An Automated, Tailored Information Application for Medication Health Literacy

Health literacy is a critically important problem in improving the effectiveness of health
care interventions. Patient behaviors essential to the successful treatment of HIV
infection, such as high levels of medication adherence, may depend on patients understanding
how to take medication, how to solve medication-related problems, and how to cope with
medication side effects. An approach that has shown promise in promoting behavior change in
HIV+ persons is the Information-Motivation-Behavior Skills (IMB) model. The intervention
proposed in this application will implement a health literacy intervention based in part on
insights about behavior change drawn from studies of this model. The purpose of the proposed
research is to implement this intervention via a computer-based and automated tailored
information application. Participants will first complete an automated computer-administered
self interview (ACASI) that will assess medication knowledge, disease knowledge likely to be
related to motivation, and problem solving skills. Results of this assessment will feed
forward to an automated training application that provides individually-tailored training on
these topics. This computer-based program will provide training, test understanding, and if
necessary reteach and retest. It will also provide printed information for participants to
take home to provide ongoing prompts. This study will comprise two phases. In the first, the
program will be developed and tested with potential users to assess its usability and detect
problems with the wording of materials. In the second phase, participants' health literacy
and cognitive status will be evaluated, their adherence to a medication for HIV infection
will be assessed using electronic monitoring, and the effects of the program on their
adherence will be tested.