Investigators in NYU Langone’s Division of General Pediatrics have made significant achievements in creating and promoting health literacy interventions to prevent medication errors and obesity, and improve chronic disease management.

The laboratory of Shonna (Hsiang) Yin, MD, MS, studies health literacy as a key factor related to adverse child health outcomes and poverty-associated health disparities. Dr. Yin’s team focuses on the development, implementation, evaluation, and dissemination of health literacy–informed interventions to improve parents’ ability to understand and act on health information. The team’s work has spanned three main areas: medication safety, early childhood obesity prevention, and asthma management.

Medication Safety

Dr. Yin serves as principal investigator of several studies examining health literacy–informed interventions to promote safe parent medication use. As part of the National Institutes of Health (NIH)–funded SAFE Rx for Kids (Safe Administration for Every Rx for Kids) R01 study, the team identified specific attributes of medication labels and dosing tools that could be optimized to reduce errors, such as units of measurement, pictograms, and tool design (type, markings, and size). An emergency department–randomized controlled trial testing a comprehensive prescription labeling and dosing strategy is underway. Findings have been used to inform national labeling and dosing standards.

As part of the HELPix (Health Education and Literacy for Parents pictogram) Project, the team is studying a low-literacy tool to enhance provider medication counseling, which includes bilingual and pictographic medication instruction sheets, demonstration/teach-back, and oral syringe provision. An emergency department–randomized controlled trial efficacy study demonstrated large reductions in dosing errors and improved adherence. A subsequent pre- and post-implementation effectiveness study found similar reductions in errors.

HELPix has been cited as a model for delivery of quality clinical care by The Joint Commission. The work is now expanding to the neonatal intensive care unit (NICU) setting and the prevention of medication errors in this high-risk population after discharge. In 2017, Dr. Yin received the Institute for Safe Medication Practices Cheers Award in recognition of the importance of the team’s research in medication safety.

Early Childhood Obesity Prevention

For the past 10 years, Dr. Yin has served as a co-principal investigator of a multisite NIH–funded R01 study to develop and test a low-literacy and numeracy-focused intervention to prevent early childhood obesity. Known as the Greenlight Intervention Study, the aim is to promote healthy lifestyles and prevent obesity among young children in under-resourced communities. Greenlight includes a toolkit for pediatric healthcare providers to use with families during well-child visits beginning in the first months of life, as well as “tangible tools” such as portion-size snack cups to reinforce healthy messages. Healthcare providers are also trained in communication strategies including teach-back and goal-setting.

Dr. Yin is also co-principal investigator of a new multisite grant funded by the Patient-Centered Outcomes Research Institute (PCORI) to look at the comparative effectiveness of Greenlight versus a technology-enhanced version of Greenlight, which supports tailored goal-setting by parents in between well-child visits.

Asthma Management

Dr. Yin is also leading efforts to develop and pilot test the efficacy of a low-literacy, pictogram- and photograph-based, web-accessible asthma action plan support tool for providers and parents.

For more information, please reach out to Dr. Yin’s team at hsiang.yin@nyulangone.org. The Yin laboratory welcomes pre- and postdoctoral students, medical students, fellows, junior faculty, and other faculty to join the team in formal and informal collaborations. Volunteers as well as students interested in doing electives, concentrations, or yearlong experiences should contact Dr. Yin at the email above.