Practical Advice Regarding the Reliability of the Patient Educational Materials Assessment Tool for Health Educators

Psychometric Testing of the Turkish Version of the Patient Education Materials Assessment Tool

AIM

The aim of this study was to test the psychometric properties of the Turkish version of the Patient Education Materials Assessment Tool METHODS: The study was carried out with intern nurses receiving education at a Nursing Faculty in Turkey between July 2019 and June 2020. 248 intern nurses participated in PEMAT-P and 223 in PEMAT-A/V in this study. Five audio-visual and five printed materials were used. The Patient Education Materials Assessment Tool and the Patient Education Materials Assessment Tool User's Guide were translated into Turkish and culturally adapted using standard guidelines. Content and construct validity analyses were performed for the validity of the Turkish version of the Patient Education Materials Assessment Tool, and internal consistency, invariability, and external consistency analyses were performed for its reliability.

RESULTS

The content validity index was 1.00 for all the scale items. At the conclusion of the factor analyses, the scale has composed a twodimension construct of understandability and actionability. The Cronbach's alpha coefficients were observed to be 0.901 of the Turkish version of the Patient Education Materials Assessment Tool for Printable Materials and 0.897 of the Turkish version of the Patient Education Materials Assessment Tool for Audiovisual Materials. The Pearson Product-Moment Correlation Coefficient (rxy) was high (Turkish version of the Patient Education Materials Assessment Tool for Printable Materials rxy=0.815, Turkish version of the Patient Education Materials Assessment Tool for Audiovisual Materials rxy=0.804). Cohen's kappa coefficients were obtained as 0.736 of the Turkish version of the Patient Education Materials Assessment Tool for Printable Materials and 0.781 of the Turkish version of the Patient Education Materials Assessment Tool for Audiovisual Materials.

CONCLUSION

The Turkish version of the Patient Education Materials Assessment Tool is a valid and reliable measurement tool in the evaluation of both printed and audiovisual patient education materials.

Development and assessment of a low literacy, pictographic asthma action plan with clinical automation to enhance guideline-concordant care for children with asthma

OBJECTIVE

Asthma is characterized by reversible pulmonary symptoms, frequent hospitalizations, poor quality of life, and varied treatment. Parents with low health literacy (HL) is linked to poor asthma outcomes in children. Recent practice updates recommended inhaled corticosteroids for the management of persistent asthma, but guideline-concordant care is suboptimal. Our aim was to develop and assess an Asthma Action Plan (AAP) that could serve as an individualized plan for low HL families and facilitate guideline-concordant care for clinicians.

METHODS

We followed the National Institute of Health 5-step "Clear & Simple" approach to develop the Uniformed Services AAP. Our AAP included symptom pictographs (dyspnea, cough, sleep, activity) and guideline-concordant clinical automation tools. Caregivers assessed the pictograms for validity (transparency of ≥ 85%; translucency score ≥ 5; and ≥ 85% recall). Readability was assessed using 7 formulas. (<6th Grade was acceptable). Comprehensibility, design quality, and usefulness was assessed by caregivers using the Consumer Information Rating Form (CIRF) (>80% was acceptable). Understandability and actionability was assessed by medical librarians using the Patient Education Materials Assessment Tool-Printable (>80% was acceptable). Suitability was assessed by clinicians using the modified Suitability Assessment of Materials (SAM) instrument (>70% was superior).

RESULTS

All 12 pictograms were validated (N = 118 respondents). Readability demonstrated a 4th grade level. Overall CIRF percentile score = 80.4%. Understandability and Actionability = 100%. Suitability score = 75%.

CONCLUSIONS

Our AAP was formally endorsed by the Allergy & Asthma Network. The Uniformed Services AAP is a novel tool with embedded clinical automation that can address low HL and enhance guideline-concordant care.