Should we test patients' "health literacy"? http://www.prenataled.com/newsletters/v3n11/v3n11-2.htm Prepared to teach low literacy patients? http://www.prenataled.com/literacy.htm Literacy http://www.prenataled.com/quiz1-1.htm Check Your Prenatal Ed IQ (effects of access to info on pregnancy and birth outcomes) http://www.prenataled.com/bibsig.htm Significance of Information Giving to Health & Satisfaction, Literature Review Summary Kirsch IS, Jungeblut A, Jenkins L, Kolsted A (1993) Adult Literacy in America. National Center for Education Statistics, US Department of Education, Washington, D.C. GPO 065-000-00588-3. To order: (202) 783-3238. Weiss BD, Hart G, McGee DL, and D?Estelle. (1992) Health status of illiterate adults: Relation between literacy and health status among persons with low literacy skills. J Am Board Fam Pract 5, 257-264. Williams MV, Parker RM, Baker DW, Parikh NS, Pitkin K, Coates WC, Nurss JR. (1995) Inadequate functional health literacy among patients at two public hospitals. JAMA, 274(21):1677-82 PATIENT & MATERIALS ASSESSMENT TOOLS Davis TC, Long SW, Jackson RH, et al. (1993) Rapid Estimate of Adults Literacy in Medicine: a shortened screening instrument. Fam Med; 25:391-395. Doak CC, Doak LG, Root JH. (1996) Teaching patients with low literacy skills (2nd edition). J.B. Lippincott Company. Philadelphia. Includes a materials assessment tool, the SAM (Suitability Assessment of Materials) that incorporates readability, graphics, format, cultural orientation. Parker RM, Baker DW, Williams MV, Nurss JR. (1995) The test of functional health literacy in adults (TOFHLA): a new instrument for measuring patients' literacy skills. J Gen Intern Med, 10(10):537-41. Weiss BD, Coyne C. (1997) Communicating with patients who cannot read. New England J Med 337(4), 272-273. ---------------------------------------------------- Skipper J.K, Leonard RC Social interaction and patient care. Philadelphia, Lippincott, 1965. Tagliacozza D, Ima K Knowledge of illness as a predictor of patient behaviour. Journal of Chronic Disease, 1970; 22 pp765-775. Greenfield S, Kaplan S, Ware JE Expanding patient involvement in care: effects on patient outcomes. Annals of Internal Medicine, 1985; 102 pp520-528. Egbert LD, Battit GE, Welch CE et al Reduction of post-operative pain encouragement and instruction to patient. New England Journal of Medicine, 1964, 270 (April 16) pp 825-827 Young JW, The effects of perceived physician competence on patients' symptom disclosure to male and female physicians. Journal of Behavioural Medicine, 1980, 3, pp279-290. 1. Gattuso SM, Litt MD, Fitzgerlad TE. Coping with gastrointestinal endoscopy: Self-efficacy enhancement and coping style. J Consult Clin Psychol 1992;60:133-139. 2. Hartfield MT, Cason CL, Cason GJ. Effects of information about a threatening procedure on patients' expectations and emotional distress. Nursing Research 1982;31. 3. Levy N, Landmann L, Sterner E, Erdreich M, Beny A, Meisels R. Does a detailed explanation prior to gastroscopy reduce the patient's anxiety? Endoscopy 1989;21:263-265. Carey RG, Posavac EJ Using patient information to identify areas for service improvement. Health Care Management Review, 1982, 7; p43-48. ----------------------------------------------------- The Center for Advancement for Health has published selected evidence > for Behavioral Risk Reduction in Clinical Settings in the following > areas: > > Dietary Practices > Diabetes > Depression > Chronic Back Pain > Cardiovascular Disease > Asthma > Alcohol and Other Misuaed Drugs > Smoking > Physical Inactivity > > They have also published a Status Report on Health Behavior Change in > Managed Care. All this material may be dowloaded from their web sit > or hard copies ordered (which make a nicer presentation). > > Their email address is: www.cfah.org > > I have discovered two additional sites: > > www.communityhealth.hrsa.gov > > www.hrsa.gov/stateprofiles > > Health Resources and Services Administration provides a Community > Status Report for every US County! There is also a comparison of > counties to peers - similar size, population composition, and density. > They have also developed state