Video-based Patient Education Research Articles

The Efficacy of Preoperative Video-Based Opioid Counseling on Postoperative Opioid Consumption After Total Knee Arthroplasty: A Prospective Randomized Controlled Trial

BackgroundThere are myriad strategies to reduce opioid consumption after total knee arthroplasty (TKA). Recent studies have suggested that preoperative counseling may reduce opioid use after a variety of orthopedic procedures. The purpose of this study was to investigate whether preoperative video-based patient education regarding opioid use and abuse reduces opioid consumption after TKA. MethodsIn this prospective randomized controlled trial, patients were randomized before TKA to either receive preoperative video-based counseling or not. Counseling involved a pretaped 5-minute video that educated patients on statistics regarding the “opioid epidemic” and discussed safe use and alternatives to opioids after TKA. There were no significant differences in baseline patient demographics between groups. All patients received a similar multimodal perioperative pain management protocol and completed a daily diary for 2 weeks postoperatively. Diary records measured pain levels using a visual analog score, opioid consumption, side effects experienced, and patient opinion and satisfaction regarding their pain control. ResultsPatients in the counseling group consumed significantly less morphine milligram equivalents on postoperative days 0 to 3 (78.8 versus 106.1, P = .020) and in week one postoperatively (129.9 versus 180.7, P = .028), with a trend of less consumption over 2 weeks postoperatively (186.9 versus 239.1, P = .194). There were no significant differences in the number of patients requiring refills, side effects, or daily pain levels between the 2 groups. ConclusionsThis study found significantly decreased opioid consumption within the first week after TKA in patients who received preoperative video counseling.

A systematic review of nonpharmacological interventions to reduce procedural anxiety among patients undergoing radiation therapy for cancer.

The primary objective was to assess the efficacy of nonpharmacological interventions delivered to adults with cancer, in the radiation oncology department, just prior to, or during radiation therapy, in reducing levels of self-reported procedural anxiety. The secondary objectives were to assess the efficacy of these interventions in reducing physiological symptoms of procedural anxiety and anxiety-related treatment disruptions. Systematic review. Electronic databases (MEDLINE, CINAHL, EMBASE, PsycINFO and Cochrane Central Register of Controlled Trials) were searched from inception up until February 2022. Population: Adult patients with cancer undergoing external beam radiation therapy. Nonpharmacological interventions delivered within the radiation therapy department. Comparison: standard care controls, or standard care plus an alternative intervention. level of self-reported procedural anxiety (primary), physiological symptoms of anxiety (secondary) and measures of anxiety-related treatment disruptions (secondary). Two reviewers independently extracted data. A meta-analysis was originally planned but deemed not feasible as the studies could not be confidently pooled for meta-analysis, due to the variability in the interventions, study designs and the generally low number of studies. Therefore, a narrative synthesis is presented. Screening of 2363 records identified nine studies that met inclusion criteria: six studies of music interventions, two of video-based patient education and one of aromatherapy. Overall, three studies received a global rating of strong methodological quality and low risk of bias. Three studies reported a significant effect of the intervention on reducing the primary outcome of self-reported procedural anxiety: two music interventions (both strong methodological quality), and one video-based patient education (moderate methodological quality). One of the studies (a music intervention) also reported a significant reduction in the secondary outcome of physiological symptoms of procedural anxiety (systolic blood pressure). The evidence for nonpharmacological interventions delivered to adults with cancer just prior to, or during radiation therapy, in reducing levels of self-reported procedural anxiety is limited, with very few well-designed studies. There is a need for interventions for procedural anxiety during radiation therapy to be evaluated through rigorous randomised controlled trials.

