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Published in: Orphanet Journal of Rare Diseases 1/2017

Open Access 01-12-2017 | Research

Developing and evaluating rare disease educational materials co-created by expert clinicians and patients: the paradigm of congenital hypogonadotropic hypogonadism

Authors: Corin Badiu, Marco Bonomi, Ivan Borshchevsky, Martine Cools, Margarita Craen, Cristina Ghervan, Michael Hauschild, Eli Hershkovitz, Erik Hrabovszky, Anders Juul, Soo-Hyun Kim, Phillip Kumanov, Beatriz Lecumberri, Manuel C. Lemos, Vassos Neocleous, Marek Niedziela, Sandra Pekic Djurdjevic, Luca Persani, Franziska Phan-Hug, Duarte Pignatelli, Nelly Pitteloud, Vera Popovic, Richard Quinton, Nicos Skordis, Neil Smith, Magdalena Avbelj Stefanija, Cheng Xu, Jacques Young, Andrew A. Dwyer, COST Action BM1105

Published in: Orphanet Journal of Rare Diseases | Issue 1/2017

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Abstract

Background

Patients with rare diseases face health disparities and are often challenged to find accurate information about their condition. We aimed to use the best available evidence and community partnerships to produce patient education materials for congenital hypogonadotropic hypogonadism (CHH) and the olfacto-genital (Kallmann) syndrome (i.e., CHH and defective sense of smell), and to evaluate end-user acceptability. Expert clinicians, researchers and patients co-created the materials in a multi-step process. Six validated algorithms were used to assess reading level of the final product. Comprehensibility and actionability were measured using the Patient Education Materials Assessment Tool via web-based data collection. Descriptive statistics were employed to summarize data and thematic analysis for analyzing open-ended responses. Subsequently, translation and cultural adaption were conducted by clinicians and patients who are native speakers.

Results

Co-created patient education materials reached the target 6th grade reading level according to 2/6 (33%) algorithms (range: grade 5.9–9.7). The online survey received 164 hits in 2 months and 63/159 (40%) of eligible patients completed the evaluation. Patients ranged in age from 18 to 66 years (median 36, mean 39 ± 11) and 52/63 (83%), had adequate health literacy. Patients scored understandability at 94.2% and actionability at 90.5%. The patient education materials were culturally adapted and translated into 20 languages (available in Additional file 1).