profiles. > > Not only are there demographics but risk factors for premature deaths, > access to care, preventive services use, measures of health (Healthy > People 2010), vulnerable populations, uninsured residents, teen > mothers, environmental health, health status compared to peers, > leading causes of death, and measures of birth and death! ---------------------------------------------------- Pritchard DA et al. J Epidemiol Comm Hlth 1999;53(5), 311-6. Nutritional counselling in general practice: a cost effective analysis. Segal L, et al. Hlth Promotion Int 1998;13(3), 197-209. Cost-effectiveness of the primary prevention of NIDDM. ------------------------------------------------------- > you've probalbly tried bmj.com, they had a recent letter (29 April 2000) > concerning expense of leaflets vs touch screens and have a good and > accessible and free cross referncing to previous issues. i'd be > interested in any references you come across about info/evidence of > health improvement for people with learning difficultes.at present, we > are involved in developing info for home carers on managing complex > health issues eg gastrostomy management at home. ----------------------------------------------------------- Mullen PD; Mains DA; Velez R. A meta-analysis of controlled trials of cardiac patient education. Patient Educ Couns 1992 Apr;19(2):143-62 Dusseldorp E; van Elderen T; Maes S; Meulman J; Kraaij V . A meta-analysis of psychoeduational programs for coronary heart disease patients. Health Psychol. 1999 Sep;18(5):506-19. Linden W; Stossel C; Maurice J. Psychosocial interventions for patients with coronary artery disease: a meta-analysis. Arch Intern Med. 1996 Apr 8;156(7):745-52. Brown SA Meta-analysis of diabetes patient education research: variations in intervention effects across studies. Res Nurs Health 1992 Dec;15(6):409-19 Brown SA. Studies of educational interventions and outcomes in diabetic adults: a meta-analysis revisited. Patient Educ Couns 1990 Dec;16(3):189-215 -------------------------------------------------------------------- My own opinion is that Adam will not find much, if anything, useful, if he is searching for a direct causal link. The reason is education of all kinds can be and has been associated with this or that outcome or measurement,. but the relationship is one of CORRELATION, not CAUSATION. That's because the learning process involves many factors, and many (if not most) of those factors cannot be controlled in a research design. Health or education professionals who "think" as a scientist/researcher and consciously, or unconsciously, search for "proof" based on the scientifc method of hypothesis to conclusion often express frustration at how wishy-washy research in education seems to be. To some extent we are talking philosophy. I conclude that education is not a science, but an art. That is not to say that data that show CORRELATION are not important and useful. -------------------------------------------------- Studies showing improved HEALTH outcomes are few and far between. Most studies that I know of have looked at Knowledge Attitude or Behaviour. There was a monograoph (now ratrher old and can;t remember the title offhand) from YORK on costs and benefits of patient information. There have also been a few reviews in the last five years so including eg Ellis......but I am sure you will have these. Some refs that you may not have in CHD, diabetes are the work by Sarah Mcghee here in Glasgow She did and RCT of shared-care bwhere part of the shared care intervention was a personalised booklet. this has been published in the following. Sarah is now in Hong Kong on SMMCGHEE@hkucc.hku.hk 1.McGhee SM, Symington E, Jones RB, Hedley AJ, McInnes G. Evaluation of a shared-care scheme for hypertension.. In: Roberts J, ed. In Current Perspectives in Health Computing. Weybridge: British Journal Healthcare Computing, 1989;19-21. 2. McGhee SM, Hedley AJ, Jones RB, et al. A computer-based shared-care scheme for hypertension in Glasgow: feasibility and acceptability.. In: Anonymous, ed. Lectures Notes in Medical Informatics.. Berlin: Sprinzer-Verlag, 1990;553-556. 