Design and Comprehension Testing of Tailored Asthma Control Infographics for Adults with Persistent Asthma

Abstract

Background Adherence to daily inhaled corticosteroid medication is important for asthma control but low health literacy is a barrier to comprehension of control status and may contribute to medication nonadherence. Infographics tailored with patients' own data can support comprehension of health status, but these have not been applied to asthma successfully. Objectives This two-phased study developed and tested tailored infographics of (1) scores on the Asthma Control Questionnaire (ACQ), a self-report measure of symptom burden, and (2) pulmonary function test (PFT) results. The infographics are intended for use as communication and adherence-promotion tools in clinical interactions. Methods For both phases, participants (18+ years, English- or Spanish-speaking, persistent asthma) were recruited through two primary care clinics. In Phase I, we used a hybrid iterative participatory design process to refine prototype designs. In Phase II, we conducted individual comprehension assessment interviews with the finalized designs. Infographics were hand-tailored for each participant using their ACQ score and PFT results collected at the start of the interview. Two independent raters scored interview transcripts for gist and verbatim comprehension based on a predetermined rubric. Results The five Phase I design sessions led to final prototypes that participants (n = 21) considered appealing and easy to comprehend. All Phase II participants (n = 10) demonstrated complete gist and verbatim comprehension. Participants reacted favorably to receiving their information via infographics and expressed intentions to engage in self-management behaviors (e.g., medication adherence, smoking cessation, weight loss, and review of their care plan) in response to the information. Conclusion This study provides preliminary evidence that infographics can support comprehension of asthma control status and promote self-management intentions among adults with persistent asthma. Infographics can be programmed into electronic health records and/or standalone applications to allow for instant tailoring at the point of care.

Implementing patient-reported outcomes in routine clinical care for diverse and underrepresented patients in the United States

“…Most studies were observational cohort studies with level 4 evidence (n = 21, 75%), followed by level 2 randomized controlled studies (n = 5, 17.9%), and level 6 qualitative studies (n = 2, 7.1%). Sample sizes within studies ranged from 10 [ 36 ] to 6454 [ 37 ]. Primary care was the most common specialty represented (n = 10, 35.7%) [ 11 , 36 , 38 – 45 ], followed by oncology (n = 4, 21.4%) [ 46 – 51 ], of which two studies were specific to breast oncology [ 46 , 47 ] and two studies were specific to urologic/radiation oncology [ 49 , 50 ].…”

“…Sample sizes within studies ranged from 10 [36] to 6454 [37]. Primary care was the most common specialty represented (n = 10, 35.7%) [11,36,[38][39][40][41][42][43][44][45], followed by oncology (n = 4, 21.4%) [46][47][48][49][50][51], of which two studies were specific to breast oncology [46,47] and two studies were specific to urologic/radiation oncology [49,50]. Remaining specialties included rheumatology [52][53][54][55] (n = 4, 14.3%), psychology/psychiatry [56][57][58] (n = 3, 10.7%), and one study each (3.6%) for neurology [37], geriatrics [59], trauma [60], home health care [61], and orthopedic hand surgery [62].…”

Group‐randomized trial of tailored brief shared decision‐making to improve asthma control in urban black adults

“…Clinicians used a tablet and/or laminated card to prompt them through the intervention with a goal of delivering the steps in seven minutes. An infographic visualization of the patient's ACQ score was used to focus attention on uncontrolled asthma (Arcia & George, 2019; Arcia et al., 2019). BREATHE was integrated into a single office visit.…”

Colors and Imagery in Tailored Infographics for Communicating Health Information to Patients and Research Participants

“…For This work is licensed under a Creative Commons Attribution 4.0 International License. Asthma Control Infographics (ACI, Study 3), the target audience was adult African American and Hispanic patients with persistent asthma and the purpose of the research was to develop tailored infographics that could serve as tools for patient-provider communication about medication adherence [1]. Key attributes of the studies and their participants are summarized in Table 1.…”