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Biomedical subjects

V O Leirer

Publications and source records attributed to V O Leirer.

At least 19 recordsLinked to original sources
PubMed2000

Medication schemas and memory for automated telephone messages.

The present study investigated whether older and younger adults use a schema to organize and remember spoken reminder messages for taking medication. Previous research has shown that older and younger adults share preferences for organizing printed instructions for taking medication, suggesting a shared schema. Older and younger participants in Experiment 1 of the present study used a similar schema to organize medication reminder messages. This finding suggests that the medication schema generalizes across communication purpose (to remind or to instruct) as well as across patient age. Medication reminder messages were better understood and remembered when organized to match this schema, whether the reminders were presented as automated telephone messages (Experiment 2) or in printed form (Experiment 3). Schema-compatible organization especially helped people draw inferences from the messages, suggesting that organization helps older and younger adults construct a situation model of the medication-taking task from the messages. Potential applications of organized messages include increasing the impact of automated systems for delivering health services.

Adult↗
PubMed1999

Effects of aging, message repetition, and note-taking on memory for health information.

This study investigated whether repetition improves older adults' memory for health service appointment messages delivered by automated telephone systems. Whereas imposed repetition reduces age differences in memory (Morrow, Leirer, Carver, Tanke, & McNally, 1999), the present study examined the effect of optional repetition. Both older and younger participants in Experiment 1 chose to repeat messages. More repetition, higher cognitive ability (working memory and processing speed), and younger age were associated with better memory for appointment information. The effect of age was eliminated when cognitive ability, but not repetition, was controlled. Thus, older adults used optional repetition in automated systems, but this strategy did not eliminate age differences in memory. In Experiment 2, older as well as younger adults took accurate notes and also repeated messages. Both note-taking and message repetition improved memory for the messages but did not reduce age differences. These findings suggest that older as well as younger adults use presentation strategies in automated messaging systems. Older adults may not take full advantage of these strategies, perhaps because of age-related declines in self-initiated or metacognitive processes.

Adult↗
PubMed1999

Repetition improves older and younger adult memory for automated appointment messages.

Automated telephone messaging systems have dramatically expanded communication about health service appointments, but few studies have directly investigated these messages. The present study investigated whether message repetition (1, 2, or 3 presentations) and listener age (mean age = 71 or 19 years) improved memory for automated appointment messages. Repetition improved older and younger adult memory for appointment information. Moreover, 2 presentations reduced age differences in accuracy of answering questions about the messages. This was not the case for free recall, suggesting that older adults differentially benefited from repetition only when provided with additional retrieval support. These findings show that older as well as younger adults benefit from at least 1 repetition of appointment messages. Actual or potential applications of this research include the use of repetition to improve comprehension of automated telephone messages.

Adult↗
PubMed1998

Icons improve older and younger adults' comprehension of medication information.

We examined whether timeline icons improved older and younger adults' comprehension of medication information. In Experiment 1, comprehension of instructions with the icon (icon/text format) and without the icon (text-only format) was assessed by questions about information that was (a) implicit in the text but depicted explicitly by the icon (total dose in a 24 hour period), (b) stated and depicted in the icon/text condition (medication dose and times), and (c) stated but not depicted by the icon (e.g., side effects). In a separate task, participants also recalled medication instructions (with or without the icon) after a study period. We found that questions about dose and time information were answered more quickly and accurately when the icon was present in the instructions. Notably, icon benefits were greater for information that was implicit rather than stated in the text. This finding suggests that icons can improve older and younger adults' comprehension by reducing the need to draw some inferences. The icon also reduced effective study time (study time per item recalled). In Experiment 2, icon benefits did not occur for a less integrated version of the timeline icon that, like the text, required participants to integrate dose and time information in order to identify the total daily dose. The integrated version of the icon again improved comprehension, as in Experiment 1, as well as drawing inferences from memory. These findings show that integrated timeline icons improved comprehension primarily by aiding the integration of dose and time information. These findings are discussed in terms of a situation model approach to comprehension.

Adult↗
PubMed1997

The role of reader age and focus of attention in creating situation models from narratives.

We examined adult age differences in the mental representation of situations and how readers update this representation during narrative comprehension. Older and younger adults memorized a building layout and then read narratives about a protagonist's actions in this building. The narratives contained critical sentences that described the protagonist moving from one room (the "source room") into another (the "goal room"), through an unmentioned path room. Each critical sentence was followed by a target sentence referring to an object in one of these rooms. Half of the target sentences explicitly mentioned the room containing this object and half did not. Reading time increased when the target object was more distant from the protagonist and when the room containing the object was not mentioned, suggesting that readers tracked the protagonist's location in the layout and allocated resources in order to maintain coherence in the situation model. Older adults' reading times differentially slowed with distance, and older readers who more accurately understood the narrative differentially slowed when the location of the target object was not mentioned. Finally, the more accurate readers (older and younger) slowed primarily when updating was most difficult (i.e., both when the room containing the object was not mentioned and for more distant objects). While these findings reveal qualitative similarity in how older and younger readers update spatially organized situation models, they also suggest that older readers must sometimes allocate more resources to this updating process in order to maintain comprehension.

