Transcript THE H.E.L.P. PROJECT

THE H.E.L.P. PROJECT
The Health Education and Literacy for Parents
ROR AND HEALTH LITERACY

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ROR proved to have
positive impact on
families
Any intervention
aimed at improving
language & literacy
development in
children should also
address parental
literacy skills
Health Education & Literacy for
Parents (HELP) Project
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Based on ROR Model
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Parent educators and trained volunteers approach
parents in clinic waiting area
Provide short term educational interventions, which
include several “activities”
Gives Parents
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Strategies to improve family & child’s health, growth
& development
“Plain language” handouts with illustrations that
support these strategies
A sense that they are “learners” –they can learn new
things with supportive help
H.E.L.P. Goals
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Improve parents’ ability to read &
understand health care instructions
Instruct parents to use written materials
to focus on child’s overall health
Help parents better communicate with
Pediatrician
Motivate parents to continue their own
education
Waiting Area Health Literacy
Intervention
Learn more about you child’s medicine activity
Understanding and “Decoding” Your Child’s Prescription
“What do you use
to give your child
liquid medicine?”
Medication Instruction Sheet (MIS)
Medication Log
(Self-Monitoring)
Questions to Ask Pediatrician/Pharmacist
Medical Diaries to Record Medications
of
e
Collaborative Resources
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New York Poison
Control Center

Literacy Assistance
Center Hotline
Quality Improvement Project
(QIP)
Evaluation of H.E.L.P. Intervention
Sheets
Aim of QIP Evaluation
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To measure the
effectiveness of
these forms:
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Does knowledge of
medication usage
improve?
Does adherence
increase ?
Is there improvement
in child’s clinical
status?
QIP Evaluation Design
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Ongoing
Convenience sample in Pediatric Clinic and
Pediatric Dental Clinic
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Baseline and Intervention Groups
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Background and Follow-up Questionnaires
Enrollment & Eligibility
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Pediatrician notifies evaluator when
patient receives liquid antibiotic
prescription
Parents are invited to participate in the
evaluation if they meet the following
criteria:
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Child (patient) under 12 years of age
Able to speak English or Spanish
Have access to a telephone at home
Procedures
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Baseline Group (n=50)
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Intervention Group (n=42)
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Standard practice
Pediatrician or Pediatric Dentist provide intervention:
Medication Sheets and Dosing Instrument
Both groups:
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Measure dosing accuracy, administer background
questionnaire
Follow-up questionnaire administered over the
telephone four to seven days later
Outcome Measures
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Dosing Accuracy
Medication Knowledge
Medication Adherence
Satisfaction with Intervention Procedures
Patient Clinical Outcome
Demographics
Baseline Intervention
(n=50)
(n=42)
84 %
90 %
78 %
72 %
91 %
90 %
81 %
67 %
Mean (SD) age of patient, yrs
3.92 (2.8)
3.55 (2.7)
Mean (SD) # Children in Home
2.35 (1.1)
2.67 (1.5)
Respondent:
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Relation: Mother
Caregiver: non-US born
Background: Hispanic/Latino
Language: Spanish
DOSING ACCURACY
Observed to measure correct dose
during demonstration
88%
% measuring correct
dose to 0.2 mL
100%
75%
49%
50%
25%
0%
Baseline
Intervention
Observed to measure correct dose
using oral syringe and dosing cup
88%
% measuring correct
dose to 0.2 mL
100%
75%
62%
50%
25%
0%
Syringe/Dosing Cup
Baseline
Syringe/Dosing Cup
Intervention
% measuring correct dose
to 0.2 mL
Observed to measure the correct
dose at baseline: kitchen spoons
verses oral syringe and dosing cup
100%
62%
75%
50%
28%
25%
0%
Kitchen spoons
Syringe and Dosing Cup
FOLLOW UP CALL:
MEDICATION KNOWLEDGE
Medication Knowledge
Baseline Intervention
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Named Prescribed Medication
84%
95%
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Knew Proper Preparation
90%
100%
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Knew Proper Medication Storage
92%
98%
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Knew Reason for Medication
92%
100%
FOLLOW UP CALL:
MEDICATION ADHERENCE
Adherence: Tracking System
Baseline Intervention
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Kept track medicine given
62 %
93 %
Correct 24 hr. dose freq.
Gave medication at correct time
Not missing doses prior day
90 %
90 %
86 %
100 %
100 %
100 %
Adherence: Use of Intervention
Materials
91% used Medicine
Instruction Sheet
94% used Medication
Log Sheet
FOLLOW UP CALL:
SATISFACTION WITH
INTERVENTION
Satisfaction: Did the Medicine
Instruction and Log Sheets Help?
% helped by intervention
sheets to use medicine
correctly
100%
92%
83%
75%
50%
25%
0%
Medicine
Instruction
Sheet
Medication
Log
Sheet
What Helped Most On
Instruction Sheet?
Pictures
11%
8%
Spanish
instructions
Simple
instructions
16%
65%
Other
Which Pictures Helped the
Most?
Dosing
pictograms
25%
Shake well
14%
42%
19%
All
Other
FOLLOW UP:
PATIENT CLINICAL OUTCOME
SUMMARY
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Results will be used to:
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Develop the intervention for other
medications
Expand intervention to other clinics at
Bellevue Hospital
Train medical and nursing staff to use
intervention
Medication Information and Log Sheets
 Dosing instrument given with each prescription
 Parent education in proper use of oral syringe
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H.E.L.P Project Contact Information
Linda van Schaick
(212) 562-3165
E-mail: [email protected]