Elizabeth A. Hahn|Hong Du|Sofia F. Garcia|Seung W. Choi|Jin Shei Lai|David Victorson|David Cella
Literacy-Fair Measurement of Health-Related Quality of Life Will Facilitate Comparative Effectiveness Research in Spanish-Speaking Cancer Outpatients
Northwestern University|NorthShore University HealthSystem|Northwestern University|Northwestern University|Northwestern University|Northwestern University|Northwestern University
background healthrelated quality life hrql assessment frequently used comparative effectiveness research lowliteracy patients often excluded appropriately translated userfriendly hrql measures essential ensure inclusion lowliterate nonenglishspeaking patients comparative effectiveness research objectives compare hrql responses across literacy levels spanishspeaking patients cancer using multimedia touch screen program subjects total 414 adult patients cancer 213 low literacy 201 high literacy research design touch screen system administered 3 questionnaires functional assessment cancer therapygeneral short form36 health survey standard gamble utility questionnaire measurement bias evaluated using item response theory effects literacy hrql evaluated using regression models results patients rated touch screen easy use commented favorably multimedia approach statistically significant item response theory measurement bias 6 10 hrql subscales however 3 showed meaningful bias lowliteracy patients significantly lower mean scores 3 4 functional assessment cancer therapygeneral subscales adjustment patient characteristics lowliteracy patients also significantly lower mean scores 5 6 short form36 subscales adjustment patient characteristics attenuated eliminated differences similar proportions low highliteracy patients valued current health equivalent perfect health conclusions study demonstrates feasibility multimedia touch screen program lowliteracy patients program provide opportunities evaluate effectiveness interventions diverse patient populations