Conclusions

Partnering with patients enabled us to create patient education materials that met patient- identified needs as evidenced by high end-user acceptability, understandability and actionability. The web-based evaluation was effective for reaching dispersed rare disease patients. Combining dissemination via traditional healthcare professional platforms as well as patient-centric sites can facilitate broad uptake of culturally adapted translations. This process may serve as a roadmap for creating patient education materials for other rare diseases.
Appendix
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Literature
1.
go back to reference EURORDIS. The voice of 12,000 patients: Experiences and expectations of rare disease patients on diagnosis and care in Europe. France: Boulogne-Billancourt; 2009. EURORDIS. The voice of 12,000 patients: Experiences and expectations of rare disease patients on diagnosis and care in Europe. France: Boulogne-Billancourt; 2009.
2.
go back to reference Holtzclaw Williams P. Policy framework for rare disease health disparities. Policy Polit Nurs Pract. 2011;12:114–8.CrossRefPubMed Holtzclaw Williams P. Policy framework for rare disease health disparities. Policy Polit Nurs Pract. 2011;12:114–8.CrossRefPubMed
3.
4.
go back to reference Ayme S, Kole A, Groft S. Empowerment of patients: lessons from the rare diseases community. Lancet. 2008;371:2048–51.CrossRefPubMed Ayme S, Kole A, Groft S. Empowerment of patients: lessons from the rare diseases community. Lancet. 2008;371:2048–51.CrossRefPubMed
5.
go back to reference Vicari S, Cappai F. Health activism and the logic of connective action. A case study of rare disease patient organisations. Inf Commun Soc. 2016;19:1653–71.CrossRefPubMedPubMedCentral Vicari S, Cappai F. Health activism and the logic of connective action. A case study of rare disease patient organisations. Inf Commun Soc. 2016;19:1653–71.CrossRefPubMedPubMedCentral
6.
go back to reference Sofolahan-Oladeinde Y, Mullins CD, Baquet CR. Using community-based participatory research in patient-centered outcomes research to address health disparities in under-represented communities. J Comp Effectiveness Res. 2015;4:515–23.CrossRef Sofolahan-Oladeinde Y, Mullins CD, Baquet CR. Using community-based participatory research in patient-centered outcomes research to address health disparities in under-represented communities. J Comp Effectiveness Res. 2015;4:515–23.CrossRef
7.
go back to reference Fromantin M, Gineste J, Didier A, Rouvier J. Impuberism and hypogonadism at induction into military service. Statistical study. Problemes Actuels d’Endocrinologie et de Nutr. 1973;16:179–99. Fromantin M, Gineste J, Didier A, Rouvier J. Impuberism and hypogonadism at induction into military service. Statistical study. Problemes Actuels d’Endocrinologie et de Nutr. 1973;16:179–99.
8.
go back to reference Boehm U, Bouloux PM, Dattani MT, de Roux N, Dode C, Dunkel L, Dwyer AA, Giacobini P, Hardelin JP, Juul A, et al. Expert consensus document: European Consensus Statement on congenital hypogonadotropic hypogonadism--pathogenesis, diagnosis and treatment. Nat Rev Endocrinol. 2015;11:547–64.PubMed Boehm U, Bouloux PM, Dattani MT, de Roux N, Dode C, Dunkel L, Dwyer AA, Giacobini P, Hardelin JP, Juul A, et al. Expert consensus document: European Consensus Statement on congenital hypogonadotropic hypogonadism--pathogenesis, diagnosis and treatment. Nat Rev Endocrinol. 2015;11:547–64.PubMed
10.
go back to reference Dwyer AA, Quinton R, Morin D, Pitteloud N. Identifying the unmet health needs of patients with congenital hypogonadotropic hypogonadism using a web-based needs assessment: implications for online interventions and peer-to-peer support. Orphanet J Rare Dis. 2014;9:83.CrossRefPubMedPubMedCentral Dwyer AA, Quinton R, Morin D, Pitteloud N. Identifying the unmet health needs of patients with congenital hypogonadotropic hypogonadism using a web-based needs assessment: implications for online interventions and peer-to-peer support. Orphanet J Rare Dis. 2014;9:83.CrossRefPubMedPubMedCentral
11.
go back to reference Crawford MJ, Rutter D, Manley C, Weaver T, Bhui K, Fulop N, Tyrer P. Systematic review of involving patients in the planning and development of health care. BMJ. 2002;325:1263.CrossRefPubMedPubMedCentral Crawford MJ, Rutter D, Manley C, Weaver T, Bhui K, Fulop N, Tyrer P. Systematic review of involving patients in the planning and development of health care. BMJ. 2002;325:1263.CrossRefPubMedPubMedCentral
12.
go back to reference Greenhalgh T, Jackson C, Shaw S, Janamian T. Achieving research impact through co-creation in community-based health services: literature review and case study. Milbank Q. 2016;94:392–429.CrossRefPubMedPubMedCentral Greenhalgh T, Jackson C, Shaw S, Janamian T. Achieving research impact through co-creation in community-based health services: literature review and case study. Milbank Q. 2016;94:392–429.CrossRefPubMedPubMedCentral