Adult↗
PubMed1996

Using icons to convey medication schedule information.

We examined older adult comprehension and memory for medication schedules conveyed by different types of visual icons as well as text. Three icons were compared: a timeline, a pair of 12 h clocks (one for AM and one for PM hours) and a 24 h clock. In Experiment 1, older and younger participants paraphrased and then recalled schedules that were conveyed by the three icons or by text. Text and timeline schedules were paraphrased more accurately than either clock icon. Paraphrase errors suggested that subjects had trouble integrating schedule information across the two 12 h clocks. Analysis of paraphrase times showed that the text schedule was paraphrased most quickly, followed by the timeline, the 24 h clock and the 12 h clock. No differences were found for the accuracy of recalling the icon and text schedules. Experiment 2 examined free and cued recall after limited study time by older adults. Because text superiority in Experiment 1 may have reflected greater familiarity with text than with icons, recall was examined across four trials in Experiment 2. Text was recalled most accurately, followed by the timeline, the 24 h clock and the 12 h clock. Study-test trials did not influence recall. Text schedules may have been generally more effective than the icons because of their greater familiarity. The timeline may have been the most effective icon because it was more compact and familiar than the clock icons used in the study. The findings suggest that including such icons in medication instructions requires training.

Journal Article↗
PubMed1996

Medication instruction design: younger and older adult schemas for taking medication.

We examined whether older and younger adults share a schema for taking medication and whether instructions are better recalled when they are organized to match this schema. Experiment 1 examined age difference in schema organization. Participants sorted medication items (e.g., purpose, dose, possible side effects) according to similarity and then ordered the items to create a preferred instruction set. Cluster analysis of the sort and order data showed that younger and older adults share a schema for taking medication. Secondary regression analyses found that verbal ability (i.e., vocabulary scores) predicted individual differences in schema organization. In Experiment 2 participants recalled instructions that were either compatible with this schema in terms of grouping and order of items or were presented in nonpreferred orders. Younger participants remembered more information than did older participants, but both age groups better remembered and preferred the more schema-compatible instructions. Secondary analyses showed that recall was also positively related to verbal ability. Along with our earlier research, this study suggests that older and younger adults possess a schema for taking medication and that instructions that are compatible with this schema provide an environmental support that improves memory for medication information.

Adult↗
PubMed1994

Automated telephone reminders in tuberculosis care.

This study assessed the impact of automated telephone reminders in a population of 2,008 patients scheduled for appointments in a public health tuberculosis clinic. Overall, remainders increased appointment attendance from 52% to 62%. Reminders were more effective for some applications than others, but the effectiveness of reminders did not differ significantly across patient age, sex, or ethnicity. Counter to theoretical predictions, neither attribution of the reminder message to an authority nor a statement stressing the importance of the appointment significantly increased the effectiveness of the reminder above the level obtained without these enhancements.

Adolescent↗
PubMed1992

Aging, expertise, and narrative processing.

In a study of how aviation expertise influences age differences in narrative processing, young and older pilots and nonpilots read and recalled aviation and general narratives. They chose referents for sentences referring to a protagonist or minor character mentioned 1 sentence (recent character) or 3 sentences (distant character) before this target sentence. All groups chose referents less accurately for sentences about distant and minor characters than about recent and protagonist characters, perhaps because these referents were less likely to be in working memory. Young readers and pilots were more accurate for distant and minor character target sentences in aviation narratives, and recalled aviation narratives more accurately. Expertise did not reduce age differences. Expertise differences may reflect decreased demands on working memory capacity, and age declines may reflect reduced capacity.

Adult↗
PubMed1992

Automated telephone reminders for improving ambulatory care services.

In conclusion, automated telephone reminders offer a single inexpensive approach to many different problems associated with ambulatory care. Depending on the exact application, their effectiveness is equal to or better than other more expensive and time-consuming approaches for reducing costs and improving the quality of patient care. In some cases, such as medication reminders, it may be the only feasible approach to effective care.

Ambulatory Care Information Systems↗
PubMed1991

Elders' nonadherence: its assessment and medication reminding by voice mail.

This study investigates four questions related to the problem of medication nonadherence among elders. First, does memory failure play a significant role in nonadherence? Second, can memory-related nonadherence be predicted by simple tests of cognitive performance? Third, can the new portable bar code scanner technology be used to unobtrusively monitor nonadherence? Most importantly, can inexpensive telephone voice mail technology be used to improve medication adherence? The results show that: elders have substantial levels of forgetting; nonadherence decreases with higher cognitive test scores; portable bar code scanners are useful for monitoring adherence; and voice mail reduces tardiness and complete forgetting.

Aged↗
PubMed1991

Marijuana carry-over effects on aircraft pilot performance.