INTEGRATING DIVERSE CANCER PERSPECTIVES: FROM DEVELOPMENT TO IMPLEMENTATION

Abstract Cancer among older adults is pervasive, putting excessive strain at the individual, caregivers, and wider society levels. In our symposium, we bring together researchers from varied disciplines—with a focus on easing the strain of cancer on older adults by identifying important gaps in care and developing and implementing innovative methods for improving health services. First, Carrion will discuss the multifactorial experience of fears and beliefs about cancer and cancer prevention in 57 older Latino men. Krok-Schoen will discuss the longitudinal association between religiosity and cognitive functioning among older adults with hematological cancers. Next, Seaman will discuss engaging hard-to-reach patients and those who underutilize the health system. Blackberry will then describe an implementation and impact framework of a five-year research program to improve care in older people with cancer. Lastly, Halpin will discuss the 36-month implementation of a video-based patient education program for patients with multiple myeloma who are preparing for autologous stem cell transplant. Understanding the development and implementation of programs aimed at improving health services among older adults with cancer will help improve understanding potential methods for identifying and addressing health services challenges in these populations.

The effect of a video tutorial to improve patients' keratoconus knowledge - a randomized controlled trial and meta-analysis of published reports.

To investigate whether a video tutorial, highlighting important aspects of keratoconus provided prior to a scheduled follow-up consultation, has a specific effect on patients' knowledge after the consultation. Single center, randomized controlled trial registered on ISRCTN registry (number ISCTN75317089, https://doi.org/10.1186/ISRCTN75317089). Consenting eligible keratoconus patients were randomly assigned to either receive a conventional face-to-face consultation (control group) or to an additional video tutorial (interventional group) on definition, risk factors and treatment options provided prior to the consultation. The main outcome measure was the difference of knowledge assessed by a questionnaire after the consultation. Of each participant, clinical characteristics, highest educational level and medical background were obtained. We also performed a meta-analysis of published reports assessing knowledge improvement by video-based patient education. We assigned 22 patients to the interventional and 21 patients to the control group. Mean age was 29.0 years (SD 11.6), 8/43 (18.6%) were female and median disease duration was 2.5 years (interquartile range: 2-5years). Compared to the control group, knowledge was 12.0% (95%CI: 5.8%-18.2%; p<0.001) higher in the interventional group. Subjects with a university degree scored 6.8% (95%CI: 3.8%-13.3%; p=0.038) higher. There was no interaction between video information and university degree. Other parameters were not associated with patient knowledge. The meta-analysis of 566 subjects enrolled in 6 studies revealed a standardized mean difference in favor of video-based education of 0.47 (95% CI: 0.30-0.64; p<0.004). The results suggest that supplementary video information embedded in the clinical management of keratoconus, helps conveying relevant disease knowledge.

Effects of Video-Based Patient Education and Consultation on Unplanned Health Care Utilization and Early Recovery After Coronary Artery Bypass Surgery (IMPROV-ED): Randomized Controlled Trial.

BackgroundHealth care utilization after coronary artery bypass graft (CABG) surgery is high and is partly of an unplanned nature. eHealth applications have been proposed to reduce care consumption, which involve and assist patients in their recovery. In this way, health care expenses could be reduced and quality of care could be improved.ObjectiveThe aim of this study was to evaluate if an eHealth program can reduce unplanned health care utilization and improve mental and physical health in the first 6 weeks after CABG surgery.MethodsA single-blind randomized controlled trial was performed, in which patients scheduled for nonacute CABG surgery were included from a single center in the Netherlands between February 2020 and October 2021. Participants in the intervention group had, alongside standard care, access to an eHealth program consisting of online education videos and video consultations developed in conjunction with the Dutch Heart Foundation. The control group received standard care. The primary outcome was the volume and costs of a composite of unplanned health care utilization, including emergency department visits, outpatient clinic visits, rehospitalization, patient-initiated telephone consultations, and visits to a general practitioner, measured using the Medical Technology Assessment Medical Consumption Questionnaire. Patient-reported anxiety and recovery were also assessed. Intention-to-treat and “users-only” analyses were used.ResultsDuring the study period, 280 patients were enrolled and randomly allocated at a 1:1 ratio to the intervention or control group. The intention-to-treat analysis consisted of 136 and 135 patients in the intervention and control group, respectively. At 6 weeks, the primary endpoint had occurred in 43 of 136 (31.6%) patients in the intervention group and in 61 of 135 (45.2%) patients in the control group (hazard ratio 0.56, 95% CI 0.34-0.92). Recovery was faster in the intervention group, whereas anxiety was similar between study groups. “Users-only” analysis yielded similar results.ConclusionsAn eHealth strategy comprising educational videos and video consultations can reduce unplanned health care utilization and can aid in faster patient-reported recovery in patients following CABG surgery.Trial RegistrationNetherlands Trial Registry NL8510; https://trialsearch.who.int/Trial2.aspx?TrialID=NL8510International Registered Report Identifier (IRRID)RR2-10.1007/s12471-020-01508-9

