Merging health literacy with computer technology: Self-managing diet and fluid intake among adult hemodialysis patients

Welch, Janet L.; Siek, Katie A.; Connelly, Kay H.; Astroth, Kim S.; McManus, M. Sue; Scott, Linda; Heo, Seongkum; Kraus, Michael A.

doi:10.1016/j.pec.2009.08.016

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Volume 79, Issue 2 , Pages 192-198, May 2010

Merging health literacy with computer technology: Self-managing diet and fluid intake among adult hemodialysis patients

Janet L. Welch
- School of Nursing, Indiana University, Indianapolis, IN, USA
- Corresponding author at: Indiana University School of Nursing, 1111 Middle Drive, NU 408, Indianapolis, IN 46202, USA. Tel.: +1 317 274 8091; fax: +1 317 278 1856.
Katie A. Siek
- Department of Computer Science, University of Colorado at Boulder, Boulder, CO, USA
Kay H. Connelly
- Computer Science Department, Indiana University, Bloomington, IN, USA
Kim S. Astroth
- Mennonite College of Nursing, Illinois State University, Normal, IL, USA
M. Sue McManus
- School of Nursing, Indiana University, Indianapolis, IN, USA
Linda Scott
- School of Nursing, Indiana University, Indianapolis, IN, USA
Seongkum Heo
- School of Nursing, Indiana University, Indianapolis, IN, USA
Michael A. Kraus
- Medical School and Clarian Health Partners, Indiana University, Indianapolis, IN, USA

Received 10 March 2009; received in revised form 20 August 2009; accepted 27 August 2009. published online 05 October 2009.

Abstract

Objective

The Dietary Intake Monitoring Application (DIMA) is an electronic dietary self-monitor developed for use on a personal digital assistant (PDA). This paper describes how computer, information, numerical, and visual literacy were considered in development of DIMA.

Methods

An iterative, participatory design approach was used. Forty individuals receiving hemodialysis at an urban inner-city facility, primarily middle-aged and African American, were recruited.

Results

Computer literacy was considered by assessing abilities to complete traditional/nontraditional PDA tasks. Information literacy was enhanced by including a Universal-Product-Code (UPC) scanner, picture icons for food with no UPC code, voice recorder, and culturally sensitive food icons. Numerical literacy was enhanced by designing DIMA to compute real-time totals that allowed individuals to see their consumption relative to their dietary prescription. Visual literacy was considered by designing the graphical interface to convey intake data over a 24-h period that could be accurately interpreted by patients. Pictorial icons for feedback graphs used objects understood by patients.

Practice implications

Preliminary data indicate the application is extremely helpful for individuals as they self-monitor their intake. If desired, DIMA could also be used for dietary counseling.

Keywords: Informatics, Self-management, Hemodialysis, Health literacy