Effects of a pain self-management intervention combining written and video elements on health-related quality of life among people with different levels of education

Abstract

Combining written and video material could increase the impact of health education for people with less education, but more evidence is needed about the impact of combined materials in different formats, especially in the context of chronic pain self-management. This study tested the impact of combining written information about self-managing chronic joint pain, which used language at a high reading level, with a DVD containing narrative video material presented directly by patients, using language at a lower reading level. Physical and mental health-related quality of life (36-Item Short Form Health Survey) was measured among 107 men with hemophilia before and 6 months after being randomly assigned to receive an information booklet alone or the booklet plus the DVD. Analysis of covariance was used to compare health outcomes between randomized groups at follow-up, using the baseline measures as covariates, with stratified analyses for groups with different levels of education. The DVD significantly improved mental health-related quality of life among those with only high school education. Video material could therefore supplement written information to increase its impact on groups with less education, and combined interventions of this type could help to achieve health benefits for disadvantaged groups who are most in need of intervention.

Video abstract

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Keywords:

• DVD
• hemophilia
• video intervention

Acknowledgments

We are very grateful to all the participants in the study; to Tom Bradley and the staff of the Haemophilia Society for undertaking the study mailings; to Ian Kelso, director and producer, and Mark Sydserff, video editor, for production of the DVD; to Bill, Robert, Chris, Jack, and Richard, who featured in the DVD; and to John Morris and Georgina Morrison for their collaboration in the project on which this study builds. We are also grateful to the journal reviewers for their helpful comments on a previous draft.

Disclosure

This work was supported by the Haemophilia Society UK and the Institute for Health Policy and Research, London Metropolitan University. Baxter and Bayer Healthcare also made small contributions to the costs of the DVD production. The authors report no other conflicts of interest in this work.