A Video-Based Intervention for Increasing Health Literacy in Total Joint Arthroplasty Patients at a Safety-Net Hospital: A Prospective Single-Blind Cohort Study

Background

Health literacy is a major determinant of health outcomes, with low literacy correlated with increased risk of postoperative complications and lower patient-reported outcomes. This study sought to increase health literacy in a subset of Los Angeles County patients who would be undergoing total joint arthroplasty (TJA) using a video-based intervention.

Methods

We enrolled 51 patients scheduled to undergo TJA. The first 26 patients were allocated into the prevideo group who underwent the typical preoperative visit, and the next 25 patients were enrolled into the video-intervention (postvideo) group.

Results

No differences in baseline health literacy based on the Newest Vital Sign survey were noted between the groups (1.88 ± 1.90 vs 1.28 ± 1.24; P = .94). Higher knowledge scores regarding arthritis and TJA were seen in the postvideo group (71.52 ± 24.50 vs 54.92 ± 26.93; P = .01). This finding was consistent in primary Spanish speakers (66.40 ± 24.51 vs 49.60 ± 24.93; P = .04). There were no differences in preoperative anxiety and information requirement between the groups (16.00 ± 6.21 vs 16.88 ± 6.27; P = .31). The total low literacy version of the Decisional Conflict Scale score utilized to quantify patients’ decisional conflict in the setting of TJA were not different between the groups (11.44 ± 14.32 vs 10.40 ± 15.41; P = .40).

Conclusions

Patient knowledge about arthritis and TJA significantly improved as measured by the modified arthritis knowledge survey in the postvideo group compared to a discussion with their surgeon.