11/12/2018 IHSI
“I owe a great debt to the many older adults in the community who have participated in my research. They not only help us test our ideas, but provide many insights from their experiences managing the impact of chronic illness on their daily lives.”
Written by IHSI
Daniel Morrow, PhD, is chair and professor in the Department of Educational Psychology in the university's College of Education. His work focuses on the effect of health literacy on positive self-care behaviors in older adults with chronic illnesses.
What is your research in health disparities about?
I investigate the contribution of health literacy to differences in health behaviors and outcomes among older adults with chronic illness. My focus has been on the impact of health literacy on understanding and remembering information needed for self-care, and more recently on risk perception and intentions to perform self-care behaviors such as taking medication. More generally, I am interested in designing health information for older adults with diverse abilities, such as medication instructions, clinical test results, and explanations of chronic illness. This is especially important in the context of health technology. Innovations such as patient portals to electronic record systems have the potential to revolutionize health care delivery for everyone, but if they are not designed for patients, they can end up magnifying rather than reducing health disparities.
How are you conducting your research?
My colleagues and I take an interdisciplinary approach, drawing on the behavioral sciences, health sciences, and engineering sciences. Our starting point is often the health sciences to identify important problems: What are key challenges for older adults’ self-care (e.g., complex medication and diet regimens) and what information and support do older adults need to succeed? Can we help older adults meet those challenges by improving health care processes? Our approach to addressing these problems draws on behavioral science theories (e.g., related to learning and behavior change) to identify processes underlying adherence or other self-care behaviors that are related to health literacy (comprehension, memory, decision making) and how health literacy influences these processes. Such studies guide redesign of health education to help older adults make decisions about self-care. This redesign often involves technology, so I work closely with my colleagues in the engineering sciences at this stage. For example, I am working with Mark Hasegawa-Johnson, Tom Huang, Suma Bhat, and their students to develop computer agents to support collaboration between older adults and their providers (e.g., through patient portals).
We use a mixed methods approach in our research, from lab experiments with quantitative measures to analyze sources of self-care problems related to health literacy, to evaluating interventions under more or less controlled conditions (e.g., randomized field trials). At every step, we also rely on more qualitative measures such as patient feedback about interventions.
How does being a part of the Illinois community support and enhance your research?
Illinois provides wonderful opportunities and resources for interdisciplinary research related to the health sciences. This kind of work is a natural fit with the Beckman Institute, where I conduct my research. Beckman is a magnet for faculty and students from the behavioral/social, health, and engineering sciences who want to work on important problems. I also benefit from clinicians from Carle, OSF, and other healthcare organizations who are keenly interested in translational interdisciplinary work to improve healthcare delivery. Just as important, I owe a great debt to the many older adults in the community who have participated in my research. They not only help us test our ideas, but provide many insights from their experiences managing the impact of chronic illness on their daily lives. They are never short on stories and suggestions!
Do you have a personal story to share or path that led to your interest in this area of study?
My interest in managing medications stems in part from my parents’ struggles to handle an increasing load of daily medications as they grew older and had to cope with chronic illness. It was pretty obvious they did not always get the help they needed from their providers to plan how to take all these medications effectively, even though they had the advantage of education and associated resources. My own experience as a patient is also important, for example, struggling to make sense of things like test results provided through my patient portal.