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PubMedDate not supplied

Expert and consumer evaluation of patient medication leaflets provided in U.S. pharmacies.

OBJECTIVE: Evaluate the distribution and quality of patient medication leaflets provided in U.S. pharmacies. DESIGN: Observational. SETTING: United States. PARTICIPANTS: 384 randomly selected community pharmacies in 44 states. INTERVENTIONS: Professional shoppers (acting as patients) presented four new prescriptions to study pharmacies. MAIN OUTCOME MEASURES: Medication leaflets obtained by shoppers were evaluated by expert and consumer raters using criteria specified in federal law mandating distribution of useful written information to 95% of individuals receiving new prescriptions by 2006. RESULTS: Leaflets were provided by pharmacies with 89% of 1,536 prescriptions presented by professional shoppers posing as patients. Leaflet quality varied: 95% of leaflets received high ratings on accuracy, but only 19% received high ratings on the specificity of directions. Fewer than 10% of all leaflets met quality criteria regarding contraindications, precautions, and how to avoid harm. One fourth of all leaflets had poor print size, according to the shoppers. CONCLUSION: Additional efforts are needed to meet federally mandated information distribution and quality goals by 2006.

Atenolol↗
PubMed2002

Readability of printed patient information for epileptic patients.

BACKGROUND: Written information can be a valuable tool in patient education. Studies evaluating written information for various disease states have frequently demonstrated that the majority of literature is written at a readability level that exceeds that of the average patient, and it has been recommended that written communications for adult patients should be provided at a fifth-grade level or lower. OBJECTIVE: To assess the readability of printed patient information available to patients with epilepsy. METHODS: Samples of written patient information (n = 101) were obtained from various sources. The information was classified based on source, content, and intended audience, and readability was assessed using the Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL) score. RESULTS: The mean FRES and FKGL score for all samples were 50.2 and 9.4, respectively. Significant differences were observed in both the FRES and FKGL score of material obtained from different sources; however, no differences were observed when material was analyzed according to content. The mean FRES and FKGL score for materials intended for adults were 49.6 and 9.5, respectively. In comparison, mean FRES and FKGL scores for materials intended for children/adolescents were 78.9 and 5.3, respectively. CONCLUSIONS: The majority of information tested was written at a level that exceeds the reading ability of many patients. The information intended for children is actually written at the appropriate level for an adult. Efforts should be taken to develop written teaching tools that target low-level readers, especially for a disease state that affects many children.

Anticonvulsants↗
PubMed2005

Can safer-sex promotion leaflets change cognitive antecedents of condom use? An experimental evaluation.

An experimental evaluation of a safer sex promotion leaflet was undertaken to assess its capacity to change antecedent cognitions of condom use. The leaflet was identified in a previous study as addressing research-based cognitive antecedents of condom use. A pre-post-test experimental study including three conditions was conducted: (a) presentation of the leaflet; (b) presentation of the leaflet plus incentive for systematic processing; (c) no-leaflet control. The leaflet was evaluated in terms of its capacity to change eight cognitive correlates of condom use identified in a recent meta-analysis. The sample consisted of 230 tenth-grade students. Following baseline assessments, leaflet-induced change was measured immediately following the intervention and at a follow up 4 weeks post-intervention. The target leaflet alone did not result in significant changes in the cognitive antecedents of condom use compared with the control condition. However, in combination with an incentive for systematic processing, the target leaflet had a greater impact on cognitive antecedents than the no-leaflet control condition. The findings are discussed with regard to the development and evaluation of research-based health-promotion materials.

Adolescent↗
PubMed2005

Randomized controlled trial of a brief research-based intervention promoting fruit and vegetable consumption.

OBJECTIVE: The present study sought to test the efficacy of a brief research-based, leaflet-like intervention to promote eating the recommended daily intake of fruit and vegetables (RDIFV). DESIGN: A controlled, pre- post-test experimental study with random allocation and a 1 week self-report behavioural follow-up was conducted. METHOD: The intervention employed persuasive communication targeting self-efficacy and intention, and invited participants to form implementation intentions in relation to acquiring and preparing fruit and vegetables for consumption. RESULTS: Intervention participants had stronger post-intervention intentions to consume the RDIFV, and higher anticipated regret in relation to failing to do so, compared with controls, controlling for pre-intervention scores. At follow-up, the intervention group was found to have eaten more fruit and vegetables and to have consumed the RDIFV more frequently. DISCUSSION: It is concluded that this study supports the previously reported power of implementation intentions to prompt enactment of intentions, and that a brief research-based leaflet-like intervention could result in immediate enhancement of intentions and anticipated regret, and promote greater fruit and vegetable consumption.

Adolescent↗
PubMed2006

Does changing the order of threat and efficacy information influence the persuasiveness of threat messages?

OBJECTIVES: The aim of this study is to investigate the impact of changing the conventional threat-before-efficacy order of threat messages on the persuasiveness of a leaflet informing women smokers of the link between smoking and cervical cancer. DESIGN: The study used a between-groups design in which women smokers were sequentially allocated to one of three groups. Two groups received one of two leaflets aimed at providing information about the link between smoking and cervical cancer: one provided threat-before-efficacy information; the other provided efficacy-before-threat information. The third group received no leaflet. METHODS: Participants (N=178) were recruited by a commercial survey organization. Purposeful sampling was used to ensure that women with a wide range of ages and educational qualifications were included. Outcomes were intention to stop smoking, recall of information, and threat and efficacy perceptions. RESULTS: Although women in the 'efficacy-before-threat' group recalled more efficacy information, and those in the 'threat-before-efficacy' group recalled more threat information, the leaflets were similarly persuasive. Compared with women not given a leaflet, those given either of the two leaflets had greater intentions to stop smoking and higher threat and efficacy perceptions. CONCLUSIONS: Informing women of the link between smoking and cervical cancer increases their intentions to stop smoking. Changing the order of threat and efficacy information does not influence the persuasiveness of this message. Order effects may be more likely in experimental contexts using weaker messages or those that are not novel.

