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Sayfi S, Charide R, Elliott SA, Hartling L, Munan M, Stallwood L, Butcher NJ, Richards DP, Mathew JL, Suvada J, Akl EA, Kredo T, Mbuagbaw L, Motilall A, Baba A, Scott SD, Falavigna M, Klugar M, Friessová T, Lotfi T, Stevens A, Offringa M, Schünemann HJ, Pottie K. A multimethods randomized trial found that plain language versions improved adults understanding of health recommendations. J Clin Epidemiol 2024; 165:111219. [PMID: 38008266 DOI: 10.1016/j.jclinepi.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/17/2023] [Accepted: 11/17/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVES To make informed decisions, the general population should have access to accessible and understandable health recommendations. To compare understanding, accessibility, usability, satisfaction, intention to implement, and preference of adults provided with a digital "Plain Language Recommendation" (PLR) format vs. the original "Standard Language Version" (SLV). STUDY DESIGN AND SETTING An allocation-concealed, blinded, controlled superiority trial and a qualitative study to understand participant preferences. An international on-line survey. 488 adults with some English proficiency. 67.8% of participants identified as female, 62.3% were from the Americas, 70.1% identified as white, 32.2% had a bachelor's degree as their highest completed education, and 42% said they were very comfortable reading health information. In collaboration with patient partners, advisors, and the Cochrane Consumer Network, we developed a plain language format of guideline recommendations (PLRs) to compare their effectiveness vs. the original standard language versions (SLVs) as published in the source guideline. We selected two recommendations about COVID-19 vaccine, similar in their content, to compare our versions, one from the World Health Organization (WHO) and one from Centers for Disease Control and Prevention (CDC). The primary outcome was understanding, measured as the proportion of correct responses to seven comprehension questions. Secondary outcomes were accessibility, usability, satisfaction, preference, and intended behavior, measured on a 1-7 scale. RESULTS Participants randomized to the PLR group had a higher proportion of correct responses to the understanding questions for the WHO recommendation (mean difference [MD] of 19.8%, 95% confidence interval [CI] 14.7-24.9%; P < 0.001) but this difference was smaller and not statistically significant for the CDC recommendation (MD of 3.9%, 95% CI -0.7% to 8.3%; P = 0.096). However, regardless of the recommendation, participants found the PLRs more accessible, (MD of 1.2 on the seven-point scale, 95% CI 0.9-1.4%; P < 0.001) and more satisfying (MD of 1.2, 95% CI 0.9-1.4%; P < 0.001). They were also more likely to follow the recommendation if they had not already followed it (MD of 1.2, 95% CI 0.7-1.8%; P < 0.001) and share it with other people they know (MD of 1.9, 95% CI 0.5-1.2%; P < 0.001). There was no significant difference in the preference between the two formats (MD of -0.3, 95% CI -0.5% to 0.03%; P = 0.078). The qualitative interviews supported and contextualized these findings. CONCLUSION Health information provided in a PLR format improved understanding, accessibility, usability, and satisfaction and thereby has the potential to shape public decision-making behavior.
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Affiliation(s)
- Shahab Sayfi
- Department of Biology, Faculty of Science, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada; Schulich School of Medicine & Dentistry, Western University, London, Ontario N6A 5C1, Canada; Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada
| | - Rana Charide
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada
| | - Sarah A Elliott
- Department of Pediatrics, Faculty of Medicine and Dentistry, Alberta Research Center for Health Evidence, University of Alberta, Edmonton, Alberta, Canada; Cochrane Child Health, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa Hartling
- Department of Pediatrics, Faculty of Medicine and Dentistry, Alberta Research Center for Health Evidence, University of Alberta, Edmonton, Alberta, Canada; Cochrane Child Health, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew Munan
- Department of Pediatrics, Faculty of Medicine and Dentistry, Alberta Research Center for Health Evidence, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa Stallwood
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada
| | - Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada
| | | | - Joseph L Mathew
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jozef Suvada
- National Evidence and Quality Platform, St. Elizabeth University of Public Health and Social Science, Research Dept., Nam. 1. Maja 1, 81000 Bratislava, Slovak Republic; Experts Consortium for COVID-19, Advisor to Government of Slovak Republic, Bratislava, Slovak Republic; WHO Executive Board, Geneva, Switzerland
| | - Elie A Akl
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada; Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Capetown, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada; Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada; Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada; Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon; Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Ashley Motilall
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada
| | - Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Maicon Falavigna
- National Institute for Health Technology Assessment, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Miloslav Klugar
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic; Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Tereza Friessová
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tamara Lotfi
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada
| | - Adrienne Stevens
- Centre for Immunization Readiness, Public Health Agency of Canada, Ottawa, Ontario K1A 0K9, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario M5T 3M6, Canada; Division of Neonatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario M5G 1X8, Canada
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
| | - Kevin Pottie
- Schulich School of Medicine & Dentistry, Western University, London, Ontario N6A 5C1, Canada; Department of Family Medicine, Western University, London, Ontario, Canada.
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Samper-Pardo M, León-Herrera S, Oliván-Blázquez B, Méndez-López F, Domínguez-García M, Sánchez-Recio R. Effectiveness of a telerehabilitation intervention using ReCOVery APP of long COVID patients: a randomized, 3-month follow-up clinical trial. Sci Rep 2023; 13:7943. [PMID: 37193738 DOI: 10.1038/s41598-023-35058-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/11/2023] [Indexed: 05/18/2023] Open
Abstract
The main objective of this study is to analyze the clinical efficacy of telerehabilitation in the recovery of Long COVID patients through ReCOVery APP for 3 months, administered in the Primary Health Care context. The second objective is to identify significant models associated with an improvement in the study variables. An open-label randomized clinical trial was conducted using two parallel groups of a total of 100 Long COVID patients. The first group follows the treatment as usual methods established by their general practitioner (control group) and the second follows the same methods and also uses ReCOVery APP (intervention group). After the intervention, no significant differences were found in favour of the group intervention. Regarding adherence, 25% of the participants made significant use of the APP. Linear regression model establishes that the time of use of ReCOVery APP predicts an improvement in physical function (b = 0.001; p = 0.005) and community social support (b = 0.004; p = 0.021). In addition, an increase in self-efficacy and health literacy also contribute to improving cognitive function (b = 0.346; p = 0.001) and reducing the number of symptoms (b = 0.226; p = 0.002), respectively. In conclusion, the significant use of ReCOVery APP can contribute to the recovery of Long COVID patients. Trial Registration No.: ISRCTN91104012.
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Affiliation(s)
- M Samper-Pardo
- Institute for Health Research Aragon (IISAragon), Zaragoza, Spain
| | - S León-Herrera
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - B Oliván-Blázquez
- Institute for Health Research Aragon (IISAragon), Zaragoza, Spain.
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain.
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain.
| | - F Méndez-López
- Institute for Health Research Aragon (IISAragon), Zaragoza, Spain
| | | | - R Sánchez-Recio
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
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