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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.155648v1 99/12/2188    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Neuhauser, L. Articles by Konishi, S. PubMed PubMed Citation Articles by Neuhauser, L. Articles by Konishi, S. Related Collections Aging Disability Access to Care Health Education Other Race/Ethnicity Qualitative Research

Linda Neuhauser, DrPH, Beccah Rothschild, MPA, Carrie Graham, PhD, MGS, Susan L. Ivey, MD, MHSA and Susana Konishi, MA

All authors are with the School of Public Health, University of California, Berkeley.

Correspondence: Correspondence can be sent to Linda Neuhauser, DrPH, Community Health and Human Development Department, School of Public Health, 50 Warren Hall, MC7360, University of California, Berkeley, CA 94720-7360 (e-mail: lindan{at}berkeley.edu). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We used participatory design methods to develop and test guidebooks about health care choices intended for 600 000 English-, Spanish-, and Chinese-speaking seniors and people with disabilities receiving Medicaid in California.

Methods. Design and testing processes were conducted with consumers and professionals; they included 24 advisory group interviews, 36 usability tests, 18 focus groups (105 participants), 51 key informant interviews, guidebook readability and suitability testing, linguistic adaptation, and iterative revisions of 4 prototypes.

Results. Participatory design processes identified preferences of intended audiences for guidebook content, linguistic adaptation, and format; guidebook readability was scored at the sixth- to eighth-grade level and suitability at 95%. These findings informed the design of a separate efficacy study that showed high guidebook usage and satisfaction, and better gains in knowledge, confidence, and intended behaviors among intervention participants than among control participants.

Conclusions. Participatory design can be used effectively in mass communication to inform vulnerable audiences of health care choices. The techniques described can be adapted for a broad range of health communication interventions.