title: The multimedia computer for low-literacy patient education: a pilot project of cancer risk perceptions.
abstract: OBJECTIVE
  Inadequate reading literacy is a major barrier to better educating patients. Despite its high prevalence, practical solutions for detecting and overcoming low literacy in a busy clinical setting remain elusive. In exploring the potential role for the multimedia computer in improving office-based patient education, we compared the accuracy of information captured from audio-computer interviewing of patients with that obtained from subsequent verbal questioning.
  
  
  METHODS
  Adult medicine clinic, urban community health center
  
  
  METHODS
  Convenience sample of patients awaiting clinic appointments (n = 59). Exclusion criteria included obvious psychoneurologic impairment or primary language other than English.
  
  
  METHODS
  A multimedia computer presentation that used audio-computer interviewing with localized imagery and voices to elicit responses to 4 questions on prior computer use and cancer risk perceptions.
  
  
  RESULTS
  Three patients refused or were unable to interact with the computer at all, and 3 patients required restarting the presentation from the beginning but ultimately completed the computerized survey. Of the 51 evaluable patients (72.5% African-American, 66.7% female, mean age 47.5 [+/- 18.1]), the mean time in the computer presentation was significantly longer with older age and with no prior computer use but did not differ by gender or race. Despite a high proportion of no prior computer use (60.8%), there was a high rate of agreement (88.7% overall) between audio-computer interviewing and subsequent verbal questioning.
  
  
  CONCLUSIONS
  Audio-computer interviewing is feasible in this urban community health center. The computer offers a partial solution for overcoming literacy barriers inherent in written patient education materials and provides an efficient means of data collection that can be used to better target patients' educational needs.
authors.affiliation: Wake Forest University School of Medicine, Winston, Salem, NC, USA. jwofford@wfubmc.edu
authors.forename: J L
authors.initials: JL
authors.lastname: Wofford
authors.forename: D
authors.initials: D
authors.lastname: Currin
authors.forename: R
authors.initials: R
authors.lastname: Michielutte
authors.forename: M M
authors.initials: MM
authors.lastname: Wofford
mesh_terms: D000328:Adult; D000368:Aged; D003144:Communication Barriers; D003197:Computer Literacy; D003201:Computers; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019212:Multimedia; D009369:Neoplasms / Q000453:epidemiology; D010353:Patient Education as Topic; D010865:Pilot Projects; D012307:Risk Factors