Implementation of an Educational iPad Application for Patients With Chronic Hepatitis B

Abstract

Chronic Hepatitis B (CHB) contributes to a high public health burden in Australia from chronic liver disease and hepatocellular carcinoma. Health literacy impacts on multiple aspects of long term management, including surveillance and long term follow up. We designed and implemented a multilingual educational iPad application for outpatients to use while in the clinic waiting room. The application employed an interactive and multimodal approach to education. It utilized graphics, audio and text to convey practical information regarding transmission of disease, long term complications, treatment and surveillance. Participants were recruited from a tertiary liver clinic and assigned to either standard treatment (routine clinical consult only) or the iPad group (clinical consult and additional education with the iPad app). There were 54 participants (control n = 29, iPad n = 25). Knowledge was assessed at baseline, secondly after the clinician appointment and finally at 6 months. Median follow up time was 6.1 months (range 0-18 months) and 87% of participants completed the final survey. At baseline, there was no difference in age, gender, proportion of newly referred patients, or use of antivirals. Baseline knowledge was similar in the two groups (61.4 vs. 55.1%, p = 0.33). The iPad group scored significantly higher after the first consult (79.5 vs. 61.5%, p = 0.0005). This improvement remained significant by the end of follow up (72.6 vs. 61.0%, p = 0.0472). To conclude, interactive education with iPads may be an effective way to improve patient knowledge.

Do health service waiting areas contribute to the health literacy of consumers? A scoping review

“…Many different types and modes of delivering interventions have been trialled in waiting areas. The most frequent type was audio-visual health information delivered via a television monitor or tablet ( n = 19) ( Eubelen et al , 2011 ; Merck et al , 2012 ; Tingey et al , 2013 , 2014 ; Snead et al , 2014 ; Hellmers et al , 2016 ; Shah et al , 2016 ; Pereira et al , 2017 ; Alnasser et al , 2018 ; Berkhout et al , 2018b ; Dineley et al , 2018 ; McIntyre et al , 2018 , 2020a , b , 2021 ; Neumann et al , 2018 ; Ha et al , 2019 ; Lavaerts, 2019 ; McNab and Skapetis, 2019 ; Vangu et al , 2019 ; Aydin et al , 2021 ; Highland et al , 2021 ; Perera et al , 2021 ). The second type was interactive platforms (i.e.…”

“…Health screening topics covered were cancer screening, intimate partner violence and genetic testing ( Houry et al , 2010 , 2011 ; Arora et al , 2013 ; Kripalani et al , 2019 ). Health conditions or treatments addressed included diabetes, stroke, cardiovascular disease, sexually transmitted infections, cancer and antibiotic use ( Chan et al , 2010 , 2015 ; Kharsany et al , 2010 ; Kuhrik et al , 2010 ; Price et al , 2010 ; Khan et al , 2011 ; Yacoub and Mehta, 2011 ; Reid et al , 2013 ; Hughes et al , 2015 ; Giannitsioti et al , 2016 ; Hellmers et al , 2016 ; Asthana et al , 2018 ; McIntyre et al , 2018 , 2020a , b , 2021 ; Neumann et al , 2018 ; Pineda-del Aguila et al , 2018 ; Ha et al , 2019 ; Ismail et al , 2019 ; Naeem et al , 2019 ; Patino et al , 2019 ; Hendricks et al , 2020 ; Aydin et al , 2021 ; Highland et al , 2021 ; Perera et al , 2021 ). Health services topics included medical imaging and educational programmes ( Merck et al , 2012 ; Tingey et al , 2013 , 2014 ; Ginat and Christoforidis, 2018 ; Dowling et al , 2019 ; Krebs et al , 2019 ; Lavaerts, 2019 ; Vangu et al , 2019 ).…”

“…One study was identified which focussed on health literacy as an outcome of interest ( Khan et al , 2011 ). All other articles measured health literacy-related outcomes: health knowledge ( Chan et al , 2010 , 2015 ; Price et al , 2010 ; Pydah and Howard, 2010 ; Khan et al , 2011 ; Yacoub and Mehta, 2011 ; Braam et al , 2012 ; Merck et al , 2012 ; Schwarz et al , 2013 ; Tannenbaum et al , 2015 ; Giannitsioti et al , 2016 ; Hellmers et al , 2016 ; Shah et al , 2016 ; Shepherd et al , 2016 ; Asthana et al , 2018 ; Dineley et al , 2018 ; Ginat and Christoforidis, 2018 ; Ha et al , 2019 ; Kripalani et al , 2019 ; Lavaerts, 2019 ; McNab and Skapetis, 2019 ; Patino et al , 2019 ; Hendricks et al , 2020 ; Perera et al , 2021 ); intentions ( Arora et al , 2013 ; Bailey et al , 2016 ; Alnasser et al , 2018 ; Dempsey et al , 2019 ); other psychological factors such as beliefs, attitudes or self-efficacy ( Price et al , 2010 ; Khan et al , 2011 ; Snead et al , 2014 ; Bailey et al , 2016 ; Kamimura et al , 2017 ; Dowling et al , 2019 ; Ismail et al , 2019 ; McIntyre et al , 2020a , b , 2021 ; Perera et al , 2021 ); self-reported health behaviours ( Pydah and Howard, 2010 ; …”

“…Interventions were evaluated using: clinical outcome measures ( Kharsany et al , 2010 ; Khan et al , 2011 ; Neumann et al , 2018 ; Pineda-del Aguila et al , 2018 ; Naeem et al , 2019 ); survey, questionnaire or knowledge test ( Chan et al , 2010 , 2015 ; Houry et al , 2010 , 2011 ; Price et al , 2010 ; Pydah and Howard, 2010 ; Khan et al , 2011 ; Leijon et al , 2011 ; Yacoub and Mehta, 2011 ; Braam et al , 2012 ; Merck et al , 2012 ; Arora et al , 2013 ; Reid et al , 2013 ; Schwarz et al , 2013 ; Hughes et al , 2015 ; Tannenbaum et al , 2015 ; Bailey et al , 2016 ; Giannitsioti et al , 2016 ; Hellmers et al , 2016 ; Pawar et al , 2016 ; Shah et al , 2016 ; Shepherd et al , 2016 ; Kamimura et al , 2017 ; Natt et al , 2017 ; Alnasser et al , 2018 ; Asthana et al , 2018 ; Dineley et al , 2018 ; Ginat and Christoforidis, 2018 ; McIntyre et al , 2018 , 2020a , b , 2021 ; Dempsey et al , 2019 ; Dowling et al , 2019 ; Grant et al , 2019 ; Ha et al , 2019 ; Ismail et al , 2019 ; Krebs et al , 2019 ; ...…”

A Dialysis Center Educational Video Intervention Increases Patient Self-Efficacy and Kidney Transplant Evaluations

“…iPads have successfully been used to deliver medical educational interventions including those targeting organ donation registrants, ESKD patients, and Hepatitis B patients. [15][16][17] Content was delivered via a blended approach, involving factual information intermixed with testimonials, an effective method to induce behavioral change. 18 The video was 12 min in length and explained the kidney transplant process from referral to entry onto the waitlist.…”