Do hospital consent forms for cardiology procedures meet health literacy standards? Evaluation of understandability and readability

Peiris, Ruwani; Cornell, Samuel; Greaves, Kim; Bonner, Carissa

doi:10.1016/j.pec.2021.08.027

Cited by 11 publications

(10 citation statements)

References 20 publications

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“…Current decision support materials available to consumers considering coronary artery calcium scoring do not meet the criteria to enable informed decision-making and do not meet the health literacy needs of the general population. This echoes similar issues identified within cardiology procedure consent forms [ 31 ]. Clinical guidelines that include CAC scans for primary prevention must be supported by best-practice decision aids to support patient decision-making about this issue.…”

Section: Discussionsupporting

confidence: 66%

“…The mean understandability and actionability scores (68% and 48%, respectively) can be compared to our previous findings about patient education materials and decision aids for related conditions. On average, the materials in this study have poor understandability and actionability, scoring slightly higher than the mean understandability score for online CVD risk calculators (64%/19%) [ 34 ], hospital consent forms for cardiology procedures (62%-understandability only) [ 31 ], and online heart failure information (56%/35%) [ 45 ], but considerably lower than online decision aids for primary CVD prevention (87%/61%) [ 33 ]. In line with our findings in this current study, reading grade levels of decision aids and other patient materials in comparable studies were also consistently higher than recommended [ 33 , 34 , 45 ], demonstrating a widespread failure to comply with the principles of universal health literacy precautions [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

“…Health literacy needs can be met using evidence-based methods to present probabilities about CVD risk, the benefits and harms of tests and prevention options, and associated uncertainties [ 30 ]. Prior reviews show that existing CVD prevention tools and cardiology procedure consent forms [ 31 ] do not meet international standards for patient decision aids [ 32 ] or universal precaution principles for health-literate design [ 33 , 34 ].…”

Section: Introductionmentioning

confidence: 99%

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Decision Support Tools for Coronary Artery Calcium Scoring in the Primary Prevention of Cardiovascular Disease Do Not Meet Health Literacy Needs: A Systematic Environmental Scan and Evaluation

McKinn

Batcup

Cornell

et al. 2022

IJERPH

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A shared decision-making approach is considered optimal in primary cardiovascular disease (CVD) prevention. Evidence-based patient decision aids can facilitate this but do not always meet patients’ health literacy needs. Coronary artery calcium (CAC) scans are increasingly used in addition to traditional cardiovascular risk scores, but the availability of high-quality decision aids to support shared decision-making is unknown. We used an environmental scan methodology to review decision support for CAC scans and assess their suitability for patients with varying health literacy. We systematically searched for freely available web-based decision support tools that included information about CAC scans for primary CVD prevention and were aimed at the public. Eligible materials were independently evaluated using validated tools to assess qualification as a decision aid, understandability, actionability, and readability. We identified 13 eligible materials. Of those, only one qualified as a decision aid, and one item presented quantitative information about the potential harms of CAC scans. None presented quantitative information about both benefits and harms of CAC scans. Mean understandability was 68%, and actionability was 48%. Mean readability (12.8) was much higher than the recommended grade 8 level. Terms used for CAC scans were highly variable. Current materials available to people considering a CAC scan do not meet the criteria to enable informed decision-making, nor do they meet the health literacy needs of the general population. Clinical guidelines, including CAC scans for primary prevention, must be supported by best practice decision aids to support decision-making.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Decision Support Tools for Coronary Artery Calcium Scoring in the Primary Prevention of Cardiovascular Disease Do Not Meet Health Literacy Needs: A Systematic Environmental Scan and Evaluation

McKinn

Batcup

Cornell

et al. 2022

IJERPH

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“…It is important to consider the availability of high-quality, clear and understandable information for people with CVD, as the burden of disease is greater for people with low health literacy. Additionally, some cardiac patients may be feeling unwell, be in pain, feel fatigued and/or be emotionally distressed during this time, which may acutely impact their health literacy [78]. A study of publicly available online CVD primary prevention decision aids (n=25) found that the aids were understandable but only had moderate actionability and high readability level beyond the literacy levels of the general population [69].…”

