Physician notification of their diabetes patients’ limited health literacy: A randomized, controlled trial

Seligman, Hilary K.; Wang, Frances F.; Palácios, Jorge; Wilson, Clifford; Daher, Carolyn; Piette, John D.; Schillinger, Dean

doi:10.1111/j.1525-1497.2005.00189.x

Cited by 124 publications

(115 citation statements)

References 58 publications

(67 reference statements)

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“…(26) By convention, scores ≤ 22 (approximately < 9 th grade reading level) were defined as limited literacy, and scores > 22 as adequate literacy. (27) Participants were randomized using a random number generator, stratified by literacy level (adequate or limited), to either first review and attempt to complete a standard California advance directive or the redesigned advance directive. Assignment was concealed in opaque envelopes.…”

Section: Randomizationmentioning

confidence: 99%

An advance directive redesigned to meet the literacy level of most adults: A randomized trial

Sudore

Landefeld

Barnes

et al. 2007

Patient Education and Counseling

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120

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Objective-To determine whether an advance directive redesigned to meet most adults' literacy needs (5 th grade reading level with graphics) was more useful for advance care planning than a standard form (>12 th grade level).Methods-We enrolled 205 English and Spanish-speaking patients, aged ≥ 50 years from an urban, general medicine clinic. We randomized participants to review either form. Main outcomes included acceptability and usefulness in advance care planning. Participants then reviewed the alternate form; we assessed form preference and six-month completion rates.Results-40% of enrolled participants had limited literacy. Compared to the standard form, the redesigned form was rated higher for acceptability and usefulness in care planning, P≤0.03, particularly for limited literacy participants (P for interaction ≤ 0.07). The redesigned form was preferred by 73% of participants. More participants randomized to the redesigned form completed an advance directive at six months (19% vs. 8%, P=0.03); of these, 95% completed the redesigned form.Conclusions-The redesigned advance directive was rated more acceptable and useful for advance care planning and was preferred over a standard form. It also resulted in higher six month completion rates.Practice Implications-An advance directive redesigned to meet most adults' literacy needs may better enable patients to engage in advance care planning.

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Section: Randomizationmentioning

confidence: 99%

An advance directive redesigned to meet the literacy level of most adults: A randomized trial

Sudore

Landefeld

Barnes

et al. 2007

Patient Education and Counseling

Self Cite

120

182

View full text Add to dashboard Cite

show abstract

“…26 Portanto, muitos advogam que o LS deva ser adequadamente avaliado para identificar os pacientes com maior risco para desfechos clínicos inadequados. 28 Considerando que o manejo bem sucedido de muitas doenças agudas e crônicas é influenciado pelo entendimento das informações de saúde, oferecer suporte adicional aos indivíduos que possam apresentar dificuldade em entender estas informações, possivelmente, influenciará nos desfechos clínicos.…”

Section: Introductionunclassified

Health Literacy: Importance of assessment in nephrology

Santos¹,

Mansur²,

Paiva³

et al. 2012

Jornal Brasileiro De Nefrologia

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“…Other studies also indicate that patients are willing to divulge their literacy status and consider it to be important clinical information. 44,45 Of course, as with any condition discovered in a physician's offi ce, limited health literacy should be kept confi dential.Self-rated reading ability, highest education level attained, and the SILS result can each provide clinicians with valuable information about a patient's learning needs. Clinicians are advised to be aware of these associations and know what questions can help them identify patients who may need assistance with navigating the health care system or understanding healthrelated materials.…”

mentioning

confidence: 99%

Screening Questions to Predict Limited Health Literacy: A Cross-Sectional Study of Patients With Diabetes Mellitus

Jeppesen¹,

Coyle²,

Miser³

2009

The Annals of Family Medicine

113

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PURPOSE Limited health literacy is increasingly recognized as a barrier to receiving adequate health care. Identifying patients at risk of poor health outcomes secondary to limited health literacy is currently the responsibility of clinicians. Our objective was to identify which screening questions and demographics independently predict limited health literacy and could thus help clinicians individualize their patient education. METHODSBetween August 2006 and July 2007, we asked 225 patients being treated for diabetes at an academic primary care offi ce several questions regarding their reading ability as part of a larger study (57% response rate). We built a logistic regression model predicting limited health literacy to determine the independent predictive properties of these questions and demographic variables. Patients were classifi ed as having limited health literacy if they had a Short Test of Functional Health Literacy in Adults (S-TOFHLA) score of less than 23. The potential predictors evaluated were self-rated reading ability, highest education level attained, Single-Item Literacy Screener (SILS) result, patients' reading enjoyment, age, sex, and race.RESULTS Overall, 15.1% of the patients had limited health literacy. In the fi nal model, 5 of the potential predictors were independently associated with increased odds of having limited health literacy. Specifi cally, patients were more likely to have limited health literacy if they had a poorer self-rated reading ability (odds ratio [OR] per point increase in the model = 3.37; 95% confi dence interval [CI], 1.71-6.63), more frequently needed help reading written health materials (assessed by the SILS) (OR = 2.03; 95% CI, 1.26-3.26), had a lower education level (OR = 1.89; 95% CI, 1.12-3.18), were male (OR = 4.46; 95% CI, 1.53-12.99), and were of nonwhite race (OR = 3.73; 95% CI, 1.04-13.40). These associations were not confounded by age. The area under the receiver operating characteristic curve was 0.9212. CONCLUSIONS Self-rated reading ability, SILS result, highest education level attained, sex, and race independently predict whether a patient has limited health literacy. Clinicians should be aware of these associations and ask questions to identify patients at risk. We propose an "SOS" mnemonic based on these fi ndings to help clinicians wishing to individualize patient education. 17 Not all of these associations have been found with perfect consistency, however. [18][19][20] We refer the interested reader to larger literature reviews and summary analyses for a more comprehensive look at the effects of literacy on health-related outcomes. 21,22 Interventions exist to aid persons with limited health literacy. Simplifying instruction forms is an effective means of ensuring better comprehension for entire patient populations. [23][24][25] Patients' health care teams may be of assistance by providing simplifi ed education and ensuring that patients understand and retain what is being said. [26][27][28] Although the use of such strategies should ...

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Physician notification of their diabetes patients’ limited health literacy: A randomized, controlled trial

Cited by 124 publications

References 58 publications

An advance directive redesigned to meet the literacy level of most adults: A randomized trial

An advance directive redesigned to meet the literacy level of most adults: A randomized trial

Health Literacy: Importance of assessment in nephrology

Screening Questions to Predict Limited Health Literacy: A Cross-Sectional Study of Patients With Diabetes Mellitus

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