Trial Outcomes & Findings for Reducing Assessment Barriers for Patients With Low Literacy (NCT NCT03584490)

NCT ID: NCT03584490

Last Updated: 2024-10-15

Results Overview

A primary outcome of this study will be the degree of DIF in NIH PROMIS questionnaire Anxiety subscale observed across adequate versus low health literacy. The outcome will be measured by a McFadden pseudo-R-square (R2), which captures the degree to which health-literacy group determines probability of response type for each item. The pseudo R2 is an analogue to R2 used in linear regression. For DIF analysis, each scale is normalized to a theta metric (mean = 0, standard dev. = 1 by definition). PROMIS is scaled by T-scores, referenced against the US population mean. Items are aggregated using item response theory, but aggregation is not relevant here because the McFadden pseudo-R2 is evaluated for each item. We report the maximum DIF value across items by condition. Pseudo-R2 values express how much health literacy and/or health literacy's interaction with anxiety determine the probability of response. Higher values correspond to higher DIF; lower values correspond to lower DIF.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

729 participants

Primary outcome timeframe

6 months

Results posted on

2024-10-15

Participant Flow

Participant milestones

Participant milestones
Measure
Pen-and-paper Format
Based on randomization, participants in this group will receive traditional pen-and-paper questionnaires about health. Phone Administration of Questionnaires: This intervention will pilot questionnaire administration over the phone with currently enrolled or previously enrolled participants from the original intervention. This method was used during the COVID-19 pandemic.
Computerized Talking Touchscreen
This group will receive the Computerized Talking Touchscreen intervention. Based on randomization, participants in this group will receive a computerized talking touchscreen version of our health questionnaires, which allows the participant to have questions and answer choices read aloud to them by the computer. Computerized Talking Touchscreen: The intervention is a computerized talking touchscreen designed to aid people with low health literacy. All Participants in both arms will complete a battery of health questionnaires. One group will complete questionnaires in traditional pen-and-paper format. The other group will receive the computerized talking touchscreen, which reads questions to participants on demand. Phone Administration of Questionnaires: This intervention will pilot questionnaire administration over the phone with currently enrolled or previously enrolled participants from the original intervention. This method was used during the COVID-19 pandemic.
Overall Study
STARTED
362
367
Overall Study
COMPLETED
235
230
Overall Study
NOT COMPLETED
127
137

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Reducing Assessment Barriers for Patients With Low Literacy

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Pen-and-paper Format
n=362 Participants
Based on randomization, participants in this group will receive traditional pen-and-paper questionnaires about health. Phone Administration of Questionnaires: This intervention will pilot questionnaire administration over the phone with currently enrolled or previously enrolled participants from the original intervention.
Computerized Talking Touchscreen
n=367 Participants
This group will receive the Computerized Talking Touchscreen intervention. Based on randomization, participants in this group will receive a computerized talking touchscreen version of our health questionnaires, which allows the participant to have questions and answer choices read aloud to them by the computer. Computerized Talking Touchscreen: The intervention is a computerized talking touchscreen designed to aid people with low health literacy. All Participants in both arms will complete a battery of health questionnaires. One group will complete questionnaires in traditional pen-and-paper format. The other group will receive the computerized talking touchscreen, which reads questions to participants on demand. Phone Administration of Questionnaires: This intervention will pilot questionnaire administration over the phone with currently enrolled or previously enrolled participants from the original intervention.
Total
n=729 Participants
Total of all reporting groups
Age, Continuous
49.75 years
n=99 Participants
48.93 years
n=107 Participants
49.5 years
n=206 Participants
Sex/Gender, Customized
sex · Male
141 Participants
n=99 Participants
140 Participants
n=107 Participants
281 Participants
n=206 Participants
Sex/Gender, Customized
sex · Female
221 Participants
n=99 Participants
227 Participants
n=107 Participants
448 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
97 Participants
n=99 Participants
109 Participants
n=107 Participants
206 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
265 Participants
n=99 Participants
256 Participants
n=107 Participants
521 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
2 Participants
n=107 Participants
2 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
9 Participants
n=99 Participants
8 Participants
n=107 Participants
17 Participants
n=206 Participants
Race (NIH/OMB)
Asian
9 Participants
n=99 Participants
14 Participants
n=107 Participants
23 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants
n=99 Participants
0 Participants
n=107 Participants
1 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
164 Participants
n=99 Participants
158 Participants
n=107 Participants
322 Participants
n=206 Participants
Race (NIH/OMB)
White
100 Participants
n=99 Participants
96 Participants
n=107 Participants
196 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
5 Participants
n=99 Participants
2 Participants
n=107 Participants
7 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
74 Participants
n=99 Participants
89 Participants
n=107 Participants
163 Participants
n=206 Participants
Region of Enrollment
United States
362 participants
n=99 Participants
367 participants
n=107 Participants
729 participants
n=206 Participants

PRIMARY outcome

Timeframe: 6 months

A primary outcome of this study will be the degree of DIF in NIH PROMIS questionnaire Anxiety subscale observed across adequate versus low health literacy. The outcome will be measured by a McFadden pseudo-R-square (R2), which captures the degree to which health-literacy group determines probability of response type for each item. The pseudo R2 is an analogue to R2 used in linear regression. For DIF analysis, each scale is normalized to a theta metric (mean = 0, standard dev. = 1 by definition). PROMIS is scaled by T-scores, referenced against the US population mean. Items are aggregated using item response theory, but aggregation is not relevant here because the McFadden pseudo-R2 is evaluated for each item. We report the maximum DIF value across items by condition. Pseudo-R2 values express how much health literacy and/or health literacy's interaction with anxiety determine the probability of response. Higher values correspond to higher DIF; lower values correspond to lower DIF.

