Education, Research, and Quality Improvement: Education, Research, and Quality Improvement II |

A Preliminary Framework for the Development of a Health Literacy Measurement Tool for Asthma and COPD FREE TO VIEW

Darrin Wiebe, MD; J FitzGerald, MD; Jessica Shum, BA; Selva Bayat, BA; Brenda Kwan, MS; Iraj Poureslami, PhD
Author and Funding Information

Health Literacy and Chronic Respiratory Disease Management Group, Vancouver, BC, Canada

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):633A. doi:10.1016/j.chest.2016.08.725
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SESSION TITLE: Education, Research, and Quality Improvement II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: While there is growing recognition of the importance of health literacy (HL) and its effect on health outcomes, functional measurement of HL remains a limitation in the respiratory field. Five domains recommended for inclusion in HL instruments include: access, understanding, communication, evaluation and use of information, are not addressed in current assessment tools. Additionally, current tools do not help clinicians and researchers to identify areas where work is needed to improve HL skills. Our Canada wide network aims to develop and validate a functional HL skills tool that will measure these five domains of HL in patients with asthma and COPD.

METHODS: Given the paucity of literature on HL measurement tools for asthma and COPD that address these functional aspects, our first goal was to determine content which will best allow us to measure disease management skills of patients. We utilized three sources of information to collect perspectives of patients, stakeholders and evidence from the literature aiming to optimize functional health literacy skills given their relevance for asthma and COPD patients. Involving key-stakeholders is a mechanism for public engagement in the research process and one that will contribute to both external validity and implementation of our proposed tool.

RESULTS: At this preliminary stage we have conducted 6 focus groups with 24 asthma patients, 22 COPD patients, 43 interviews with respirologists, general practitioners, respiratory educators, policy-makers, and HL researchers to capture patients’ and professionals’ viewpoints. We have begun a systematic review of published and gray literature to elucidate the scope and deficiencies of existing tools within the context of the aforementioned domains of HL. Preliminary analysis of 10 tools shows mainly the assessment of access and understanding domains. There is a paucity in assessment of communication, evaluation and use. We identified common components of HL skills acknowledged by the three information resources. Access to understandable information, lack of communication with care providers, and comprehension of therapeutic instructions were identified as barriers to management of disease among all information sources. Patient input focused on a “lack of continuity and standardization of care” when moving between providers. Different professionals outlined the importance of encouraging self-efficacy as a method of patient empowerment to adopt the role of “self-navigator”. Policy-makers mentioned that there is a need not to just measure individuals’ abilities and skills but also to “assess what proportion of the health care system actually has HL and cultural competency built into its rules, regulations, and policies”.

CONCLUSIONS: We have generated knowledge from the three resources which will enable us to develop an item pool and the conceptual framework for assessing HL as it pertains directly to functional self-management skills.

CLINICAL IMPLICATIONS: Beyond consideration of medications in an individualized action plan (AP), this novel tool will customize management focusing on functional HL skills. This will provide a unique AP that considers not only medical needs, but the broader context of patient skills, promoting understanding and adherence.

DISCLOSURE: The following authors have nothing to disclose: Darrin Wiebe, J FitzGerald, Jessica Shum, Selva Bayat, Brenda Kwan, Iraj Poureslami

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