Adult↗
PubMed2006

A randomized controlled trial of smoking cessation for pregnant women to test the effect of a transtheoretical model-based intervention on movement in stage and interaction with baseline stage.

OBJECTIVES: To examine whether, as predicted by the transtheoretical model (TTM), stage-matched interventions will be more effective than stage-mismatched interventions. DESIGN: Randomized controlled trial of smoking cessation advice to pregnant smokers. METHODS: Pregnant women currently smoking at 12 weeks gestation were enrolled in a pragmatic three-arm trial of TTM-based interventions to help them stop smoking. One arm constituted standard midwifery advice and a self-help leaflet on stopping smoking, which is generally appropriate for women in preparation. Two arms were TTM-based. Differences in positive movement in stage towards quitting from enrolment to 30 weeks gestation and 10 days post-partum were calculated for each arm of the trial. We then examined whether, as predicted from the TTM, the relative benefit of the TTM-based intervention was greater for women in precontemplation and contemplation, for whom the control intervention was stage-mismatched, than for women in preparation, for whom the control intervention was stage-matched. RESULTS: Women in the TTM-based arms were statistically significantly more likely to move forward in stage than were women in the control arm. Contrary to the TTM-derived hypothesis, the greater relative benefit of the TTM-based intervention was seen for women in preparation stage at baseline, rather than women in precontemplation and contemplation. CONCLUSIONS: The TTM-based intervention was more effective in stage movement, but this could be due to its greater intensity. The failure to confirm that stage-matching was important casts doubt on the validity of the TTM in explaining smoking cessation behaviour in pregnancy.

Adolescent↗
PubMedDate not supplied

Increasing the impact of health plan report cards by addressing consumers' concerns.

Most plan report cards that compare the performance of health plans have framed the decision about plan choice as an opportunity to get better-quality care. This study uses a controlled experimental design to examine the effect of reframing the health plan choice decision to one that emphasizes protecting oneself from possible risk. The findings show that framing the health plan decision using a risk message has a consistent and significant positive impact on how consumers comprehend, value, and weight comparative performance information.

Attitude to Health↗
PubMed2000

New developments in smoking cessation.

Research on smoking has increased in the past several years, and many new therapeutic modalities have been developed. Primary intervention for smoking cessation begins with systematic identification of smokers and a formal diagnosis of nicotine dependence. Providing self-help brochures without clinical advice has marginal efficacy, but these can be useful as an adjunct to clinician intervention. Several large studies have shown that physician advice alone can lead to quit rates of up to 10%, and follow-up for patients trying to quit can double cessation rates. Behavioral therapy alone has demonstrated cessation rates of approximately 20% for those willing to participate. Drug therapy remains the most attractive method of smoking cessation for many patients. The standard approach has been nicotine substitution using one of the four forms of nicotine replacement (gum, patches, nasal spray, inhaler) currently available. The efficacy of nicotine replacement products is similar, with each agent providing a doubling of the cessation rate. Thus, the choice of agent depends on patient factors and preference. Bupropion is the first nonnicotine-containing agent approved for smoking cessation, with cessation rates ranging from 10.5 to 24.4%, depending on dose. One-year follow-up suggests a continued benefit with this agent. The combination of bupropion and transdermal nicotine has also been shown to be effective for smoking cessation in clinical trials. Effective approaches to smoking cessation should combine identification of smokers, provision of advice at each visit, and widespread availability of treatment.

Administration, Cutaneous↗
PubMed1975

Instructions for patients--a positive factor in removable partial denture service.

Studies have shown that improper wearing and care of removable partial dentures may adversely affect abutment teeth and associated periodontal tissues. A comprehensive removable partial denture service should include not only accurate construction of the prosthesis, but also printed instructions for the patient. Printed instructions help to inform the patient that delivery of removably partial dentures is only a part of our health service designed to maintain good oral health. A text of such concise printed information and instructions for the patient is presented.

Denture, Partial, Removable↗
PubMed2000

Readability of published dental educational materials.

BACKGROUND: A growing number of adult Americans are functionally illiterate. These people often do not understand educational documents written by health care professionals, especially if English is the reader's second language. This problem has received little attention in dentistry. METHODS: In this study, the author selected a sampling of 24 patient educational documents from several dental resources and reviewed them for readability, using a computer-based program that assigns a reading level of understanding on the basis of a standard formula known as the Flesch-Kincaid Formula. The author also conducted a subjective review of each document to identify seemingly unnecessary professional jargon and words that were unlikely to be understood by many readers. RESULTS: Reading levels varied from third to 23rd grade (according to the Flesch-Kincaid Formula), and 41.7 percent of the materials were written at greater than the recommended level for understanding by most patients (mean level: seventh to ninth grade). Many dental specialty publications were written at or near college levels. Many documents had multiple grammatical errors. Seventy-nine words in the reviewed documents were considered to be jargon or potentially obscure to many lay readers. CONCLUSIONS: More attention needs to be focused on the preparation of written educational materials for dental patients, to make the documents more understandable to the average patient. Guidelines for acceptable writing are available in the medical, nursing and pharmaceutical literature.

Adult↗