Tuesday, 14 July 2009
Janet L. Welch, DNS, RN1
Kay Connelly, PhD2
Katie A. Siek, PhD3
Josette Jones, RN, PhD, BC4
Susan M. Perkins, PhD5
Beenish Chaudry, MS6
Janet Kain, MS7
Linda Scott, MS7
Kim Astroth, PhD8
Seongkum Heo, PhD7
Sue McManus, MSN9
Jerry T. Mooney, MA5
Cynthia S. Johnson, MA5
1Department of Adult Health, Indiana University, Indianapolis, IN
2School of Computer Science, Indiana University, Bloomington, IN
3Department of Computer Science, University of Colorado at Boulder, Boulder, CO
4Department of Informatics, Indiana University, Indianapolis, IN
5Division of Biostatistics, Indiana University School of Medicine, Indianapolis, IN
6Department of Computer Science, Indiana University, Bloomington, IN
7School of Nursing, Indiana University, Indianapolis, IN
8Mennonite College of Nursing, Illinois State University, Normal, IL
9Division of Nephrology, Richard L. Roudebush VA Medical Center, Indianapolis, IN
Learning Objective 1: describe how numerical literacy was incorporated in the design of an electronic self-monitoring device.
Learning Objective 2: describe methods used to merge visual literacy skills into the design of an electronic self-monitoring device.
Purpose: Individuals receiving hemodialysis self manage a complex and restrictive diet and fluid regimen. The ability to implement this dietary regimen requires the ability to read food labels, make conversions, and perform calculations. Past reports indicate, however, that a large number of US adults have difficulty reading. Additionally, about one-third of hemodialysis patients cannot perform simple calculations. We have been developing the Dietary Intake Monitoring Application (DIMA), an electronic self-monitoring program, for use on a personal digital assistant (PDA). Early development focused on computer literacy skills, information literacy skills, and the creation of an interface usable by individuals with varying degrees of visual acuity and manual dexterity. The purpose of this report is to describe how we merged numerical literacy skills (ability to calculate and reason numerically) and visual literacy skills (ability to understand graphs) into the final phase of designing the interface.
Methods: We used a participatory design approach with 40 individuals who were receiving out-patient hemodialysis therapy at an urban, inner-city facility. Participants were middle-aged and 85% were African American.
Results: Numerical literacy skills were integrated by the computation of real-time totals. Real-time, 24-hour totals allow individuals to see their intake relative to their dietary prescription for six main categories. Visual literacy skills were considered in design in two major ways. First, a graphical interface was designed to convey intake data over a 24-hour period that could be accurately interpreted by patients. Participants selected the graphical display they found easiest to interpret. Second, labels for the feedback graphs are displayed pictorially using objects easily understood by the patient group.
Conclusion: The interface has been completed and a pilot study is currently in progress to obtain usability, feasibility, and preliminary efficacy information.
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