No abstract

Due to a higher prevalence estimates of risk factors, it is assumed that socially disadvantaged persons have a considerable need for health-related information and prevention. Yet this target group is hardly ever reached. There is a need to examine whether available health-related information is appropriate for the needs of socially disadvantaged people. On behalf of the Institute for Quality and Efficiency in Health Care (IQWiG) a qualitative study was conducted to evaluate published health-related information by socially disadvantaged people. Semi-structured interviews were carried out with 28 persons with low income, low occupational status and a very low education level. 7 different types of health information (4 texts and 1 film, quiz and flyer each) were evaluated regarding their suitability. The interviews were audio-taped, transcribed according to protocol, and qualitatively analysed in view of the central questions. Respondents evaluate the film format most positively, because of the vividness of the contents. In text-based information, a clear structure of the text and the use of case examples are particularly advantageous. All respondents accept the credibility of the given information. Problems occur regarding the comprehensibility and sentence structures with complex information. Numerous technical terms and foreign words remain misunderstood, even though explanations are given in the text. Compact contents and the description of several alternative therapy options are experienced as overstraining. Furthermore, the recognition of hazard potentials is hindered by misinterpretation of percentages or negated descriptions of frequencies. Some respondents doubt that they would read text-based health information voluntarily in their everyday life, especially when texts are lengthy. The respondents wish clear guidance, which relieves them of an active informed decision-making. They prefer advice they can apply in their everyday life and to recognise their personal affliction in the information. It becomes apparent that the health-related information published by the IQWiG only partly meets the needs of socially disadvantaged people. But a mere simplification of the content seems insufficient. Instead a more detailed consideration of the personal circumstances of the target group and a better communication of practical information are needed.

Background Asthma education programs (AEPs) have been shown to increase quality of life and reduce emergency treatments and hospital admissions. Despite the proven benefits, only a minority of asthma patients attend such programs. To increase the number of educated patients, an online education program (electronic AEP, eAEP) for asthma patients has been developed. The present study aims to investigate the effectiveness of the eAEP in terms of asthma knowledge, asthma control and emergency treatments in general practice settings. Methods This is a cluster randomized controlled trial including 100 patients with bronchial asthma from 20 general practices in Bavaria, Germany. General practices will be randomly assigned to either the intervention or control group. Patients in the intervention group will receive access to the eAEP and instructions to complete this program within two weeks. Patients in the control group will receive usual care including a referral to face-to-face AEP (fAEP) by a certified primary care physician or a pulmonologist according to guideline recommendations. Furthermore, patients of both the intervention and control groups will be invited to a follow-up consultation in their general practice after completion of the eAEP and fAEP (three weeks and twelve weeks after study inclusion, respectively) to discuss any open issues. Outcomes for both groups will be assessed at baseline (t0), after two weeks (t1), three months (t2) and six months (t3). The primary outcome is the comparison of asthma knowledge gain between intervention and control groups after completion of the eAEP (two weeks after study inclusion) and fAEP (twelve weeks after study inclusion), respectively. Secondary outcomes include asthma control, frequency of emergency treatments, patient autonomy as well as attitudes towards asthma medication. Discussion The results of the present trial will provide knowledge about the effectiveness of an online education program for asthma patients compared to usual care in primary care. Trial registration German Clinical Trials Register (DRKS), DRKS00028805. Registered 22 April 2022.