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Zwi S, Isautier J, Webster AC, Lambert K, Shepherd HL, McCaffery KJ, Sud K, Saunders J, O'Lone E, Liu N, Kim J, Robbins A, Muscat DM. A feasibility study of a best practice health literacy app for Australian adults with chronic kidney disease. PEC INNOVATION 2022; 1:100047. [PMID: 37213763 PMCID: PMC10194182 DOI: 10.1016/j.pecinn.2022.100047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/14/2022] [Accepted: 05/02/2022] [Indexed: 05/23/2023]
Abstract
Objective To investigate feasibility of the SUCCESS app; a cross-platform e-health innovation to improve health literacy, self-management and shared decision-making among culturally-diverse Australian haemodialysis patients. Methods Multi-site, pre-post, mixed-methods study. Haemodialysis patients ≥18 years used the app for 12 weeks. Qualitative data from 18 interviews were thematically analysed to evaluate app acceptability. Quantitative analysis using paired sampled t-tests evaluated feasibility outcomes pertaining to recruitment, retention, data collection and app efficacy (including health literacy; decision self-efficacy; quality of life; behaviour; knowledge; confidence). Results We successfully recruited diverse participants (N = 116; 45% born overseas; 40% low/moderate health literacy) from four Local Health Districts in Sydney, Australia. However, only 61 participants completed follow-up questionnaires. Qualitative analyses provided insights into acceptability and user engagement. Quantitative analyses showed significant improvements on the health literacy domain 'Ability to actively engage with healthcare providers' (Mean Difference [MD] = 0.2 on a 5-point scale; CI95%: 0.0-0.4; p = 0.03) and decision self-efficacy (MD = 4.3 on a 10-point scale; CI95%: 0.6-7.9; p = 0.02) after 12 weeks app use. Conclusions The SUCCESS app was feasible and acceptable to participants. The app will be adapted to facilitate ongoing use and engagement among diverse haemodialysis patients. Innovation This is the first health literacy-informed app to promote active participation in haemodialysis self-management and decision-making, tailored toward culturally-diverse and low health literacy groups.
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Affiliation(s)
- Stephanie Zwi
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Jennifer Isautier
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Angela C. Webster
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, NSW, Australia
- Westmead Applied Research Centre, Westmead Hospital, Westmead, NSW, Australia
| | - Kelly Lambert
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia
| | | | - Kirsten J. McCaffery
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Kamal Sud
- Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Department of Renal Medicine, Nepean Hospital, Nepean Blue Mountains Local Health District, NSW, Australia
| | - John Saunders
- Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, Local Health District, NSW, Australia
| | - Emma O'Lone
- Department of Renal Medicine, Royal North Shore Hospital, Northern Sydney Local Health District, NSW, Australia
| | - Na Liu
- School of Computer Science, Faculty of Engineering, The University of Sydney, NSW, Australia
| | - Jinman Kim
- School of Computer Science, Faculty of Engineering, The University of Sydney, NSW, Australia
- Telehealth and Technology Centre, Nepean Hospital, Nepean Blue Mountains Local Health District, NSW, Australia
| | | | - Danielle Marie Muscat
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Corresponding author at: Room 127A, Edward Ford Building (A27), The University of Sydney, 2006 New South Wales, Australia.
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