3.McGhee SM, Hedley AJ, Jones RB, et al. A cost-effectiveness analysis : shared-care compared with nurse-practitioner and specialist clinics.. In: Anonymous, ed. First Asia-Pacific Medical Informatics Conference.. Hong Kong: 1991;324-327. 4.Day JL, Rayman G, Hall L, Davies P. 'Learning Diabetes' - a multi-media learning package for patients, carers and professionals to improve chronic disease management. Med Inform 1997; 22:91-104. In diabetes John Day in Ipswich has looked mainly at knowledge (I think). The studies are not RCTs and so offer only weak evidence anyway. 1. Graham AJ, Rayman G, Davies M, Mackie A, Day JL. Evaluation of 'Learning Diabetes' a multimedia education programme. (Abstract) Diabetic Medicine 1999;16 Suppl 1:19 In other patient groups there have been studies looking at KAB, eg wendy graham in aberdeen in Graham W, Smith P, Kamal A, Fitzmaurice A, Smith N, Hamilton N. Randomised controlled trial comparing effectiveness of touch screen system with leaflet for providing women with information on prenatal tests. BMJ 2000; 320:155-160. and my own work in cancer Jones R, Pearson J, McGregor S, Cawsey A, Barrett A, Atkinson JM, Craig N, Gilmour WH, McEwen J. Randomised trial of personalised computer based information for cancer patients. BMJ 1999;319:1241-1247. anxiety (this was the pilot study, the main RCT is still awaiting a publishing result) White J, Jones R, McGarry E. Interactive treatment in primary care: can computers provide 'real' therapy? Clinical Psychology Forum 1999; 131: 18-20. and schizophrenia (ditto) AR Morton, L Patterson, R Jones, JM Atkinson, D Coia. Personalised patient information for patients with schizophrenia living in the community. In Current Perspectives in Healthcare Computing 1998 pp94-104. Published by BJHC Books, Weybridge Surrey. and primary care patient held records Jones RB, McConville J, Mason D, Macpherson, Naven L, McEwen J. Attitudes towards, and utility of, an integrated medical-dental patient-held record in primary care. BJGP 1999; 49:368-373. --------------------------------------------------------------- Decision aids for patients facing health treatment or screening decisions: systematic review Annette M O'Connor, Alaa Rostom, Valerie Fiset, Jacqueline Tetroe, Vikki Entwistle, Hilary Llewellyn-Thomas, Margaret Holmes-Rovner, Michael Barry, and Jean Jones BMJ 1999; 319: 731-734. ------------------------------------------------------------- Greenfield S, Kaplan S, Ware JE. Expanding patient involvement in care. Effects on patient outcomes. Ann Intern Med 1985 102 520-8 Brody DS, Miller SM, Lerman CE Smith DG, Caputo GC. Patient perception of involvement in medical care: relationship to illness and outcomes. J Gen Intern Med 1989;4;506-11 Kaplan SH, Greenfield S, Ware JE Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Med Care 1989; 27 S110-27. --------------------------------------------------------------- there is an excellent seminal early piece of work (in the professional nursing literature) regarding the giving of information (Or not) pre-op and shorter inpatient stays' / quicker recovery from op if info given / heightened awareness it was published by the royal college of nursing around the seventies.... written by jack heywood called 'prescription for pain' principle wuld apply for what you're trying to prove i feel even though it is more general ------------------------------------------------------------ If the interest is in the effect of physician patient agreement, especially with regard to the outcomes of care, here are a few more references: Starfield B et al. The influence of practitioner-patient agreement on outcome of care. Am J PUblic Health 1981; 71:127-32 Starfield B et al. Patient-provider agreement about problems. Influence on outcome of care. JAMA 1979; 242:344-6 Starfield B et al. Presence of observers at patient-practitioner interactions: impact on coordination of care and methodologic implications. Am J Public Health 1979:69:1021-5 Please also check Chapter 9 (Practitioner-Patient Interactions) in my book Starfield, B. Primary Care: Balancing Health Needs, Services, and Technology. Oxford University Press (NY) 1998
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