Adapting Enhanced Recovery Programs for Low Health Literacy Patients
University of Alabama at Birmingham
Summary
Low health literacy patients are a vulnerable population at high-risk for surgical disparities including longer hospital stays, more complications, and more readmissions. This study will adapt enhanced recovery programs (ERPs) to low health literacy patients with a multilevel, health literacy-based implementation strategy (called VISACT - VISuAl aids, Coach providers in communication, and Train organizations in health literacy) to improve ERP fidelity and thereby outcomes. In the final aim of this project (Specific Aim 3), the VISACT intervention will be tested in a pilot trial. Findings from this study will lay the foundation for a multi-institutional stepped-wedge trial and establish key principles for adapting interventions to eliminate disparities.
Description
Rationale: Low health literacy affects over a third of surgical populations and is associated with significantly worse outcomes in surgery. Interventions that reduce disparities in this large population are urgently needed. Previous work has shown that enhanced recovery programs (ERPs) mitigate racial disparities in surgical outcomes and offer a pragmatic way to address surgical disparities. Existing ERPs, however, work poorly for patients with low health literacy who still experience worse outcomes. This gap arises from the lack of fit between current ERPs and the needs of low health literacy…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * Adult patients \>= 18 years of age undergoing surgery under an enhanced recovery program (ERPs) * Adult caregivers/providers, organizational leaders, \>= 18 years of age with direct or indirect involvement with ERP implementation * All genders * All race/ethnicities * Able to consent * English-speaking Exclusion Criteria: * Child (\<18 years of age) * Patients undergoing operations not included under ERPs * Participants unable to consent for the study * Participants whose mental state excludes them from being able to understand contents of the informed consent form and…
Interventions
- OtherEducational intervention (VISACT)
The intervention is an implementation strategy called VISACT: VISuAl aids, Coach providers in communication, and Train organizations in health literacy. This strategy will be delivered to patients, providers, and organizations through a novel interactive response platform.
Location
- University of Alabama at BirminghamBirmingham, Alabama