Age Differences In Responding To Graphically Conveyed Health Risk Information

摘要

Patient portals to Electronic Health Records (EHR) have thernpotential to revolutionize patient-centered care by providingrnpatients ready access to their health information.rnUnfortunately, portals are underutilized because they arerndifficult to use, especially by older adults with low healthrnliteracy (Czaja et al., 2015). Health literacy, the degree tornwhich individuals have the capacity to obtain, process, andrnunderstand basic health information and services needed tornmake appropriate health decisions (Ratzan & Parker, 2000),rntends to decline with age in part because of age-relatedrndeclines in processing capacity (e.g., working memoryrncapacity, Barrington & Yoder-Wise, 2006; Chin et al., 2011).rnEHR patient portals function out of a secure online websiternthat gives patients 24-hour access to personal healthrninformation from anywhere with an Internet connection.rnIdeally, they enable health organizations to enhance patientproviderrncommunication, empower patients, support carernbetween visits, and, most importantly, improve patientrnoutcomes. In reality, limited use of patient portals byrnvulnerable populations is a critical health care problem. Anrnimportant barrier to effective use is comprehension of portalbasedrnnumeric information, especially by patients with limitedrnhealth literacy and numeracy abilities. Therefore, an importantrnchallenge is to design (numeric) health information in portalsrnto be easier to understand and use. This involves reducingrndemands on age-vulnerable abilities (e.g., numeracy,rnprocessing capacity) and leveraging age-related strengths suchrnas knowledge (e.g., about language and health; Beier &rnAckerman, 2005) and affective processing because affectiverngoals (e.g., focusing on positive emotions in order to selfregulaternemotion) becomes more important with age (Reed &rnCarstensen, 2012). According to Fuzzy Trace Theory,rnunderstanding and using numeric information involvesrndeveloping gist-based representations of the meaning of therninformation (e.g., risk is higher or lower) in addition tornverbatim representations of the numbers (Reyna & Brainerd,rn1995). Older adults may be adept at gist-based understandingrnbecause gist is often grounded in knowledge of the domainrn(health) and organized in terms of affective distinctions.rnUnfortunately, portal-based numeric information such asrnclinical test results is often presented with little context tornsupport gist-based processing (Morrow et al., 2017). In thisrnstudy, we investigated whether older and younger adults canrndevelop gist-based representations of risk from test resultrninformation that is presented in graphically enhanced formatsrnthat provide context for gist comprehension.