The effect of video-based educational program on satisfaction and comfort in patients undergoing transradial coronary angiography: A single-blinded, randomized controlled trial

Cardiac catheterization has been the most widely used diagnostic method, and in most cases, invasive diagnostic methods are associated with stress and concern that can affect the satisfaction and comfort of patients undergoing transradial coronary angiography. In this randomized controlled trial, a total of 89 patients undergoing transradial coronary angiography were recruited using convenience sampling. Then, the patients were assigned to two groups of intervention and control using blocked randomization, as those in the intervention group received video-based patient education and those in the control group received no training. Data were collected using the Persian version of the patient satisfaction questionnaire and the visual analog scale. The variables were measured before, 2, 4, and 8hours after the angiography. The results indicated that, after the intervention, the mean scores of satisfaction and comfort in the intervention group were higher than in the control group (P<.001). Video-based educational strategies should be integrated into the nursing interventions to improve patients' health status.

Developing a visual aid to improve women’s knowledge of hysterectomy

BackgroundFemale reproductive anatomy and physiology, compounded by low health literacy, can result in limited patient understanding of gynecologic procedures, complicating the already challenging patient decision-making process. ObjectiveDescribe a process of developing an effective visual aid that accurately communicates the risks, benefits, and possible outcomes of hysterectomy surgical approaches. Patient InvolvementNone. MethodsThis qualitative study was performed in a private practice and an academic institution with a total of 8 female non-clinical employees in the English-speaking group and 9 non-employees in the Spanish-speaking group. A 5-minute video focusing on the hysterectomy procedure was developed and shown to focus group participants. A discussion led by a sociologist obtained feedback regarding understanding and perceptions of video content to validate the tool, which was analyzed to extract themes that could guide refinements. ResultsFocus group participants wanted more information on post-hysterectomy quality of life and desired a longer video that included more general information about hysterectomies. All participants felt the video would be a valuable aid if watched prior to undergoing a hysterectomy and would be an effective tool for improving patient communication. DiscussionWhile there was strong support for the video-based patient education program, participants found some elements confusing (e.g., type and magnitude of risk, scope of aftercare) and expressed interest in more in-depth information. Our development process would have been enhanced by involving patients before the initial version of the video was created, holding more and more diverse focus groups and ensuring that translation was both accurate and culturally appropriate. Practical ValueThis study offers lessons learned in the process of developing a video-based visual aid for improving women's knowledge of hysterectomy and may inform other efforts to help patients understand complex medical pathology and procedures.

Effect of video-based patient education on pancreatic cancer knowledge and behavior.

