June 11, 2007
To: Seleda Perryman, HHS
FR: Sandra W. Hilfiker, ODPHP
RE: Request for Clearance of Individual Study re: OMB No. 0990-0281, Prevention Communication Formative Research, Submission #7
The Office of Disease Prevention and Health Promotion (ODPHP) seeks to create training to help senior citizens with low literacy and low health literacy find and assess health information online. Several federal agencies have launched websites specifically addressing web-based health information to help older Americans stay healthy and make better health decisions. However, unless older adults possess the ability to use computers effectively (computer literacy), access and use health information online (e-health literacy), and critically evaluate media messages (media literacy) they may lack some of the necessary skills to seek health information online. According to Bernhardt and Cameron (2003), “Abilities in … media literacy and computer literacy represent the cognitive aspects of health literacy that are necessary for people to access, process, understand, and critically analyze health information and instructions.” A 2006 report from the DHHS Office of Disease Prevention and Health Promotion on Expanding the Reach and Impact of Consumer E-Health Tools mentions that a “broad and inclusive vision of consumer e-health is needed to ensure equitable access and appropriate [health] content for all” and recommends that consumers acquire the skills to select, assess and use e-health tools for themselves and their loved ones.
This training is designed to address the need for improved computer literacy, e-health literacy and media literacy skills in United States adult populations ages 65 and over, who are less likely to be able to use the Web for health information than younger age groups. The training session consists of three 30-minute modules within a two-hour training and testing session that reviews web navigation and introduces website quality and media literacy concepts specifically addressed to the use of federal health-related websites. In order to design an eventual online tutorial, this training information must be tested for its ability to foster confidence in computer usage for acquiring Internet e-health skills, and engage participants with the training content. The purpose of the proposed research is to measure these properties with a low literacy/low health literacy audience and derive actionable recommendations to inform and shape the online version of the training.
The information collected will be used to:
Provide an opportunity for potential users to interact with and provide feedback on e-health training materials used to navigate federal online health information posted on existing HHS websites.
Determine the degree of confidence older adults feel in using and evaluating e-health materials currently available from Federal government agencies, before and after the training.
Provide an empirical and customer-centered basis on which to make recommendations for the development of effective interactive e-health literacy training tools for older adults.
Serve as a platform to assess the extent to which ODPHP can collaborate with other senior-related agencies to connect older audiences with health-related government web sites and thereby improve health outcomes and health decision-making.
The respondents will consist of 24 older adults aged 65 years and older, to reflect the age range of low health literacy populations who are less likely to use online government resources for health information. A diverse group of participants will be recruited, with emphasis on low literacy and low health literacy. All participants will be recruited in Montgomery County, MD, Philadelphia, PA or the Newark, Delaware region. Each participant will take part in a small group training session using web-based health content located on federal agency websites. All participants will be asked pre-test and post-test questions about their confidence in using health information online. Participants are volunteers and will be remunerated at $10/participant.
Research participants will be screened and recruited by ODPHP staff in collaboration with senior center personnel.
Participants will be recruited and screened. The three groups of 8 respondents each will be invited to come to a community senior center location and spend two hours engaged in computer training activities and pre- and post-tests. They will fill out a consent form and a demographic questionnaire, and respond to two sets of questions regarding e-health literacy before and after participating in the training. All forms will be administered using printed materials. Participants will be asked to give consent to having their session audiotaped. The consent form will also display the OMB Clearance number, expiration date, and burden disclosure statement.
The protocol for the training will be based on computer literacy, ehealth literacy and media literacy principles. Participants will be administered a brief explanation, followed by a series of tasks to perform using each Web site. Typical examples of tasks include:
Using federal Web sites to locate information on elder fall prevention.
Finding a tip or strategy to start exercising or keep track of exercise.
Finding information that will help decide if immunizations are needed.
Finding information about a specific health topic of interest.
Printing a list of questions to discuss with a healthcare professional.
As they complete the tasks, participants will be encouraged to ask questions to help them understand navigation and quality of Web-based health information. Their comments will be captured on audiotape for qualitative analysis. Quantitative analysis of pre- and post-test surveys will also be analyzed to examine:
How participants report using online health information before the training.
Whether they report intention to use online health information after the training.
Response to the three types of literacy training
Based on the experience of community senior center staff, a small remuneration of $10 is sufficient because respondents will derive training or informational benefits from this research study. The participants are likely to already have established experiences in basic computer skill development at senior centers, and will be motivated by a desire to learn more about health information options available to them online.
This proposed study attempts to answer the following five research questions:
RQ1: Which factors allow senior citizens to gain confidence in finding health information online?
RQ 2: Which factors help senior citizens evaluate the quality of health information online?
RQ 3: Which types of training activities help low literacy older adults use online health information to ask questions or make health decisions?
RQ4: Does the training produce a change in seniors’ confidence around using the Internet to search for and interact with health information? If so, in what ways?
RQ5: Is the adapted eHEALS instrument an effective measure for gauging seniors’ confidence in using the Internet for health information needs?
ODPHP seeks clearance for 24 respondents to ensure that enough data is gathered to be able to form preliminary actionable conclusions for adjusting the training curriculum to meet future research needs.
The protocol is designed to take two hours per participant. Thus, the estimated number of hours anticipated for 24 research participants is about 48 hours.
The cumulative number of hours used under OMB No. 0990-0281 is 1096 hours.
Screener is included with the study instruments.
The questionnaires will be pre-tested to assure that all items are comprehensible to participants.
References
Bernhardt, J.M. and Cameron, K.A. (2003). Accessing, understanding, and applying health communication messages: The challenge of health literacy. In Thompson, T.L., Dorsey, A.M., Miller, K.I. and Parrott, R. (Eds.), Handbook of Health Communication, (pp. 583-605). Mahwah, NJ: Lawrence Erlbaum.
Baur, C. and Kanaan, S.B. (2006). Expanding The Reach And Impact Of Consumer E-Health Tools. Washington, D.C.: U.S. Department of Health and Human Services.
| File Type | application/msword |
| File Title | June 11, 2007 |
| Author | Authorized User |
| Last Modified By | Authorized User |
| File Modified | 2007-06-15 |
| File Created | 2007-06-15 |