13.
go back to reference Wallerstein N, Duran B. Community-based participatory research contributions to intervention research: the intersection of science and practice to improve health equity. Am J Public Health. 2010;100 Suppl 1:S40–46.CrossRefPubMedPubMedCentral Wallerstein N, Duran B. Community-based participatory research contributions to intervention research: the intersection of science and practice to improve health equity. Am J Public Health. 2010;100 Suppl 1:S40–46.CrossRefPubMedPubMedCentral
16.
go back to reference Chew LD, Bradley KA, Boyko EJ. Brief questions to identify patients with inadequate health literacy. Fam Med. 2004;36:588–94.PubMed Chew LD, Bradley KA, Boyko EJ. Brief questions to identify patients with inadequate health literacy. Fam Med. 2004;36:588–94.PubMed
17.
go back to reference Chew LD, Griffin JM, Partin MR, Noorbaloochi S, Grill JP, Snyder A, Bradley KA, Nugent SM, Baines AD, Vanryn M. Validation of screening questions for limited health literacy in a large VA outpatient population. J Gen Intern Med. 2008;23:561–6.CrossRefPubMedPubMedCentral Chew LD, Griffin JM, Partin MR, Noorbaloochi S, Grill JP, Snyder A, Bradley KA, Nugent SM, Baines AD, Vanryn M. Validation of screening questions for limited health literacy in a large VA outpatient population. J Gen Intern Med. 2008;23:561–6.CrossRefPubMedPubMedCentral
18.
go back to reference Shoemaker SJ, Wolf MS, Brach C, (Prepared by Abt Associates IuCNHI: The Patient Education Materials Assessment Tool (PEMAT) and User’s Guide. In Book The Patient Education Materials Assessment Tool (PEMAT) and User’s Guide (Editor ed.^eds.). Maryland: Agency for Healthcare Research and Quality; 2013. Shoemaker SJ, Wolf MS, Brach C, (Prepared by Abt Associates IuCNHI: The Patient Education Materials Assessment Tool (PEMAT) and User’s Guide. In Book The Patient Education Materials Assessment Tool (PEMAT) and User’s Guide (Editor ed.^eds.). Maryland: Agency for Healthcare Research and Quality; 2013.
19.
go back to reference Shoemaker SJ, Wolf MS, Brach C. Development of the Patient Education Materials Assessment Tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information. Patient Educ Couns. 2014;96:395–403.CrossRefPubMedPubMedCentral Shoemaker SJ, Wolf MS, Brach C. Development of the Patient Education Materials Assessment Tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information. Patient Educ Couns. 2014;96:395–403.CrossRefPubMedPubMedCentral
20.
go back to reference Saldana J. Coding manual for qualitative researchers. Thousand Oaks, CA: Sage; 2009. Saldana J. Coding manual for qualitative researchers. Thousand Oaks, CA: Sage; 2009.
21.
go back to reference Safeer RS, Keenan J. Health literacy: the gap between physicians and patients. Am Fam Physician. 2005;72:463–8.PubMed Safeer RS, Keenan J. Health literacy: the gap between physicians and patients. Am Fam Physician. 2005;72:463–8.PubMed
22.
go back to reference Doak CC, Doak LG, Root JH. Teaching Patients with Low Literacy Skills. 2nd ed. Philadelphia, PA: J.B. Lippincott Company; 1996. Doak CC, Doak LG, Root JH. Teaching Patients with Low Literacy Skills. 2nd ed. Philadelphia, PA: J.B. Lippincott Company; 1996.
23.
go back to reference Bronstein MG, Kakkis ED. Patients as key partners in rare disease drug development. Nat Rev Drug Discov. 2016;15:731–2.CrossRefPubMed Bronstein MG, Kakkis ED. Patients as key partners in rare disease drug development. Nat Rev Drug Discov. 2016;15:731–2.CrossRefPubMed
24.
go back to reference Forsythe LP, Szydlowski V, Murad MH, Ip S, Wang Z, Elraiyah TA, Fleurence R, Hickam DH. A systematic review of approaches for engaging patients for research on rare diseases. J Gen Intern Med. 2014;29 Suppl 3:S788–800.CrossRefPubMed Forsythe LP, Szydlowski V, Murad MH, Ip S, Wang Z, Elraiyah TA, Fleurence R, Hickam DH. A systematic review of approaches for engaging patients for research on rare diseases. J Gen Intern Med. 2014;29 Suppl 3:S788–800.CrossRefPubMed
25.
go back to reference Hartzler A, Pratt W. Managing the personal side of health: how patient expertise differs from the expertise of clinicians. J Med Internet Res. 2011;13:e62.CrossRefPubMedPubMedCentral Hartzler A, Pratt W. Managing the personal side of health: how patient expertise differs from the expertise of clinicians. J Med Internet Res. 2011;13:e62.CrossRefPubMedPubMedCentral
26.
go back to reference Kauw D, Repping-Wuts H, Noordzij A, Stikkelbroeck N, Hermus A, Faber M. The contribution of online peer-to-peer communication among patients with adrenal disease to patient-centered care. J Med Internet Res. 2015;17:e54.CrossRefPubMedPubMedCentral Kauw D, Repping-Wuts H, Noordzij A, Stikkelbroeck N, Hermus A, Faber M. The contribution of online peer-to-peer communication among patients with adrenal disease to patient-centered care. J Med Internet Res. 2015;17:e54.CrossRefPubMedPubMedCentral
