PRP052: Improving eHealth literacy of patients with complex care needs: a mixed methods research protocol [work-in-progress]

Pierre Pluye, MD, PhD; Reem El Sherif, MBChB, MSc; Quan Nha Hong; Fabio Balli; Vera Granikov; Jiamin Dai; Roland Grad, MD, CCFP, FCFP; Virginie Paquet, MISt

Abstract

CONTEXT: Community-dwelling patients with complex care needs (hereafter ‘the patients’) usually combine chronic illness, polypharmacy, low socioeconomic status (SES), and difficulties in care coordination and communication with health professionals. They seek, evaluate and use information to choose optimal care. However, the patients with low eHealth literacy often have difficulty finding trustworthy information that is easy to read, listen to or watch. Improving eHealth literacy can: increase participation in self-care and health; decrease medical problems, reduce social inequalities, and limit the use and cost of services. OBJECTIVES: (i) To describe the acceptability, ease of use, and drawbacks of a literacy intervention; (ii) to explain their benefits and improve them; and (iii) to test the feasibility of a randomized controlled trial (RCT). DESIGN: Mixed methods study (sequential explanatory design) - Pilot approved by the McGill IRB. INTERVENTION: Innovative ‘Online Health Information Aid’ website (OHIA) and video aimed to enhance patients’ ability to find, evaluate and use online health information (three principles of eHealth literacy). PHASE 1 QUANTITATIVE. FEASIBILITY STUDY (STEPPED WEDGE): Estimated values of parameters to design an RCT will be explored: 100 low SES patients will be randomly assigned to four groups who will receive the intervention in turn. Pre- and post-intervention data will be collected, and descriptive statistics calculated. PHASE 2 QUALITATIVE. MULTIPLE CASE STUDY: The patients’ experience with the intervention will be described with a purposeful sample of 30 participants from phase-one. Cases will be participants’ recent searches for online health information and will be identified using ‘journey mapping’ and ‘critical incident’ techniques. For each case, data will be collected from interviews, observations and documents. Thematic analysis: The participants' experience will be described in terms of acceptability, ease of use, benefits and potential harms; mechanisms of action and suggestions for improvement. Qualitative Comparative Analysis: Cases will be compared, and patterns of conditions explaining benefits identified. INTEGRATION: Quantitative and qualitative results will be integrated into a joint-display table to provide recommendations for improving the intervention and planning an RCT. RESULTS: Pilot results will be reported at the conference.
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Judy Belle Brown
jbbrown@uwo.ca 11/20/2021

Pierre et al., - a very cool study and can't wait until next year for more information!! Come celebrate NAPCRG turning 50!!

Pierre Pluye
11/22/2021

Thank you very much, sure we will:)

Diane Harper
harperdi@med.umich.edu 11/21/2021

VERY nice to see the collaborations between the informaticists and the docs! It is very hard for patients to navigate the portal when they do not feel there is a human they can call on for support. Thank you for sharing with us at NAPCRG.

Pierre Pluye
11/22/2021

Great comment. We did not have resources to provide human help via phone. Participants nevertheless loved the video, and found it easy-to-understand and useful. We'll try to recruit more participants in the next phase.

Viv Ramsden
viv.ramsden@usask.ca 11/22/2021

Pierre et al. Very interesting study. Do you think that this study might benefit from having a Patient/Community Advisory Committee? I just know from the study that I did on health literacy what I thought would be the outcome was the exact opposite of that which was desired by the community members who were not so different from your sample/population. I look forward to learning about the results/findings when they become available. Hope all is well in your world.

Pierre Pluye
11/22/2021

Absolutely yes. Thanks. The current phase is an application with patient partners representing the targeted population. They love the project, and I am and the team eager to learn from them. Merci!

Amalia Issa
amalia.issa2@mcgill.ca 11/22/2021

Interesting and important study! Very nice work from an excellent team! I'm looking forward to seeing how this develops further. 

Pierre Pluye
11/22/2021

Thank you very much Amalia, very appreciated.

Jack Westfall
jwestfall@aafp.org 11/22/2021

Terrific project. Great poster and abstract. Thanks for sharing at NAPCRG. looking forward to learning more at NAPCRG 2022!

Pierre Pluye
11/22/2021

Thank you, we'll do!

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