Research Projects

We are currently working on three major topics, Health Literacy, MedTable and Electronic Medical Records(EMR) Systems. For each topic, we have different projects investigating multiple aspects of the topic. Please click on the project page for more information.

The broad goals of the project are to improve self-care (such taking medications) and health outcomes among older adults. Older adults with chronic illnesses such as hypertension (high blood pressure) often have less effective health literacy skills than younger adults do. Health literacy is defined at the ability to access, understand, and use information to make effective health care decisions, and is often measured by your ability to read lists or health-related words or to understand brief health-related texts such as medication instructions. Many earlier studies have shown that older adults with lower health literacy skills tend to have poorer self-care and health outcomes, but we don’t know why. We are investigating how low health literacy undermines health outcomes. The first step is to better understand what abilities are involved in health literacy is and how they influence comprehension of health information. We have three specific goals:

The first goal is to identify health literacy abilities by examining how performance on measures of health literacy depend on general cognitive abilities such as short-term memory or attention, as well as knowledge about health care. 

Selected Publications:
Chin, J., Morrow, D. G., Stine-Morrow, E. A. L., Conner- Garcia, T., Graumlich, J. F., & Murray, M. D. (2011). The Process-Knowledge Model of Health Literacy: Evidence from a Componential Analysis of Two Commonly Used Measures.Journal of Health Communication, 16, 222-241.

The second goal is to investigate if these abilities influence how well patients understand, remember, and make decisions about medication instructions related to hypertension.  This will help explain why patients with low health literacy have trouble understanding information needed for their self-care. 

Selected Publications:
Chin, J., Payne, B.R., Stine-Morrow, E. A.L., Morrow, D. G., Gao, X., Conner-Garcia, T., Graumlich, J. F. & Murray, M. D. (2012). The effects of domain-general and health knowledge on sentence processing and recall among older adults. Poster at the Cognitive Aging Conference 2012, Atlanta, GA. [pdf]
Chin, J., Stine-Morrow, E. A.L., Morrow, D. G., Gao, X., Conner-Garcia, T., Graumlich, J. F. & Murray, M. D. (2011). The effects of domain general and health knowledge in processing general and health texts among older adults with hypertension. In Proceedings of the 53rd Annual Meeting of the Human Factors and Ergonomics Society 2011. San Antonio, TX: Human Factors and Ergonomics Society.

Our third goal is to investigate how to design texts, such as using multimedia information, that help lower literacy patients understand health information, despite their cognitive and knowledge limits.

Selected Publications:
D'Andrea, L.; Kopren, K.; Chin, J.; Shake, M.; Morrow, D. G.; Stine-Morrow, E. A. L.; Bertel, S.; Conner-Garcia, T.; Graumlich, J.; Murray, M. D. (2010). Impact of Health Knowledge on Older Adults' Comprehension of Multimedia Health Information. Proceedings of the Human Factors and Ergonomics Society 54th Annual Meeting. Human Factors & Ergonomics Society: Santa Monica.

Other relevant projects:
Reading habits and health literacy

 [Click here for more information about these projects]

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MedtableTM is an Electronic Medical Record (EMR)-integrated tool designed to address the significant problem of medication nonadherence, especially barriers related to patients’ limited cognitive resources and ineffective patient-provider communication. MedtableTM supports the patient-provider collaboration needed to create effective medication schedules that are easy to implement by diverse patients. The tool builds on prior research and, through its integration with EMR systems, creates medication lists and schedules that are more easily updated, more accurate and more reliable. Used in clinical practice, it is expected to improve patient satisfaction, medication understanding and adherence, as well as health outcomes among patients struggling to manage multiple medications.

Representative Publications:
Liao, Q., Chin, C., McKeever, S., Kopren, K., Morrow, D. G., Davis, K., Wilson, E.A.H., Kaiser, D., Wolf, M., Conner-Garcia, T., & Graumlich, J. F. (2011). MedtableTM: An EMR-Based Tool to Support Collaborative Planning for Medication Use. Proceedings of the 55th Annual Meeting of the Human Factors and Ergonomics Society 2011. Las Vegas, NV: Human Factors and Ergonomics Society.

The goal of this project is to evaluate how a new EMR system influences clinician communication, information management, and decision-making related to patient care at Carle Clinic. The study involves a pre-implementation and post-implementation phase.  Prior to implementation, we will analyze how physicians, nurses, and office staff manage information needed for patient care goals (e.g., diagnosis, developing and monitoring treatment plans) as these goals are accomplished through typical clinic activities (patient scheduling, office visits with patient-physician consultation; patient referral and follow-up) in the current clinic environment. Interviews with key clinicians and surveys will guide an observational study designed to measure the amount of time clinicians devote to different patient care activities and to managing information related to these activities.  The interview and observational measures will be supplemented by self-report measures of clinician workload and perceived timeliness of care related to information management, as well as measures derived from the EMR systems (e.g. frequency of sending clinical messages).

 [Click here for more Information about this project]

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Expertise and Aging in Pilot Performance
Dr. Morrow is investigating conditions under which pilot expertise helps offset age-related declines in cognitive abilities, so that older pilots maintain high levels of performance on piloting tasks related to communication, comprehension, and decision-making. We find that expertise is most likely to mitigate age declines when the task provides domain-relevant environmental support for pilots, such as taking notes while listening to complex Air Traffic Control messages.

Representative Publications:
Morrow, D. G.; Miller, L. M. S.; Ridolfo, H. E.; Magnor, C.; Fischer, U. M.; Kokayeff, N. K.; Stine-Morrow, E. A. L. (2009)/ Expertise and age differences in pilot decision making. Aging, Cognition, & Neuropsychology, 16, 33-35.

Morrow, D.G., Menard, W., Ridolfo, H., Sanborn, A., Stine-Morrow, E.A.L., Magnor, C., Herman, L., Teller, T., and Bryant, D. (2003), Environmental Support Promotes Expertise-based Mitigation of Age Differences on Pilot Communication Tasks. Psychology and Aging, 18, 268-284.

Prospective Memory Intervention to Improve Medication Adherence

    Collaborator: Dr. Kathleen Insel at the University of Arizona 
    [Details in progress]

Human-Automation Relationship Taxonomy

    Collaborator: Dr. Frank Durso from the Georgia Institute of Technology.
    [Details in progress]