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Does written hepatitis C information meet the needs of injecting drug users?

Does written hepatitis C information meet the needs of injecting drug users?. Professor Avril Taylor University of Paisley. Background to Study. Much information on HCV disseminated through written materials In 2003 an awareness campaign used cards and posters

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Does written hepatitis C information meet the needs of injecting drug users?

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  1. Does written hepatitis C information meet the needs of injecting drug users? Professor Avril Taylor University of Paisley

  2. Background to Study • Much information on HCV disseminated through written materials • In 2003 an awareness campaign used cards and posters • Knowledge evaluated pre and post campaign • No difference in knowledge • Other health literacy studies find discrepancy between literature and reading ability

  3. Aims of the Study • To assess the reading levels of injecting drug users • To assess any association between reading level and risk behaviours • To assess the readability levels of written harm reduction leaflets on HCV • To assess sources of HCV knowledge • To determine IDUs preference for knowledge acquisition

  4. Method • IDUs reading levels assessed using two validated tools (REALM and S-TOFHLA) • Interviewed using structured questionnaire - drug use, risk behaviours, knowledge of HCV, sources of knowledge, preferred format • Leaflets assessed using SMOG

  5. REALM • Rapid Estimate of Adult literacy in Medicine • Assesses adults’ ability to read common medical words and lay terms for body parts and illnesses • 66-item word recognition test • One mark is given for each correctly pronounced word • The REALM score is the sum of correctly pronounced words

  6. REALM Scores and Reading Age

  7. S-TOFHLA • Short Test of Functional Health Literacy in Adults • Respondents read out loud a number of sentences • Fill in a missing word from a provided list

  8. S-TOFHLA Your doctor has sent you to have a____________ X-ray.                                                   a. Stomach                                                  b. Diabetes                                                  c. Stitches                                                  d. germsYou must have an_________ stomach when you come for_____.a. asthma                                                     a. is                           b. empty                                                      b. am                           c. incest                                                        c. if                           d. anaemiad. itThe x-ray will____________ from 1 to 3 __________ to do.                    a. take                                a. beds                    b. view                                b. brains                   c. talk                                  c. hours                   d. look                               d. diets

  9. S-TOFHLA Grades and Literacy Level

  10. Leaflet Assessment • 10 HCV leaflets distributed within GGHB and the recruitment centres were evaluated • The SMOG (simplified measure of gobbledygook) Readability Formula determines the readability level of written material • If someone has a reading age of, say, 12 years, they will understand 90-100% of material with a readability level of 12 • Most people will understand a readability level of about 10

  11. Sample characteristics • 150 Glasgow IDUs • 69% male • Mean age = 32.02 years • Mean age left school = 14.87 years • Mean age first injected = 21.58 years • 60% no qualifications • 48 refused to take part

  12. Results REALM scores 11 years 12 – 14 years > 14 years or less Total (n=150) 12 (8%) 34 (23%) 104 (69%) Males (n=104) 11(11%) 15 (14%) 78 (75%) Females (n=46) 1 (2%) 19 (41%) 26 (56%) Mean age 35.9 31.0 31.9 11years or less. At the very least will need low literacy materials 12-14 years. Will struggle with most patient education materials >14 years. Will be able to read most patient education materials

  13. Results TOFHLA scores Inadequate Marginal Adequate Total (n=150) 19 (13%) 14 (9%) 117 (78%) Males (n=104) 16 (15%) 9 (9%) 79 (76%) Females (n=46) 3 (7%) 5 (11%) 38 (83%) Mean age 35.1 33.231.4 Inadequate. Unable to read and interpret health texts Marginal. Has difficulty reading and interpreting health texts Adequate. Can read and interpret most health texts

  14. REALM and TOFHLA REALM 11 years or less 12 – 14 years > 14 years ( n=12) (n=34) (n=104) TOFHLA Inadequate 9 (75%) 7 (21%) 3 (7.5%) Marginal 0 6 (18%) 8 (8%) Adequate 3 (25%) 21 (6%) 93 (89%)

  15. Risk Behaviours – Injecting with used n/s 11 years 12 – 14 > 14 years Total or less years (n=12) (n=34) (n=104) (n=150) Ever share n/s 5 (42%) 15 (44%) 55 (53%) 75 (50%) Shared last 4 (33%) 6 (18%) 20 (19%) 30 (20%) 6 months

  16. Risk Behaviours – other paraphernalia 11 years or less 12 – 14 years > 14 years Total (n=12) (n=34) (n=104) (n=150) Ever share spoon 8 (67%) 20 (59%) 73 (70%) 101 (67%) Shared spoon 6 (50%) 14 (41%) 47 (45%) 67 (45%) last 6 months Ever share filter 8 (67%) 19 (56%) 74 (71%) 101 (67%) Filter last 6 months 6 (50%) 13 (38%) 49 (47%) 66 (44%)

  17. HCV Knowledge Think easily transmitted 11 years or less 12 – 14 years > 14 years Total Injecting with used n/s 11 (92%) 34 (100%) 101 (97%) 146 (97%) Drawing up used spoon 11 (92%) 34 (100%) 88 (85%) 133 (89%) Used filter 11 (92%) 32 (94%) 92 (89%) 135 (90%) Used flush water 10 (83%) 29 (85%) 90 (87%) 129 (86%)

  18. How received Hepatitis C knowledge 11 years 12 – 14 >14 years Total or less years Verbal 10 (83%) 25 (74%) 81 (78%) 116 (77%) Poster 1 (8%) 8 (24%) 26 (25%) 35 (23%) Leaflet 6 (50%) 22 (65%) 76 (73%) 104 (69%) Other 1 (8%) 3 (9%) 14 (14%) 18 (12%) (TV, press etc)

  19. Found source helpful/very helpful 11 years 12 – 14 > 14 years Total or less years Verbal 9 (90%) 22 (80%) 69 (85%) 100 (86%) Poster 0 5 (63%) 15 (58%) 20 (57%) Leaflet 0 5 (23%) 15 (18%) 20 (19%) Other 1 (100%) 3 (100%) 11 (79%) 15 (83%) (TV, press etc.)

  20. Leaflet assessment • 10 leaflets ranged between equivalent reading age of 13-17 years • Mean readability level of 15-16 years • Those with reading age of 12-14 years or less (31%) would have problems understanding most of the leaflets • Some of those aged >14 years would have difficulty reading the leaflets

  21. Would you like to know more about Hepatitis C?

  22. Leaflet assessment Leaflet Reading Age L1 14-15 L2 13-14 L3 13-14 L4 14-15 L5 13-14 L6 17-18 L7 13-14 L8 15-16 L9 17-18 L10 17-18 • Aim is for readability of 10 or under

  23. Preferred source of information 11 years 12 – 14 >14 years or less years Verbal 11 (92%) 29 (85%) 71 (68%) Leaflets/posters 1 (8%) 1 (3%) 23 (22%) TV/DVD/Web 0 3 (9%) 7 (7%)

  24. Conclusion • At least average reading age • Risk behaviours continue despite widespread knowledge of injecting transmission factors • At least one third would have difficulty reading current literature • Only 19% of those who had read a leaflet found it helpful; only 18% of those with reading age of >14 found it helpful • Only 23% had read a poster • Preferred source of information was verbal communication for all reading groups • 60% wanted to know more about HCV; 57% of >14 group • Implications for staff training

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