27.
go back to reference Kruer MC, Steiner RD. The role of evidence-based medicine and clinical trials in rare genetic disorders. Clin Genet. 2008;74:197–207.CrossRefPubMed Kruer MC, Steiner RD. The role of evidence-based medicine and clinical trials in rare genetic disorders. Clin Genet. 2008;74:197–207.CrossRefPubMed
28.
go back to reference Watson MS, Epstein C, Howell RR, Jones MC, Korf BR, McCabe ER, Simpson JL. Developing a national collaborative study system for rare genetic diseases. Genet Med. 2008;10:325–9.CrossRefPubMed Watson MS, Epstein C, Howell RR, Jones MC, Korf BR, McCabe ER, Simpson JL. Developing a national collaborative study system for rare genetic diseases. Genet Med. 2008;10:325–9.CrossRefPubMed
29.
go back to reference Fox S. Peer-to-peer healthcare: many people - especially those living with chronic or rare diseases - use online connections to supplement professional medical advice. Washington, D.C.: Pew Internet; 2011. Fox S. Peer-to-peer healthcare: many people - especially those living with chronic or rare diseases - use online connections to supplement professional medical advice. Washington, D.C.: Pew Internet; 2011.
30.
go back to reference Nambisan P, Nambisan S. Models of consumer value cocreation in health care. Health Care Manag Rev. 2009;34:344–54.CrossRef Nambisan P, Nambisan S. Models of consumer value cocreation in health care. Health Care Manag Rev. 2009;34:344–54.CrossRef
31.
go back to reference (EUCERD) EUCoEoRD: Recommendations on quality criteria for centres of expertise for rare diseases in member states. In: Book Recommendations on Quality Criteria for Centres of Expertise for Rare Diseases in Member States (Editor ed.^eds.). City; 2011. (EUCERD) EUCoEoRD: Recommendations on quality criteria for centres of expertise for rare diseases in member states. In: Book Recommendations on Quality Criteria for Centres of Expertise for Rare Diseases in Member States (Editor ed.^eds.). City; 2011.
32.
go back to reference Diseases EUCoEoR. Recommendations to the European Commission and the Member States on European Reference Networks for Rare Diseases. 2013. Diseases EUCoEoR. Recommendations to the European Commission and the Member States on European Reference Networks for Rare Diseases. 2013.
34.
go back to reference Sung NS, Crowley Jr WF, Genel M, Salber P, Sandy L, Sherwood LM, Johnson SB, Catanese V, Tilson H, Getz K, et al. Central challenges facing the national clinical research enterprise. JAMA. 2003;289:1278–87.CrossRefPubMed Sung NS, Crowley Jr WF, Genel M, Salber P, Sandy L, Sherwood LM, Johnson SB, Catanese V, Tilson H, Getz K, et al. Central challenges facing the national clinical research enterprise. JAMA. 2003;289:1278–87.CrossRefPubMed
35.
go back to reference Thornicroft G, Lempp H, Tansella M. The place of implementation science in the translational medicine continuum. Psychol Med. 2011;41:2015–21.CrossRefPubMed Thornicroft G, Lempp H, Tansella M. The place of implementation science in the translational medicine continuum. Psychol Med. 2011;41:2015–21.CrossRefPubMed
36.
go back to reference Bellgarda MI, Sleemanc MW, Guerrerod FD, Fletcher S, Baynam G, Goldblatt J, Rubinstein Y, Bell C, Groft S, Barreroa R, et al. Rare disease research roadmap: navigating the bioinformatics and translational challenges for improved patient health outcomes. Health Policy Technol. 2014;3:325–35.CrossRef Bellgarda MI, Sleemanc MW, Guerrerod FD, Fletcher S, Baynam G, Goldblatt J, Rubinstein Y, Bell C, Groft S, Barreroa R, et al. Rare disease research roadmap: navigating the bioinformatics and translational challenges for improved patient health outcomes. Health Policy Technol. 2014;3:325–35.CrossRef
Metadata
Title
Developing and evaluating rare disease educational materials co-created by expert clinicians and patients: the paradigm of congenital hypogonadotropic hypogonadism
Authors
Corin Badiu
Marco Bonomi
Ivan Borshchevsky
Martine Cools
Margarita Craen
Cristina Ghervan
Michael Hauschild
Eli Hershkovitz
Erik Hrabovszky
Anders Juul
Soo-Hyun Kim
Phillip Kumanov
Beatriz Lecumberri
Manuel C. Lemos
Vassos Neocleous
Marek Niedziela
Sandra Pekic Djurdjevic
Luca Persani
Franziska Phan-Hug
Duarte Pignatelli
Nelly Pitteloud
Vera Popovic
Richard Quinton
Nicos Skordis
Neil Smith
Magdalena Avbelj Stefanija
Cheng Xu
Jacques Young
Andrew A. Dwyer
COST Action BM1105
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Orphanet Journal of Rare Diseases / Issue 1/2017
Electronic ISSN: 1750-1172
DOI
https://doi.org/10.1186/s13023-017-0608-2

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