This is a cluster randomised controlled trial of the effectiveness of an intervention which uses accessible and interactive information technology to support general practice nurses to better communicate with patients with low health literacy, to help them use information, set priorities, navigate referral and maintain behaviour change.
NHMRC Project Grant APP1125681
Professor Mark Harris
Professor Nigel Stocks, Professor Don Nutbeam, Professor Nick Zwar, Professor Jonathan Karnon, Professor Elizabeth Denney-Wilson, Associate Professor Margo Barr, Professor Siaw Teng-Liaw, Dr Annie Lau.
Sharon Parker (Trial Coordinator), Katrina Baikie (RA), An Tran (RA), Shoko Saito (RA)
The burden of chronic disease is an urgent public health priority, accounting for 90% of deaths in Australia. This is especially important for disadvantaged Australians for whom there are widening disparities in the burden of chronic diseases and their risk factors. Low health literacy (HL) affects 59% of the population and contributes directly and indirectly to these disparitie. For example low HL explains a substantial proportion of the difference in the uptake of preventive programs and self-management of chronic diseases. People with low health literacy communicate less well with health care providers, miss opportunities for prevention and suffer adverse health outcomes as a result. Providers communicate less successfully with patients with low HL, often incorrectly assuming they are not interested in an active role in their health care. To achieve better outcomes for these patients we need to adjust communication to fit patient health literacy and to take opportunities to develop HL skills. This project uses both these approaches to preventive care for patients with low HL in Australian general practice.
To evaluate the implementation and effectiveness of a preventive care intervention for obesity that is tailored to the needs of, and develops the knowledge and skills of patients with low health literacy.
To assess the delivery of this intervention within primary care.
Design: A cluster randomised controlled trial. Practices were randomly assigned to the HeLP GP intervention or to receive usual care provided by the GP and practice nurse.
Setting: Primary care practices in Sydney and Adelaide.
Practice recruitment: Practices were recruited with the assistance of South Western Sydney and Adelaide Primary Health Networks (PHN’s).
Patient recruitment: Eligible patients were invited to participate on presentation to their practice. Eligible patients were those:
Exclusion criteria included:
The HeLP GP intervention comprised:
At the health check patients could choose to take up mysnapp, Get Healthy or both. This combination intervention aimed to increase the knowledge of patients relating to diet and physical activity and their individual skills to address weight management behaviours.
The intervention model will be evaluated against a number of practice and patient variables including:-
Ethics and consent
This trial was approved by the University of New South Wales Human Research Ethics Committee (HC17474). The University of Adelaide Human Research Ethics committee ratified this approval.
This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12617001508369). Date registered 30 October 2017.
During 2018/2019 22 practices were recruited with 11 allocated to each group. A total of 317 patients provided consent to participate in the trial
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Mark Harris Phone: 02 9385 8402 Email: firstname.lastname@example.org
University of Adelaide, University of Sydney, Australian Institute of Health Innovation Macquarie University, South Western Sydney PHN, Adelaide PHN