NEW ORLEANS — Spanish-language users of a bilingual interactive computer program in an urgent care clinic reaped the most educational benefit from the system, a study has shown.
The findings suggest that computerized educational modules may be an important tool to help reduce health care disparities among medically underserved populations, Bonnie Leeman-Castillo said in a presen-tation at the annual meeting of the Society of General Internal Medicine.
During a 4-month period, 296 adults seeking care for acute respiratory tract infections at an urgent care facility in Denver were referred to a free-standing computer that housed an audiovisual education module that provided information in both English and Spanish. The module prompted the patients to provide information about demographics, knowledge and attitudes about antibiotics and acute respiratory infections, reasons for seeking care for their illness, and a symptom inventory.
“The computer then suggested a likely diagnosis based on the patients' symptoms and provided information about how to best treat the illness,” said Ms. Leeman-Castillo, a Ph.D. candidate in the Health and Behavioral Science Program at the University of Colorado at Denver.
After using the program, patients were asked to rate their experience with it in terms of complexity, understanding, and perceived usefulness. The main outcome measures, she said, “were whether the patient learned something new about colds and flu and whether they trusted the computer information.”
With respect to demographics, 81% of the users were aged 18–44, 59% were female, 54% were Hispanic, 50% had household incomes of less than $10,000, and 16% completed the Spanish-language version of the module.
Patients who answered questions in Spanish were significantly less likely to report prior computer experience and more likely to require help using the system. In terms of ease of use and understanding the computer messages, the differences between those who responded in English and Spanish were small but significant. About 84% of the English-speaking respondents, compared with 71% of those who responded in Spanish, rated the program as easy to use, and 87% of those who answered in English said they understood the information, compared with 81% of the Spanish-speaking group.
After adjustment for patient demographics and computer module qualities, Spanish-language users were significantly more likely to report learning something new from the program and trusting the information, Ms. Leeman-Castillo said.
“Interestingly, we found that prior computer experience was a strong negative predictor of learning something new and trusting the information,” suggesting that populations with the least exposure to and experience with interactive computer media may get the most out of such health learning tools, she said.
In general, the interactive module seemed to be well received by patients and effective at disseminating important health information, particularly to populations that may not otherwise be getting important public health information about such things as antibiotic overuse, she noted. However, “our finding that prior computer experience was associated with less learning and trust deserves further exploration,” she concluded.
Ms. Leeman-Castillo stated that she had no financial interests or other relationship with the manufacturers of the commercial products or suppliers of the commercial services relative to the health-information module.