|
BACKGROUND/RATIONALE:
Low health literacy and physicians poor communication skills are serious barriers to collaborative care and self-management in adults with chronic illness. Models of successful self-management require physicians with excellent communication skills and patients who are active and knowledgeable about their conditions. The proposed pilot study will test the feasibility of two interventions: one focused on improving the ability of veterans with poor health literacy to communicate their questions and concerns about chronic disease self-management to their physician; the other to help physicians with poor communication skills to communicate more effectively with veterans who have poor health literacy. This proposal is aligned with continuing efforts in the VA to increase patients level of involvement in their care and overcome barriers of low health literacy. This is the first study of its kind in the VA to intervene with both members of the physician-patient dyad in an attempt to improve care processes and outcomes related to self-management.
OBJECTIVE(S):
This project has four specific aims:
1.Test the feasibility of assessing and enrolling veterans with poor health literacy and multiple co-morbid conditions, and physicians with poor communication skills to participate in the study;
2.Test the feasibility of a one-on-one consultation between veterans with low health literacy and a health educator focusing on communicating about self-management;
3.Simultaneously, test the feasibility of a physician-based communication enhancement intervention;
4.Use the pilot data to develop an IIR that will test the effectiveness of the interventions in a randomized clinical trial.
METHODS:
This is a pre-implementation study of two separate interventions that have been shown to be effective but have not been studied in combination. The study will be conducted in the primary care clinics of the Richard L. Roudebush VA Medical Center. The participants are five physicians with poor communication skills and 15 patients with chronic disease who have low health literacy. Study methods include health literacy screening, video-taping of patient-physician interaction before and after the interventions, follow-up interviews regarding the barriers and facilitators of the interventions, and analysis of Time 1 and Time 2 differences in veterans assertiveness and physicians encouragement of communication about self-management.
FINDINGS/RESULTS:
None at this time.
IMPACT:
The proposed study directly addresses a stated need to enhance self-management skills of veterans with chronic diseases in general, and those with poor health literacy skills, in particular. It will test the feasibility of a pair of interventions designed to reduce barriers caused by patients poor health literacy and physicians poor communication skills. The results from this pilot study will lead to the development of a 3 arm randomized controlled trial (physician intervention only, patient intervention only, and both interventions together) to improve self-management through facilitated communication.
PUBLICATIONS:
None at this time.
DRA:
Health Services and Systems
DRE:
Communication and Decision Making
Keywords:
Communication -- doctor-patient
MeSH Terms:
Communication
|
