University of Georgia Researchers Receive Stimulus Funding To Improve Health Literacy of Elderly
By Rachel Hobgood and Sherrie Whaley
November 6, 2009
Athens, Ga. — Improving the health literacy skills of Georgia's elderly and disabled is the goal of a University of Georgia research project that has been funded by federal stimulus monies.
UGA researchers Vicki Freimuth and Don Rubin received $970,039 through the American Recovery and Reinvestment Act for a two-year project that uses volunteers to help vulnerable elderly persons improve their interactions with health care providers.
Freimuth serves a joint appointment in UGA's Grady College of Journalism and Mass Communication and Department of Speech Communication. She also serves as director of UGA's Center for Health & Risk Communication. Rubin is professor emeritus of speech communication and a Center for Health & Risk Communication researcher.
The research project will train Meals on Wheels volunteers to become health literacy coaches for older adults. Meals on Wheels volunteers regularly bring meals to the elderly and disabled, who otherwise cannot provide food for themselves. The Georgia project will be conducted in the urban counties of DeKalb, Fulton and Cobb and in several rural counties in southwest Georgia.
"Older adults often are less likely to express their needs to doctors," explained Freimuth. "They are more passive patients." This passivity makes them less likely to ask questions when they don't understand heath care professionals, which can impede treatment. For example, older adults are at risk of dangerous medication errors because they are not well-enough informed about how to properly take their medication.
Freimuth and Rubin's research will focus on oral communication between healthcare professionals and older adults. Many of the older adults receiving Meals on Wheels services are socially isolated, and their interaction with the volunteer is one of their few chances during the day for interaction.
"There is a lot of research on the elderly's ability to read and understand written materials given by healthcare professionals," said Freimuth. "There is much less information on how the elderly take in oral information, which is one of the main ways they receive information from healthcare professionals."
Previous research affirms that Meals on Wheels volunteers can conduct health promotion during brief encounters with clients. The volunteers are ideally suited to be health literacy coaches, since they enjoy special status as intimate, welcome and regular visitors to the otherwise difficult-to-reach homebound, noted Freimuth.
The project will randomly assign 1,200 Meals on Wheels recipients to one of three treatment groups. In treatment one, the volunteers will not make any changes to their behavior. The second treatment will ask Meals on Wheels volunteers to merely give "Ask-Me-3" health-promoting brochures and materials to their clients with a modicum of additional discussion.
"Ask-Me-3" is a patient education program developed in conjunction with the American Medical Association and other partners which encourages patients to ask three questions of health care professionals: "What is my main problem?" "What do I need to do?" and "Why is it important for me to do this?" These questions help patient understanding and can ultimately lead to better self-treatment and health.
The third treatment group for the project will receive the "Ask-Me-3" brochures, as well as four brief coaching sessions by the Meals on Wheels volunteers. The coaching sessions will help the clients prepare for health appointments prior to visiting health care professionals.
If successful, said Freimuth, the intervention can be implemented nationally, potentially reaching over 3 million vulnerable older adults.
UGA graduate students Mumbi Okundaye, a master's student in public health, and John Parmer, a doctoral student in health promotion, will provide additional assistance on the project along with program manager, Terry Kaley.
The ARRA is funding research projects in all 50 states. The bulk of the funding is being provided by the Department of Energy, the National Institutes of Health and the National Science Foundation. The stimulus is supporting science and engineering, helping to provide employment and training for the next generation of doctors, engineers, scientists and researchers.