Health literacy and task environment influence parents' burden for data entry on child-specific health information: randomized controlled trial

• Published in: Journal of medical Internet research Vol. 13; no. 1; p. e13
• Main Authors: Porter, Stephen C, Guo, Chao-Yu, Bacic, Janine, Chan, Eugenia
• Format: Journal Article
• Language: English
• Published: Canada Gunther Eysenbach MD MPH, Associate Professor 01-01-2011; Gunther Eysenbach; JMIR Publications
• Subjects: Adult; Attention Deficit Disorder with Hyperactivity - psychology; Attention deficit hyperactivity disorder; Burden; Child; Children; Children & youth; Chronic illnesses; Clinical trials; Cohort Studies; Computers; Consumer Health Information; Data entry; Disease management; Female; Health education; Health information; Health Literacy; Humans; Information sharing; Male; Original Paper; Parents; Parents & parenting; Pediatrics; Personal health; Spanish language; Task Performance and Analysis; Workloads
• ISSN: 1438-8871; 1438-8871
• DOI: 10.2196/jmir.1612

Health care systems increasingly rely on patients' data entry efforts to organize and assist in care delivery through health information exchange.
We sought to determine (1) the variation in burden imposed on parents by data entry efforts across paper-based and computer-based environments, and (2) the impact, if any, of parents' health literacy on the task burden.
We completed a randomized controlled trial of parent-completed data entry tasks. Parents of children with attention deficit hyperactivity disorder (ADHD) were randomized based on the Test of Functional Health Literacy in Adults (TOFHLA) to either a paper-based or computer-based environment for entry of health information on their children. The primary outcome was the National Aeronautics and Space Administration Task Load Index (TLX) total weighted score.
We screened 271 parents: 194 (71.6%) were eligible, and 180 of these (92.8%) constituted the study cohort. We analyzed 90 participants from each arm. Parents who completed information tasks on paper reported a higher task burden than those who worked in the computer environment: mean (SD) TLX scores were 22.8 (20.6) for paper and 16.3 (16.1) for computer. Assignment to the paper environment conferred a significant risk of higher task burden (F(1,178) = 4.05, P = .046). Adequate literacy was associated with lower task burden (decrease in burden score of 1.15 SD, P = .003). After adjusting for relevant child and parent factors, parents' TOFHLA score (beta = -.02, P = .02) and task environment (beta = .31, P = .03) remained significantly associated with task burden.
A tailored computer-based environment provided an improved task experience for data entry compared to the same tasks completed on paper. Health literacy was inversely related to task burden.