This study finds evidence for 24-h carry-over effects of a moderate social dose of marijuana on a piloting task. In separate sessions, nine currently active pilots smoked one cigarette containing 20 mg of delta 9 THC and one Placebo cigarette. Using an aircraft simulator, pilots flew just before smoking, and 0.25, 4, 8, 24, and 48 h after smoking. Marijuana impaired performance at 0.25, 4, 8, and 24 h after smoking. While seven of the nine pilots showed some degree of impairment at 24 h after smoking, only one reported any awareness of the drug's effects. The results support our preliminary study and suggest that very complex human/machine performance can be impaired as long as 24 h after smoking a moderate social dose of marijuana, and that the user may be unaware of the drug's influence.

Adult↗
PubMed1990

Memory skills elders want to improve.

While many research studies have investigated memory training for elders, none have asked which specific memory skills elders would like to improve. This study investigates two related questions. First, which memory skills elders would like to improve? Second, is there a common set of these memory skills? Elders completed a three-part questionnaire. First, it asked for subject demographics. Second, it asked for the first, second, third, and then all other memory skills they would most like to improve. Finally, it asked elders to rate the importance of 10 specific memory skills. The results indicate that elders share a common set of memory skills they wish to improve. They are: (a) people's names, (b) important dates, (c) location of household objects, (d) recent and past events, (e) meetings and appointments, (f) information and facts, (g) general improvement, and (h) medication. One conclusion from these findings is that at least some memory training research should focus on these specific memory skills.

Aged↗
PubMed1989

Increasing influenza vaccination adherence through voice mail.

The number of influenza and influenza-related deaths is alarmingly high, yet mean vaccination adherence rates among the high-risk elderly population remain at only 20%. The present study investigates the use of an inexpensive voice-mail system, TeleMinder, as a method of increasing influenza vaccination adherence among a subpopulation of elders identified as low adherers. The first group of older people received no intervention. Group 2 received a voice-mail message informing them of the cost, time, date, and location of an influenza vaccination clinic. Group 3 was exposed to posted and verbal announcements alone. Group 4 both received voice mail and was exposed to posted and verbal announcements. Vaccination adherence levels for groups 1 through 4 were 1.5%, 11.8%, 7.4%, and 37.5%, respectively. Voice mail significantly increased vaccination adherence either alone or in combination with posted and verbal announcements. These findings suggest that voice mail provides an inexpensive means of increasing influenza vaccination rates.

Aged↗
PubMed1989

Marijuana, aging, and task difficulty effects on pilot performance.

This study provides evidence that diverse factors can cumulatively contribute to human/machine performance decrements. In separate sessions, young and old pilots smoked one of three cigarettes containing either 0 mg, 10 mg, or 20 mg of the active ingredient, delta 9 THC. They flew a calm and a turbulent flight in a light aircraft simulator at 1, 4, 8, 24, and 48 hour (h) delay after smoking. Effects were found at 1 and 4 h after smoking in the turbulent flight conditions when 20 mg cigarettes were smoked. Drug dose level, age, weather conditions (i.e., task difficulty), and delay period all affected pilot performance. Most important, these variables produced cumulative performance decrements.

Adult↗
PubMed1988

Elders' nonadherence, its assessment, and computer assisted instruction for medication recall training.

This study investigates three questions related to the problem of medication nonadherence among elders. First, does recall failure play a significant role in nonadherence? Recent research suggests that it may not. Second, can the new portable bar code scanner technology be used to study nonadherence? Other forms of monitoring are obtrusive or inaccurate. Finally, can inexpensive computer assisted instructions (CAI) be used to teach mnemonic techniques specifically designed to improve medication schedule recall? Current research on memory training teaches nonspecific mnemonics and uses the expensive classroom approach. Results of the present study suggest that physically active and cognitively alert elders do have significant nonadherence (control group = 32.0%) problems related to forgetting and that CAI courseware can significantly reduce (medication recall training group = 10.0%) this form of nonadherence. Portable bar code technology proved easy to use by elderly patients and provided detailed information about the type of forgetting underlying nonadherence. Most significant recall failure was in the complete forgetting to take medication rather than delays in medicating or overmedicating.

Aged↗
PubMed1986

Hangover effects on aircraft pilots 14 hours after alcohol ingestion: a preliminary report.

Using a repeated measures counterbalanced design, the authors had 10 Navy P3-C Orion pilots fly two carefully designed simulated flights under control (no hangover) and hangover conditions. For the control condition, pilots drank no alcohol within 48 hours before the simulated flight. For the hangover condition, they flew 14 hours after drinking enough ethanol mixed with diet soft drinks to attain a blood alcohol concentration of 100 mg/dl. Pilot performance was worse in the hangover condition on virtually all measures but significantly worse on three of six variance measures and one of six performance measures. The results indicate that caution should be exercised when piloting an aircraft 14 hours or less after ingesting similar quantities of alcohol.

Adult↗