Section: Visual Materialsmentioning

confidence: 99%

Information Needs and Communication Strategies for People with Coronary Heart Disease: A Scoping Review

Zwack¹,

Smith²,

Poulsen³

et al. 2022

Preprint

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A critical aspect of coronary heart disease (CHD) care and secondary prevention is ensuring patients have access to evidence-based information. The purpose of this review is to summarise the guiding principles, content, context and timing of information and education that is beneficial for supporting people with CHD and potential communication strategies including digital interventions. We conducted a scoping review involving searching four databases (Web of Science, PubMed, CINAHL, Medline) for articles published from January 2000 to August 2022. Literature was identified through title and abstract screening by expert reviewers. Evidence was synthesised according to the review aims. Results demonstrated that information-sharing, decision-making, goal-setting, positivity and practicality are important aspects of secondary prevention and should be patient-centred and evidenced based with consideration of patient need and preference. Initiation and duration of education is highly variable between and within people, but hence communication and support should be regular and ongoing. In conclusion, text messaging programs, smartphone applications and wearable devices are examples of digital health strategies that facilitate education and support for patients with heart disease. There is no one size fits all approach that suits all patients at all stages and hence flexibility and a suite of resources and strategies is optimal.

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“…Los estudios muestran el análisis actualmente utilizando estas herramientas para analizar la legibilidad de la información en salud, de patologías tratamientos, consentimientos informados, folletos de salud etc., siguen coincidiendo en que la información disponible está a un nivel de lectura superior al recomendado, considerándose como ilegibles (Abdi et al 2021;Behmer et al, 2020;Bompastore et al, 2018;Corcoran y Ahmad, 2016;Bompastores et al, 2018;Ostrovsky , 2022;Kecojevic et al, 2020;Moore y Milar, 2021;Peiris et al, 2021;Stefu et al, 2021;Stavropoulou-Tatla et al, 2022;Willian et al, 2022).…”

Section: Introductionunclassified

Análisis de la legibilidad de la información sanitaria dirigida a la población vulnerable

Piris¹

2022

RevPropul

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El presente estudio evalúa la calidad de los materiales educativos en salud dirigidos a los usuarios/as migrantes, facilitados por organismos públicos, y disponibles en internet, con el fin de favorecer los autocuidados respecto a su salud, mediante un estudio observacional descriptivo, en el que se identifican páginas web de salud de organismos oficiales para población inmigrante, mediante el uso del motor de búsqueda Google. Tras analizarse las características interactivas de las webs seleccionadas, y del total de documentos disponibles, se evalúa la legibilidad del contenido con el analizador MU y la comprensión y usabilidad con la Herramienta de Evaluación de Materiales de Educación del Paciente (PEMAT), por observadores. Como resultados se obtiene que las páginas webs de organismos oficiales para inmigrantes, son precisas, con credibilidad, avaladas por fuentes y accesibles, pero dichas webs y el material del que disponían no estaban actualizados. La media de legibilidad de los documentos en castellano fue de 49,10 (DT=6,61); para los documentos en francés de 51,87 (DT=8,58) y los documentos en inglés 64,57 (DT=8,73). La puntuación promedio de comprensión PEMAT fue de 68,69 (DT=16,95) y de capacidad de acción 54,41 (DT= 24,26). Se concluye que los materiales educativos en salud no alcanzaron una calidad óptima. El nivel de lectura está por encima del promedio de un adulto, por lo que hay que hacer esfuerzos para mejorar la comprensión y usabilidad de los textos, así como contar con el público diana para la elaboración de materiales de educación sanitaria.

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Do hospital consent forms for cardiology procedures meet health literacy standards? Evaluation of understandability and readability

Cited by 11 publications

References 20 publications

Decision Support Tools for Coronary Artery Calcium Scoring in the Primary Prevention of Cardiovascular Disease Do Not Meet Health Literacy Needs: A Systematic Environmental Scan and Evaluation

Decision Support Tools for Coronary Artery Calcium Scoring in the Primary Prevention of Cardiovascular Disease Do Not Meet Health Literacy Needs: A Systematic Environmental Scan and Evaluation

Information Needs and Communication Strategies for People with Coronary Heart Disease: A Scoping Review

Análisis de la legibilidad de la información sanitaria dirigida a la población vulnerable

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