Creating an Evidence-Based Education Tool for the Low Literacy Patient

Thursday, 16 July 2009: 10:30 AM

Karen Stonecypher, MSN, RN
Clinical Practice Office, Michael E. DeBakey VA Medical Center, Houston, TX
Pamela Willson, RN, PhD, FNP, BC
Elsevier Review and Testing, Elsevier Publishing, Houston, TX

Learning Objective 1: Develop a patient education tool which will address the Joint Commission requirements for medical information written for the low literacy patient.

Learning Objective 2: Evaluate the evidence-based practice that supports utilizing charts and illustrations to support the readability level of the written text for education of stroke patients.

Purpose: According to the National Assessment of Adult Literacy, 43% of adults are functionally illiterate, with adults 65 years of age and older comprising 59% of this population. The creation of education materials supported by evidence-based research for low-literacy design was the foundation for this project.

Methods: An interdisciplinary team of experts consisting of nursing, social work, therapies (physical, occupational, recreational, and kinesiology), speech pathology, and nutrition collaborated to develop an educational tool for patients who had experienced a stroke and their families. The “Veteran’s Self-Management Guide to Stroke Prevention” defined stroke types, factors related to stroke risks and methods for stroke risk factor reduction, self-management techniques to address healthy behavior changes, and home safety issues. A national celebrity developed illustrations utilized throughout the book that were target audience specific--the military veteran. Collaboration with the National Stroke Association guided the didactic pedagogical content presented. Evidence-based research findings for stroke education from the Joint Commission were incorporated within the information design to support a Stroke Center of Excellence. Both provider and target audience evaluation was undertaken.

Results: Providers addressed the clarity of the message, readability level, font type and size, illustration styles for the charts, and pertinent targeted messaging. Patients (n= 16) and caregivers (n= 14) evaluated the guide using a 9-item Likert scale and open-ended comments. Patients were mostly male (94%), Caucasian (47%) with a mean age of 59 years. Ninety-seven percent of patients and caregivers found the guide to be an “excellent” or “very good” resource. There was no significant difference in responses between patients and caregivers.Conclusion: Initial testing of this low-literacy educational tool suggests that this guide is an appropriate, easy to use stroke self-management guide for veterans and their caregivers in this agency. Veteran specific illustrations enhanced this guide.