Danielle M Muscat1, Heather L Shepherd2, Suzanne Morony1, Sian K Smith3, Haryana M Dhillon4, Lyndal Trevena1, Andrew Hayen5, Karen Luxford6, Don Nutbeam7, Kirsten McCaffery8. 1. The Screening and Test Evaluation Program (STEP), Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), Sydney School of Public Health, The University of Sydney, NSW, Australia. 2. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), Sydney School of Public Health, The University of Sydney, NSW, Australia; Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, NSW, Australia. 3. Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, NSW, Australia. 4. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), Concord Clinical School, The University of Sydney, NSW, Australia; School of Psychology, The University of Sydney, NSW, Australia. 5. School of Public Health and Community Medicine, University of New South Wales, NSW, Australia. 6. Patient-based care, Clinical Excellence Commission, NSW, Australia. 7. Office of the Vice Chancellor, University of Southampton, Southampton, UK. 8. The Screening and Test Evaluation Program (STEP), Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), Sydney School of Public Health, The University of Sydney, NSW, Australia. Electronic address: kirsten.mccaffery@sydney.edu.au.
Abstract
OBJECTIVE: Participation in shared decision-making (SDM) may be difficult for adults with lower literacy. Tools to support consumers to engage in SDM are rarely designed for or evaluated with adults with lower literacy and/or poor English language. METHODS: Qualitative interviews were conducted with 26 adults with lower literacy and/or poor English language skills to investigate (a) whether participants where able to read and understand two generic SDM consumer support tools (Smart Health Choices and AskShareKnow question-sets), (b) which question-set was easier for participants and, (c) perceived usefulness of the question-sets and barriers to use. Interviews were analysed using Framework Analysis. RESULTS: Participants had difficulties understanding terms embedded within both the AskShareKnow and Smart Health Choices questions. Our findings suggest that the AskShareKnow question-set was easier for our participants than the Smart Health Choices questions, and clarification using a structured response was reasonably effective. While participants appreciated the usefulness of the questions, they identified important barriers to use. CONCLUSIONS: Generic question-sets alone are not sufficient to support SDM for adults with lower literacy and/or poor English-language skills. PRACTICE IMPLICATIONS: To ensure that SDM is accessible to all, we must consider how best to support adults with low literacy and/or poor English-language skills to participate in this process.
OBJECTIVE: Participation in shared decision-making (SDM) may be difficult for adults with lower literacy. Tools to support consumers to engage in SDM are rarely designed for or evaluated with adults with lower literacy and/or poor English language. METHODS: Qualitative interviews were conducted with 26 adults with lower literacy and/or poor English language skills to investigate (a) whether participants where able to read and understand two generic SDM consumer support tools (Smart Health Choices and AskShareKnow question-sets), (b) which question-set was easier for participants and, (c) perceived usefulness of the question-sets and barriers to use. Interviews were analysed using Framework Analysis. RESULTS:Participants had difficulties understanding terms embedded within both the AskShareKnow and Smart Health Choices questions. Our findings suggest that the AskShareKnow question-set was easier for our participants than the Smart Health Choices questions, and clarification using a structured response was reasonably effective. While participants appreciated the usefulness of the questions, they identified important barriers to use. CONCLUSIONS: Generic question-sets alone are not sufficient to support SDM for adults with lower literacy and/or poor English-language skills. PRACTICE IMPLICATIONS: To ensure that SDM is accessible to all, we must consider how best to support adults with low literacy and/or poor English-language skills to participate in this process.
Authors: Michèle Dugas; Marie-Ève Trottier; Selma Chipenda Dansokho; Gratianne Vaisson; Thierry Provencher; Heather Colquhoun; Maman Joyce Dogba; Sophie Dupéré; Angela Fagerlin; Anik M C Giguere; Lynne Haslett; Aubri S Hoffman; Noah M Ivers; France Légaré; Jean Légaré; Carrie A Levin; Matthew Menear; Jean-Sébastien Renaud; Dawn Stacey; Robert J Volk; Holly O Witteman Journal: BMC Med Inform Decis Mak Date: 2017-01-19 Impact factor: 2.796
Authors: Danielle M Muscat; Heather L Shepherd; Don Nutbeam; Suzanne Morony; Sian K Smith; Haryana M Dhillon; Lyndal Trevenal; Andrew Hayen; Karen Luxford; Kirsten McCaffery Journal: Health Lit Res Pract Date: 2017-12-11
Authors: Christine M Gunn; Ariel Maschke; Michael K Paasche-Orlow; Nancy R Kressin; Mara A Schonberg; Tracy A Battaglia Journal: J Gen Intern Med Date: 2020-09-15 Impact factor: 5.128
Authors: Marguerite Clare Tracy; Heather L Shepherd; Pinika Patel; Lyndal Jane Trevena Journal: J Med Internet Res Date: 2020-05-29 Impact factor: 5.428