11005 Background: Treatment outcomes for pancreatic cancer are optimized when patients/caregivers are engaged, informed and supported participants in their care. However, challenges exist regarding care engagement, disease and treatment related education, and the attainment of adequate psychosocial support. To address these needs, we created video-based patient education activities with the National Pancreas Foundation to empower patients/care with information and resources on pancreatic cancer facts, diagnosis, medical management, and strategies to minimize side effects and maximize quality of life. Methods: One 1-hour patient education activity was broadcast live and online, followed by on-demand release, in 2018-2019 at CancerCoachLive.com and via Facebook Video for 12 months. Features included panel discussions, slides, live polling and Q&amp;A, and video vignettes of real patient experiences. Knowledge-focused test questions were administered at 3 time points (pre-activity, immediate post-activity, and 2-mos [follow-up] post). Behavioral and communication-focused questions were also asked at follow-up. Data from these questions, live poll responses, and learner-submitted questions pre-event and during live Q&amp;A were analyzed to determine engagement, lessons learned and continuing patient needs. Results: In total, 6,276 patients took part in the activity. Patient questions prior to and during the activity focused on basic knowledge about pancreas gland function, tumor development, disease escalation, and medical management. In-session polling results revealed that prognosis and life expectancy were the top concerns for participants. Two months post-education evaluation showed: 33% reported improved communication with their healthcare providers (HCPs) regarding pancreatic cancer; 46% reported improved feelings of being more “in-control” of health care decisions; 25% reported improved care behaviors for their health. Reports of improved HCP communication were specific to: side effect management, clinical trials availability, treatment option knowledge, and confidence related to engaging in discussions. Knowledge improvements were observed for 3 of 4 questions related to facts about the pancreas, pancreatic cancer, and treatment.Conclusions: Patient/caregiver education on pancreatic cancer yields gains in knowledge and behavior, improves patient/caregiver engagement, improves treatment decision-making, and maximizes quality of life.

Re: A Novel Video-Based Patient Education Program to Reduce Penile Prosthetic Surgery Cancellations.

Re: A Novel Video-Based Patient Education Program to Reduce Penile Prosthetic Surgery Cancellations.

A Novel Video-Based Patient Education Program to Reduce Penile Prosthetic Surgery Cancellations.

Penile prosthetic surgery is an effective treatment for men with erectile dysfunction. Cancellation of surgery is disruptive and costly to patients, physicians, and the healthcare system. This pilot study sought to analyze surgery cancellations and implement a video-based patient education program to decrease surgery noncompletion.Baseline penile prosthetic surgery completion, rescheduling, and cancellation rates among consecutively scheduled surgeries were determined using a national cohort. Selected prosthetic surgeons then implemented Vidscrip, a video-based patient education program. Prerecorded videos were delivered via text message 14 days, 7 days, and 1 day preoperatively, as well as 1 day postoperatively. Subsequent analysis determined noncompletion rates, reasons for noncompletion, surgeon volume, and video utilization.Two-hundred twenty-six surgeries were scheduled in the baseline cohort; 141 were completed, and 85 were rescheduled or canceled. Among the intervention cohort, 290 patients completed, 7 rescheduled, and 37 canceled surgery. After program implementation, the surgery noncompletion rate was reduced compared to baseline (13.2% vs. 37.6%, p < .05), corresponding to a number needed to treat of 4.1. When stratified by surgeon volume, there was no difference in noncompletion rate (>20 cases vs. ≤20 cases: 8.20% vs. 32.0%, p = .35). Video utilization was widely variable among practices (median viewing time 58.6 min, IQR 5.09–113).Penile prosthetic surgery is frequently rescheduled or canceled. Implementing a video-based patient education program reduces surgery noncompletion, improving efficiency and quality of care. Wider implementation is needed to validate these findings, while cost-effectiveness analyses may further support their broad adoption.

Video-based patient education on carcinoid syndrome: Positive knowledge and behavior shift for patients.

