Abstract
BackgroundThe debilitating effects of recurrent stroke among aging patients have urged researchers to explore medication adherence among these patients. Video narratives built upon Health Belief Model (HBM) constructs have displayed potential impact on medication adherence, adding an advantage to patient education efforts. However, its effect on medication understanding and use self-efficacy have not been tested.ObjectiveThe researchers believed that culturally sensitive video narratives, which catered to a specific niche, would reveal a personalized impact on medication adherence. Therefore, this study aimed to develop and validate video narratives for this purpose.MethodsThis study adapted the Delphi method to develop a consensus on the video scripts’ contents based on learning outcomes and HBM constructs. The panel of experts comprised 8 members representing professional stroke disease experts and experienced poststroke patients in Malaysia. The Delphi method involved 3 rounds of discussions. Once the consensus among members was achieved, the researchers drafted the initial scripts in English, which were then back translated to the Malay language. A total of 10 bilingual patients, within the study’s inclusion criteria, screened the scripts for comprehension. Subsequently, a neurologist and poststroke patient narrated the scripts in both languages as they were filmed, to add to the realism of the narratives. Then, the video narratives underwent a few cycles of editing after some feedback on video engagement by the bilingual patients. Few statistical analyses were applied to confirm the validity and reliability of the video narratives.ResultsInitially, the researchers proposed 8 learning outcomes and 9 questions based on HBM constructs for the video scripts’ content. However, following Delphi rounds 1 to 3, a few statements were omitted and rephrased. The Kendall coefficient of concordance, W, was about 0.7 (P<.001) for both learning outcomes and questions which indicated good agreement between members. Each statement’s Cronbach alpha was above .8 with SD values within a range below 1.5 that confirmed satisfactory content and construct validity. Approximately 75% (6/8) of members agreed that all chosen statements were relevant and suitable for video script content development. Similarly, more than 80% (8/10) of patients scored video engagement above average, intraclass correlation coefficient was above 0.7, whereas its Kendall W was about 0.7 with significance (P<.001), which indicated average agreement that the video narratives perceived realism.ConclusionsThe Delphi method was proven to be helpful in conducting discussions systematically and providing precise content for the development of video narratives, whereas the Video Engagement Scale was an appropriate measurement of video realism and emotions, which the researchers believed could positively impact medication understanding and use self-efficacy among patients with stroke. A feasibility and acceptability study in an actual stroke care center is needed.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12618000174280; https://www.anzctr.org.au /Trial/Registration/TrialReview.aspx?id=373554&isReview=true
Highlights
BackgroundMedication nonadherence is prevalent at large especially in major chronic diseases, despite patient education and advanced knowledge and methods [1]
The Delphi method was proven to be helpful in conducting discussions systematically and providing precise content for the development of video narratives, whereas the Video Engagement Scale was an appropriate measurement of video http://aging.jmir.org/2019/1/e11539/
This study hypothesized that providing video narratives incorporated with theoretical behavioral constructs adjunct to the existing medication therapy adherence clinic (MTAC)’s patient education effort, informational brochures, counseling, and medication review would result in better stroke awareness, medication understanding, and use self-efficacy toward improved adherence
Summary
Medication nonadherence is prevalent at large especially in major chronic diseases, despite patient education and advanced knowledge and methods [1]. Insufficient patient education intervention reported the effects of video education in patients with chronic medical conditions such as stroke. It is unknown if personal stories related to stroke medication management can enhance self-efficacy and promote adherence to stroke preventative medication or control stroke risk factors. The debilitating effects of recurrent stroke among aging patients have urged researchers to explore medication adherence among these patients. Video narratives built upon Health Belief Model (HBM) constructs have displayed potential impact on medication adherence, adding an advantage to patient education efforts. Its effect on medication understanding and use self-efficacy have not been tested
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