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The Talking Touchscreen (La Pantalla Parlanchina): Innovative Multimedia Methods for Health Outcomes Assessment and Patient Education in Underserved Populations

*Elizabeth Ann Hahn, Feinberg School of Medicine, Northwestern University 
Kathleen Yost, Mayo Clinic 
Kimberly Webster, Feinberg School of Medicine, Northwestern University 
Sofia Garcia, Feinberg School of Medicine, Northwestern University 
Seung Choi, Feinberg School of Medicine, Northwestern University 

Keywords: health literacy, health information technology, psychometrics, underserved populations

Electronic media are useful in decision-making and patient-reported outcomes (PRO) assessment, yet may be inaccessible to low-literate patients. We developed a bilingual, multimedia Talking Touchscreen (TT). We validated the TT with 420 English- and 414 Spanish-speaking cancer patients, many computer-naive. Patients (97%) rated the TT as “easy” or “very easy” to use. Item response theory analyses suggested no systematic literacy bias. We next designed and validated a new TT-based health literacy test. Among 619 English-speaking primary care patients, the majority (93%) had no difficulty self-administering the test; Spanish testing is ongoing. We are now conducting two randomized trials of the TT for delivering patient education for cancer and Type 2 diabetes patients. The TT is easy to use and acceptable for self-administration of questionnaires and tests, and for delivering patient education information. Self-administration of questionnaires should reduce staff burden and costs, interview bias, and stigma related to low literacy. The TT increases access of underserved populations to new technologies, and contributes information about their experiences with new technologies.