e15697 Background: Carcinoid syndrome (CS) negatively affects quality of life (QOL), compromising physical, daily, and emotional functioning. Reticence to discuss symptoms, particularly debilitating diarrhea, perpetuates negative QOL, as does confusion of CS symptoms with other conditions and dietary challenges. To address these needs, we created video-based patient education activities with the Carcinoid Cancer Foundation (CCF) to empower patients with information and resources on CS facts, diagnosis, medical management, eating well and self-care. Methods: Two 1-hour patient education activities were broadcast live online and on-demand in 2017 and 2018 at CancerCoachLive.com , carcinoid.org, and Facebook Live for 6+ months. Features included panel discussions, slides, live polling and Q&amp;A, and video vignettes of real patient experiences. Knowledge-focused test questions were administered at 3 time points (pre-activity, immediate post-activity, and 8-week [follow-up] post). Behavioral and communication-focused questions were also asked at follow up. Data from these questions, live poll responses, and learner-submitted questions pre-event and during live Q&amp;A were analyzed to determine engagement, lessons learned and continuing patient needs. Results: In total, 1,893 patients took part in the activities, and attracted 39,821 Facebook engagements (“views”). Respondents (n = 116-119) reported: 57%, improved communication with their healthcare providers (HCPs) regarding CS; 44%, improved feeling of being “in-control” of health care decision; 31%, improved care behaviors for their health. Improved communication with their HCPs were specific to: their disease and symptoms, treatments, and diet. Changes in behaviors included: dietary changes, more “involved” in care decisions, asking questions of HCPs, and proactively learning about CS. Knowledge improvements were observed on 7 of 8 questions on CS facts, diet, and treatment (5 of 7 statistically significant; average effect size = 1.16; n averaged 382 pre and 96 post). Conclusions: Patient education on CS can yield immediate and sustained gains in knowledge and behavior, which may improve diagnosis, treatment, and improve patient QOL.

Addressing Challenges in Living with AML: Impact of Video-Based Patient Education on Knowledge and Behavior

Background: Delivering high-quality cancer care requires meeting the needs of cancer patients and their families. The Committee on Improving the Quality of Cancer Care has stated that systems should support all patients and families in making informed health care decisions that are consistent with their needs, values, and preferences (http://www.ncbi.nlm.nih.gov/books/NBK202146/). Fundamental to this is the need to foster good communication, developing and disseminating evidence-based information to inform patients, caregivers, and the cancer care team about treatment options. We created a patient education activity to empower patients with information and resources focused on: general facts about AML, testing and results interpretation, treatment options, and resources for self-care and support.Methods: A one-hour online video-based program targeting patients with AML and their caregivers was developed in July 2017 to address the identified audience needs. The program was video-based, and broadcast an interactive panel discussions with a physician specialist in AML, a nurse practitioner specialist in AML, and a patient advocate from the Leukemia & Lymphoma Society. The program integrated educational slides, live polling and Q&A with audience participants, and patient video vignettes that touched on real patient experiences regarding life with AML. Programs were initially broadcast live and were later “chapterized” into 4 smaller segments and made available on-demand at CancerCoachLive.com, LLS.org, and on social media platforms (e.g., LLS and Cancercoach Facebook pages, YouTube) for 6 months. Knowledge-focused test questions were administered at 3 time points (pre-activity, immediate post-activity, and 8-week [follow-up] post), in addition to behavioral and communication-focused questions being asked at the follow up point. Data from these questions, live polling responses, and learner-submitted questions during live Q&A were analyzed to determine engagement, lessons learned and continuing patient-education gaps.Results: In total, 8,935 learners took part in the program (262 on cancercoach platform/8,673 via social media platforms). 69% of respondents reported that communication and collaboration with their healthcare provider(s) improved as a result of participating in the educational program; 27% reported improvements in care for their health. Respondents reported examples of improved communication with their HCPs specific to: their disease, traditional and alternative forms of treatment, and side-effects. Reported changes in behavior and self-care included: being more active, altering self-care behaviors when undergoing chemotherapy, and keeping informed of research and treatments. Learners showed improvements on 4 knowledge questions, including questions pertaining to: 1) Common long-term or late side effects of treatment (45 and 74% relative increases); 2) Factors related to treatment for AML (26 and 33% relative increases); 3) Factors related to testing for AML (5 and 7% relative increases); and the relationship between AML symptoms and low blood count (1 and 3% relative increases). Although this study is limited to patient and caregiver self-report, educational evaluation results and participant questions indicate that patients and caregivers benefit from online education on AML.Conclusions: Education on AML specifically catered to patients and their families can yield immediate and sustained gains in knowledge and behavior, which may improve their adherence to treatment, quality of life, and patient outcomes. DisclosuresNo relevant conflicts of interest to declare.

