Communicating Risk Information Using Technology
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Indiana University School of Medicine
Indianapolis
Diabetes and Cardiovascular Disease Risk Factors
Primary Care Clinics
Spanish-speaking Latinos |
PROJECT
Patients received an individualized multimedia presentation on cardiovascular disease risk factors.
Patients with type 2 diabetes view an individually tailored multimedia presentation designed for a low-literacy, Spanish-speaking audience. The presentation informs patients about their own cardiovascular disease risk and facilitates dialogue between patients and providers regarding possible strategies to reduce cardiovascular disease risk. Patients view the initial presentation, consisting of six segments and lasting approximately 12-13 minutes, on a tablet computer, in the waiting room prior to their office visit. The initial presentation includes information about the patient’s 10-year risk of death or heart attack. It also presents their most recent HbA1c, blood pressure, cholesterol and smoking status information, compared to targets.
Additional segments of the initial presentation include illustrations and descriptions of a heart attack, a testimonial from a recovering heart attack patient, a review of options for reducing risk, and a brief coaching session. Presentations at subsequent visits address specific cardiovascular disease risk factors.
RATIONALE
Though cardiovascular disease is the leading cause of death in Latino patients with type 2 diabetes, risk factors for the disease are under-treated. This intervention provides an efficient means of communicating individualized health risk information to patients in an environment where health care providers often lack the time to properly inform patients themselves, or have difficulty communicating across a language barrier.
Additionally, the tablet multimedia presentation uses graphics and testimonials to make the health information messages more accessible to patients with low health literacy, and has been tailored to reflect Spanish-speaking Latino cultural beliefs and norms. More effectively communicating these risk factors, and the behaviors necessary to address them has the potential to improve medication adherence, clinical outcomes, patient and physician satisfaction, and health-related quality of life.
EVALUATION PLAN
Funded by Finding Answers in 2008.
Physicians are being randomized in a controlled trial of the intervention versus usual care. Intervention physicians are presenting the multimedia presentation to patients with type 2 diabetes who smoke or have at least one out-ofrange
cardiovascular disease risk factor. Researchers are evaluating the effect of the intervention on therapeutic intensification in the treatment of cardiovascular disease risk factors and on additional clinical outcomes including HbA1c, blood pressure and lipid levels. Researchers are also investigating behavioral factors such as smoking status and medication adherence as well as patients’ health-related quality of life. Finally, the study is assessing pre- and post-intervention patient and physician satisfaction.
Principal Investigators:
- Paris Roach, MD
- David G. Marrero, PhD
For More Information
Please contact:
Paris Roach, MD
paroach@iupui.edu
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