Tools For Advancing Pharmacy Practice
Promoting health communication between the community-dwelling well-elderly and pharmacists: The Ask Me 3 program

https://doi.org/10.1331/JAPhA.2008.07073Get rights and content

Objective

To describe readiness to use clear health communication principles with a pharmacist before and after participating in the Ask Me 3 (What is my main problem?, What do I need to do?, Why is it important for me to do this?) program.

Design

Modified, separate-sample, pretest–posttest study.

Setting

Senior centers in Polk County, IA, between March 2006 and February 2007.

Participants

106 community-dwelling well-elderly.

Intervention

Information on demographic characteristics, regularity of health care and medication use, health literacy level, and a measurement of multidimensional health locus of control were collected from participants, who were then were randomly allocated to one of three assessment subgroups: (1) pretest–posttest, (2) pretest only, and (3) posttest only during each of 12 Ask Me 3 program educational sessions.

Main outcome measure

Readiness to use the seven principles of clear health communication described in the Ask Me 3 program.

Results

Participants were predominantly women and white, had a high school education or higher, had a yearly income of $25,000 or less, and had a mean age of 75.1 years. A majority reported good to excellent health status and visited their physician two or more times per year. All took medications regularly for a medical problem. A minority had inadequate to marginal health literacy. Before the Ask Me 3 program, a majority reported planning to or actively asking their pharmacist (1) for help with questions about their medications (88.2%), (2) to explain how to take their medication (82.6%), (3) to describe the main problem for which their medication is being prescribed (78.6%), and (4) to describe what can happen if they don't take their medication (74.3%). Approximately one-half of participants (55.2%) made a list of health or medication concerns to tell their pharmacist. A minority brought a list of current medications (47.8%) or brought a friend or family member to help when visiting their pharmacist (27.9%). A significantly higher proportion of participants reported planning to or actively bringing a list of current medications when visiting the pharmacist (P ≤ 0.025) after participating in the Ask Me 3 program. Increases were not statistically significant for the remaining principles.

Conclusion

The Ask Me 3 program is a practical tool that creates awareness and reinforces principles of clear health communication. The Ask Me 3 program should be evaluated in diverse pharmacy and health care settings with patients at high risk for poor health communication.

Section snippets

Objective

To date, no reports have been published in the peer-reviewed literature on the effectiveness of the Ask Me 3 program in promoting patients' use of the principles of clear health communication with their pharmacist. Therefore, this study sought to evaluate the impact of a live Ask Me 3 educational program on participants' readiness to use the seven principles of clear health communication when communicating with their pharmacist. A sample of community-dwelling well-elderly participants from Polk

Methods

Using available Ask Me 3 educational materials from the Partnership for Clear Health Communication,9,10 a standardized presentation focusing on clear health communication was provided on 12 separate occasions to community-dwelling well-elderly participants in Polk County, IA, by study investigators (M.J.M. and M.A.C.). The presentation explained barriers to health communication and offered recommendations to improve health communication using the principles of the Ask Me 3 program. For this

Background characteristics

Data were collected on 118 participants. Four participants were excluded due to ineligibility or protocol deviations. Eight participants did not report regular medication use and therefore were not included in the final analytical sample of 106.

The overall study sample had a mean (±SD) age of 75.1 ±  years, was predominantly women (67.0%) and white (77.5%), had an income of $25,000 or less (72.5%), and had at least a high school education or equivalent (80.2%) (Table 1).

A majority of participants

Discussion

Findings from the first reported evaluation of the Ask Me 3 program in the pharmacy-relevant environment are reported here. The only other published evaluation of the Ask Me 3 program was reported in a Hispanic pediatric outpatient practice, in which 41.5% (n = 163 of 393) of patients reported hearing about the Ask Me 3 program and, of those, 50.3% (n = 82 of 163) reported using the program 6 months after implementation, which equated to an overall usage rate of approximately 20.9% (n = 82 of

Limitations

Practical evaluation studies in realistic settings often pose considerable obstacles and threats to internal validity. Measurement concerns, sample size accrual, and generalizability can also be problematic.

In this study, a modified pretest–posttest design was used to mitigate three key threats to internal validity.14 The one sample pretest–posttest analysis controlled only for selection and mortality concerns, while the separate sample pretest–posttest analyses controlled for pretest

Conclusion

The Ask Me 3 program is a practical tool used to create awareness and reinforce principles of clear health communication. A comprehensive effort should be made to further expand the evaluation of the Ask Me 3 program in diverse pharmacy and health care settings with patients at high risk for poor health communication.

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    Disclosure: Dr. Abrams has received support from Wellmark Foundation to implement the Ask Me 3 program at the Iowa Health System and has received an unrestricted educational grant as a Pfizer Visiting Professorship in Health Literacy/Clear Health Communication. The other authors declare no conflicts of interest or financial interests in any product or service mentioned in this article, including grants, employment, gifts, stock holdings, or honoraria.

    Funding: Polk County Senior Services provided $10 gift cards to study participants.

    Previous presentation: Presented in part at the American Pharmacists Association Annual Meeting and Exposition, March 16–19, 2007, Atlanta, GA.

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