Outcome measures

Outcome measures
Measure
Pen-and-paper Format
n=362 Participants
Based on randomization, participants in this group will receive traditional pen-and-paper questionnaires about health. Phone Administration of Questionnaires: This intervention will pilot questionnaire administration over the phone with currently enrolled or previously enrolled participants from the original intervention. This method was used during the COVID-19 pandemic.
Computerized Talking Touchscreen
n=367 Participants
This group will receive the Computerized Talking Touchscreen intervention. Based on randomization, participants in this group will receive a computerized talking touchscreen version of our health questionnaires, which allows the participant to have questions and answer choices read aloud to them by the computer. Computerized Talking Touchscreen: The intervention is a computerized talking touchscreen designed to aid people with low health literacy. All Participants in both arms will complete a battery of health questionnaires. One group will complete questionnaires in traditional pen-and-paper format. The other group will receive the computerized talking touchscreen, which reads questions to participants on demand. Phone Administration of Questionnaires: This intervention will pilot questionnaire administration over the phone with currently enrolled or previously enrolled participants from the original intervention. This method was used during the COVID-19 pandemic.
The Degree of Differential Item Functioning (DIF) in NIH Patient-Reported Outcomes Measurement Information System (PROMIS Profile 57 v 2.0) Anxiety Subscale
0.06 Pseudo-R2
0.02 Pseudo-R2

PRIMARY outcome

Timeframe: 6 months

A primary outcome of this study will be the degree of DIF observed in the Patient Health Questionnaire (PHQ-9), a questionnaire used to measure depression across adequate versus low health literacy. The outcome will be measured by a McFadden pseudo-R-square (R2), which captures the degree to which health-literacy group determines probability of response type for each item. Pseudo-R2 is an analogue to R2 used in linear regression. For DIF analysis, each scale is normalized to a theta metric (mean = 0, standard dev. = 1 by definition). Normally items are aggregated by a sum score, but the aggregation is not relevant to this study because the McFadden pseudo-R2 is evaluated for each item, not for aggregate scores. We report the maximum DIF value across items by condition. Pseudo-R2 values express how much health literacy and/or health literacy's interaction with depression determine the probability of response. Higher values correspond to higher DIF; lower values correspond to lower DIF.

Outcome measures

Outcome measures
Measure
Pen-and-paper Format
n=362 Participants
Based on randomization, participants in this group will receive traditional pen-and-paper questionnaires about health. Phone Administration of Questionnaires: This intervention will pilot questionnaire administration over the phone with currently enrolled or previously enrolled participants from the original intervention. This method was used during the COVID-19 pandemic.
Computerized Talking Touchscreen
n=367 Participants
This group will receive the Computerized Talking Touchscreen intervention. Based on randomization, participants in this group will receive a computerized talking touchscreen version of our health questionnaires, which allows the participant to have questions and answer choices read aloud to them by the computer. Computerized Talking Touchscreen: The intervention is a computerized talking touchscreen designed to aid people with low health literacy. All Participants in both arms will complete a battery of health questionnaires. One group will complete questionnaires in traditional pen-and-paper format. The other group will receive the computerized talking touchscreen, which reads questions to participants on demand. Phone Administration of Questionnaires: This intervention will pilot questionnaire administration over the phone with currently enrolled or previously enrolled participants from the original intervention. This method was used during the COVID-19 pandemic.
Patient Health Questionnaire (PHQ-9)
0.00 Pseudo-R2
0.02 Pseudo-R2

PRIMARY outcome

Timeframe: 6 months

A primary outcome will be the degree of DIF in NIH PROMIS questionnaire Depression subscale observed across adequate versus low health literacy. The outcome will be measured by a McFadden pseudo-R-square (R2), which captures the degree to which health-literacy group determines probability of response type for each item. The pseudo R2 is an analogue to R2 used in linear regression. For DIF analysis, each scale is normalized to a theta metric (mean = 0, standard dev. = 1 by definition). PROMIS is scaled by T-scores, referenced against the US population mean. Items are aggregated using item response theory, but aggregation is not relevant here because the McFadden pseudo-R2 is evaluated for each item. We report the maximum DIF value across items by condition. Pseudo-R2 values express how much health literacy and/or health literacy's interaction with depression determine the probability of response. Higher values correspond to higher DIF; lower values correspond to lower DIF.

Outcome measures

Outcome measures
Measure
Pen-and-paper Format
n=362 Participants
Based on randomization, participants in this group will receive traditional pen-and-paper questionnaires about health. Phone Administration of Questionnaires: This intervention will pilot questionnaire administration over the phone with currently enrolled or previously enrolled participants from the original intervention. This method was used during the COVID-19 pandemic.
Computerized Talking Touchscreen
n=367 Participants
This group will receive the Computerized Talking Touchscreen intervention. Based on randomization, participants in this group will receive a computerized talking touchscreen version of our health questionnaires, which allows the participant to have questions and answer choices read aloud to them by the computer. Computerized Talking Touchscreen: The intervention is a computerized talking touchscreen designed to aid people with low health literacy. All Participants in both arms will complete a battery of health questionnaires. One group will complete questionnaires in traditional pen-and-paper format. The other group will receive the computerized talking touchscreen, which reads questions to participants on demand. Phone Administration of Questionnaires: This intervention will pilot questionnaire administration over the phone with currently enrolled or previously enrolled participants from the original intervention. This method was used during the COVID-19 pandemic.
The Degree of Differential Item Functioning (DIF) in NIH Patient-Reported Outcomes Measurement Information System (PROMIS Profile 57 v 2.0) Depression Subscale
0.04 Pseudo-R2
0.04 Pseudo-R2

Adverse Events

Pen-and-paper Format

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Computerized Talking Touchscreen

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

James W. Griffith, PhD

Northwestern University

Phone: 3125035345

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place