Video-Based Patient Education Improves Patient Attitudes Toward Resident Participation in Outpatient Surgical Care

Decipher if patient attitudes toward resident participation in surgical care can be improved with patient education using a video-based modality. A survey using a 5-pt Likert scale was created, piloted, and distributed in general and colorectal surgery outpatient clinics that had residents involved with patient care at 2 facilities, both with control and intervention groups. The intervention group viewed a short video (∼4 min) explaining the role, education, and responsibilities of medical students, residents, and attending surgeons prior to answering the survey. General and colorectal surgery outpatient clinics at the University of Texas Health San Antonio, Texas. A total of 383 responses were collected, all clinic patients were eligible. The majority of patients (82%) welcomed resident participation in their health care. Eighteen percent of patients did not expect residents to be involved in their care. Patients had favorable views of residents participating during their surgical procedures with 77% responding "agree" or "strongly agree" to a senior resident assisting with a complicated procedure. Patients who viewed the video versus control were less concerned with how much of the procedure the resident would perform (76% vs 86%, p = 0.010). Patients who viewed the video felt less inconvenienced (p = 0.004). The majority of patients are welcoming to resident participation in their surgical care but only 54% were expecting resident involvement at their clinic visit. Early explanation with an educational video of resident roles, education, and responsibilities may help bridge the gap and improve patient experience.

Does YouTube provide high-quality resources for patient education on atrial fibrillation ablation?

ObjectiveCatheter ablation has a role in the treatment of selected patients with atrial fibrillation (AF). Patients are increasingly utilising the internet as an education resource. However, there is limited oversight on online patient information. This study aimed to determine the quality of video-based patient education resources for catheter ablation in AF. MethodsYouTube was searched for “Ablation” and one of “Atrial Fibrillation” or “AFib” or “AF” (a total of three searches). Videos were included if they discussed catheter ablation and excluded if they primarily discussed surgical/hybrid ablation or were non-English language. Each video was scored by two authors for compliance with a gold-standard item set created from patient booklets from the Arrhythmia Alliance. ResultsA total of 6357 videos were identified from all searches. Of these, a total of 111 videos met inclusion criteria and were included in the analysis. The median number of views for each video was 1794.5 (IQR 335 to 10,972) with a median duration of 217 s (IQR 135 to 444 s). The median number of essential criteria found in each video was 4/21 (IQR 3 to 6), and no video met all the essential criteria. Video score was not significantly correlated with video likes or number of views. ConclusionsNo available videos provide sufficiently detailed information for a patient to have a reasonable understanding of catheter ablation. A lack of correlation between views/‘likes’ and video score suggests patients are unable to critically evaluate these resources for educational content.

Video-based education about systemic corticosteroids enhances patient knowledge more than verbal education: A randomized controlled trial

Video-based patient education about long-term systemic corticosteroid treatment has not been assessed. To compare video-based versus verbal education in patient knowledge gained and satisfaction. English-speaking adults (≥18 years) were recruited from March-August 2013 from medical dermatology clinics. Study provider clinics were the unit of randomization. Verbal subjects heard a script based on the standard discussions of two top systemic corticosteroid prescribers at Emory. Video subjects viewed a video developed by the investigators. A 12-item survey created by the the investigators assessed baseline and post-education knowledge (immediate, one-, three-, and six-month). Baseline knowledge scores averaged 7.2±2.2 correct answers with no between-group differences. Post-education, the video group's (N=39) mean paired score difference was 0.9±2.0 higher than the verbal group's (p&lt;0.04). After 1 month, most scores maintained gains with no between-group differences. 97% of patients in each group were satisfied (none were unsatisfied) with their education. Our cohort was more literate than the general public, and a minority of subjects completed long-term follow up assessments. Video education enhanced near-term patient knowledge more than verbal education and maintained patient satisfaction.

