Appl Clin Inform 2019; 10(04): 643-654
DOI: 10.1055/s-0039-1693713
Special Topic: Visual Analytics in Healthcare
Georg Thieme Verlag KG Stuttgart · New York

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

Adriana Arcia
1  Columbia University School of Nursing, New York, New York, United States
,
Maureen George
1  Columbia University School of Nursing, New York, New York, United States
,
Maichou Lor
1  Columbia University School of Nursing, New York, New York, United States
,
Sabrina Mangal
1  Columbia University School of Nursing, New York, New York, United States
,
Jean-Marie Bruzzese
1  Columbia University School of Nursing, New York, New York, United States
› Author Affiliations
Funding This work was supported by an intramural grant from Columbia University School of Nursing. Dr. Lor and Ms. Mangal were supported by T32 NR007969 Reducing Health Disparities through Informatics (RHeaDI).
Further Information

Publication History

15 April 2019

17 June 2019

Publication Date:
04 September 2019 (online)

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.

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects, and was reviewed by the Columbia University Medical Center Institutional Review Board.