Page 215 - THE DUTCH TALKING TOUCH SCREEN QUESTIONNAIRE
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During all future evaluation studies, researchers should avoid giving assistance and encouragements to participants completing a TT questionnaire in order to avoid interviewer bias, increase transparency of data collection and do justice to the goal of supporting patients in taking on an active mutual-partnered role in provider-patient interaction. Furthermore, the quality of usability studies can be increased by incorporating technology for eye tracking and monitoring of use of buttons and functions, as well as recording completion time of sections of a questionnaire and the questionnaire as a whole, into TTs. The TSTI method [4] proved to be a very useful and thorough method to test usability as well as validity of TT questionnaires in research populations that include participants with low functional health literacy. When TSTI research into a TT questionnaire shows satisfactory outcomes on validity, a next step in the validation process can be taken by applying quantitative research using Item Response Theory [58] to create representative data, without the need for participants to fill out an additional questionnaire as a ‘gold standard’.
The current research project has confirmed what has been earlier described about how hard it is to recruit and include hard-to-reach patient populations [35]. The researchers of the current project have been able to include vulnerable members of the target populations in all of the studies presented in this thesis. They were able to do so by carefully choosing suitable data collection methods and using physical therapists as intermediaries for recruitment of eligible patients and training them in recognizing and communicating with people with low functional health literacy. Training physical therapists in recognizing low functional health literacy in people was necessary because, at the beginning of the current research project in 2010, apart from the Dutch version of the Set of Brief Screening Questions [59], Dutch versions of Health Literacy Assessment tools were not available and the awareness of clinicians about the meaning and ramifications of low functional health literacy was not yet widespread. A lot has changed in these aspects in the past eight years. Physiotherapists, not least the ones that participated within this research project, are very much aware that there are people with low functional health literacy among their patient populations. In theory, it should be easier to identify them because of the increasing availability of feasible Dutch versions of good quality functional health literacy assessment tools such as the Dutch versions of the Short Assessment of Health
General discussion
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