Effects of Video- and Pamphlet-based Patient Educations on Anxiety and Satisfaction Among Candidates for Gastroscopy

Background: Endoscopy is a diagnostic tool, which causes its candidates different levels of anxiety. Anxiety can reduce patients’ tolerance and cooperation and increase the likelihood of endoscopy-related complications. One strategy to alleviate anxiety is patient education. However, previous studies reported conflicting findings about the most appropriate patient education method. Objectives: This study aimed at examining the effects of video- and pamphlet-based patient educations on anxiety and satisfaction among candidates for gastroscopy. Methods: This quasi-experimental study was conducted on 90 patients referred to the endoscopy unit of Valiasr hospital in Birjand city, Iran. The patients were selected through convenience sampling method and randomly allocated to a video, pamphlet, or control group. Data were collected using a demographic questionnaire, a researcher-made questionnaire for satisfaction assessment, and the Spielberger’s state-trait anxiety inventory. One day before gastroscopy, the participants completed the demographic questionnaire and Spielberger’s state-trait anxiety inventory. Then, educations were provided to them. In the day of their gastroscopy, their anxiety was reassessed both two to three hours before and immediately after the procedure. Collected data were entered into the SPSS software version 15. As all study variables had normal distribution, the data were analyzed by performing the one-way analysis of variance, the Tukey’s post hoc, the paired- and independent-sample t test, the chi-square, and Fisher’s exact tests at a significance level of less than 0.05. Results: The groups did not differ significantly from each other regarding the pretest and posttest values of total, state, and trait anxiety. However, the level of patient satisfaction in the video group was significantly greater than the control and pamphlet groups (P < 0.05). Moreover, patient satisfaction was not significantly correlated with patients’ demographic characteristics. Conclusions: Video-based patient education can improve patient satisfaction among candidates for gastroscopy.

Abstract B78: Using the Quality in the Continuum of Cancer Care framework to develop a multilevel intervention to improve cancer screening and follow-up among the medically underserved

Abstract Introduction: Screening for cervical, colorectal, and breast cancer is an evidence-based strategy to reduce the morbidity and mortality from these cancers. However a large proportion of medically underserved individuals do not obtain regular screening. Using the Quality in the Continuum of Cancer Care (QCCC) framework, we developed and implemented a comprehensive systems design intervention to improve the delivery, uptake, and follow-up of cervical, colorectal, and breast cancer screening within a network of healthcare institutions that serve the medically underserved in Harris County, Texas. Methods: An academic-community partnership, the Community Network for Cancer Prevention, was established between an academic cancer center, the county's safety net healthcare system, and several academic and community-based healthcare institutions. Clinical advisory boards, comprised of physicians, nurses, and public health professionals, were established for each cancer line. The QCCC framework was used to identify system-level failures that impede processes and transitions in the continuum of care from risk assessment to detection and from detection to diagnosis. Project components were developed to address the identified failures. Results: System failures identified at the risk assessment to detection phases included 1) failure to identify individuals in need of screening, 2) inadequate capacity to screen, and 3) inadequate access to care. Failures identified at the detection to diagnosis phases included 1) failures in the screening test results notification system, 2) failures in inter-provider communication, 3) failures in inter-institutional referrals for clinical follow-up, 4) patient non-adherence, and 5) inadequate access to care. Project components to address the identified failures include community outreach, patient education, and patient navigation. Community outreach involves a community theater program aimed to increase awareness of cancer risk and the current cancer screening guidelines among medically underserved individuals in the larger community; healthcare access navigators available at each performance assist audience members in applying for healthcare coverage through the safety net healthcare system. Patient education involves using the electronic medical record to identify patients due or past due for cervical, colorectal, and/or breast cancer screening. These patients are then targeted for a video-based patient education intervention while they wait to be seen by their healthcare provider. Motivational messaging in the videos encourages patients to discuss the particular screening test with their provider. Finally, patient navigation involves a team of navigators who actively communicate with patients and providers to ensure follow-up among patients with an abnormal screening test result. A real-time tracking database is used to monitor all screen-test positive patients as they move through the different stages of diagnostic and therapeutic follow-up. Conclusion: The QCCC provides a systematic approach for assessing factors that influence cancer care processes at the risk assessment, screening, detection, and diagnosis phases, as well as transitions between them. Focusing on transitions between phases is particularly useful for developing systems-level interventions to improve the delivery, uptake, and follow-up of cancer screening. Citation Format: Jane R. Montealegre, Loretta Hanser, Maria Daheri, Roshanda Chenier, Ivan Valverde, Glori S. Chauca, Luis O. Rustveld, Matthew L. Anderson, Lois Ramondetta, Milena Gould-Suarez, Musher L. Benjamin, Larry D. Scott, Juli R. Nangia, Brian C. Reed, Janet Hoagland-Sorensen, Alyssa Rieber, Maria L. Jibaja-Weiss. Using the Quality in the Continuum of Cancer Care framework to develop a multilevel intervention to improve cancer screening and follow-up among the medically underserved. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B78.

