Development and field testing of a consumer shared decision-making training program for adults with low literacy

Abstract

A c c e p t e d M a n u s c r i p t Highlights  We developed a comprehensive consumer SDM training program for adults with low literacy for delivery in education settings. The program aims to improve SDM knowledge, skills and self-efficacy.  Consumer input was fundamental in our iterative development process. *Highlights (for review)Page 2 of 34 A c c e p t e d M a n u s c r i p t as a means to engage in SDM during healthcare interactions. Conclusions:There is an ethical imperative to develop SDM interventions for adults with lower literacy. Generic training programs delivered direct-to-consumers in adult education settings offer promise in a national and international environment where too few initiatives exist.Practice implications: Formative evaluation of the program offers practical insights into developing consumer-focused SDM training. The content of the program can be used as a guide for future efforts to engage consumers in SDM.

Shared Decision Making in the Emergency Department Among Patients With Limited Health Literacy: Beyond Slower and Louder

“…The resources needed to adequately prepare this vulnerable population to effectively and equitably participate in the SDM process in outpatient studies has been considerable, requiring six hours, in one study. 74 These resources and time are not typically available in the rapid-paced ED setting, and in the setting of acute illness or cognitive impairment would likely require even more resources and time. The question of how best to involve our patients to the degree that they are able and prefer is an important one and underpins all the other SDM research foci in this patient population.…”

Qualitative insights into the experience of teaching shared decision making within adult education health literacy programmes for lower‐literacy learners

“…We developed a novel SDM training programme for adults with lower literacy to develop communicative and critical health literacy skills . The programme was delivered in Australian adult basic education settings in 2014 by trained adult educators as a core component of a broader health literacy programme and was evaluated as a cluster‐randomized controlled trial .…”

“…13 We developed a novel SDM training programme for adults with lower literacy to develop communicative and critical health literacy skills. 14 The programme was delivered in Australian adult basic education settings in 2014 by trained adult educators as a core component of a broader health literacy programme and was evaluated as a cluster-randomized controlled trial. 15 An exploratory qualitative substudy was conducted with adult educators who participated in the trial to explore views and experiences of teaching health literacy skills (including SDM) and determine whether the programme is contextually appropriate and sufficiently tailored to learner needs, and teaching and institutional objectives.…”

Health communication in science, teaching and clinical practice: Selected papers from the Amsterdam EACH 2014 Conference

“…For example, adult patients with lower literacy often have greater difficulty in understanding complex medical problems and may experience a greater power imbalance between the doctor and themselves. Muscat et al [2] discuss the creation of a SDM intervention, developed for adult low literacy patients. While it takes two to tango in medical consultations, as we learned from Charles et al [3], the authors shift the focus to patient education, providing an intervention that allows patients to take a more active role in SDM.…”