vs 61.1 , mean difference 23.3 , p = 0.031 ) , adult clinical observation domain ( mean I : C ; 73.3 vs. 58.0 , mean difference 10.9 , p = 0.02 ) and health information domain ( mean I : C ; 63.6 vs. 56.1 , mean difference 6.8 , p = 0.01 .