ビデオを用いた患者教育による術後痛および破局的思考の改善効果

ビデオを用いた患者教育による術後痛および破局的思考の改善効果

Ten Steps to Develop Patient Education Videos for Individuals of All Health Literacy Levels

Objectives: (1) Create a protocol for developing educational videos for patients of all health literacy levels. (2) Describe National Institutes of Health (NIH) guidelines, evidence-based principles of instructional design, and industry best practices related to creating educational videos for patients. Methods: Utilizing (1) NIH guidelines for patient education materials, (2) evidence-based principles of instructional design, and (3) industry best practices, a 10-step protocol was developed for creating video-based patient education materials. As a proof-of-concept, these 10 steps were used to create a short video to help patients understand flexible laryngostroboscopy. Results: Using NIH guidelines, a script was created with text designed for the sixth-grade reading level using the SMOG Readability Formula. Evidence-based principles of instructional design that were incorporated into the video included: the Personalization Principle, Multimedia Principle, Coherence Principle, Contiguity Principle, and Practice Principle. A video was recorded with a high definition camera, and audio narration was recorded separately. A short video describing laryngeal anatomy and showing actual footage laryngostoboscopy was edited on Camtasia Studio 8.0 and produced for optimized viewing on the iPad. The video was pilot tested on patients prior to undergoing flexible laryngostroboscopy at an outpatient otolaryngology–head and neck surgery clinic. Conclusions: There is currently no protocol for creating educational videos for patients with limited health literacy. This 10-step protocol was created to help those creating educational videos incorporate NIH guidelines, evidence-based principles of instructional design, and industry best practices into their projects.

Online video improves clinical outcomes in adults with atopic dermatitis: A randomized controlled trial

Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense pruritus that causes significant disease and psychosocial burden in patients. Patient education has the potential to improve clinical outcomes and patient knowledge of this condition. We sought to assess the effectiveness of online video education at improving AD knowledge and disease severity compared with a written pamphlet, and to determine the usefulness and appeal of the two educational delivery vehicles. In a randomized controlled trial, 80 participants were randomized to receive either online video-based patient education or written pamphlet education about AD and its management. We assessed AD disease severity using the patient-oriented eczema measure (POEM) scale. AD knowledge was assessed with standardized questionnaires at baseline and after the 12-week intervention. All participants had similar baseline knowledge and AD severity at the beginning of the study. On study completion, improvements in AD knowledge assessed by questionnaire were significantly greater in the video group than the pamphlet group (3.05 vs 1.85, P = .011). Online video-based education resulted in greater improvement in clinical outcome, as measured by POEM, compared with pamphlet-based education (POEM score reduction of 3.30 vs 1.03, P = .0043). Finally, although the usefulness of both interventions was rated equally (P = .77), the online video was significantly more appealing than the pamphlet (P = .0086). This study is limited to AD in adults. Online video for patient education is an effective and appealing tool for improving clinical outcomes in adult patients with AD.