Rebecca L. Sudore|C. Seth Landefeld|Deborah E. Barnes|Karla Lindquist|Brie Williams|Robert V. Brody|Dean Schillinger
An advance directive redesigned to meet the literacy level of most adults: A randomized trial
San Francisco VA Medical Center|University of California, San Francisco|San Francisco VA Medical Center|University of California, San Francisco|San Francisco VA Medical Center|University of California, San Francisco|San Francisco VA Medical Center|University of California, San Francisco|San Francisco VA Medical Center|University of California, San Francisco|San Francisco General Hospital|University of California, San Francisco|San Francisco General Hospital|University of California, San Francisco
determine whether advance directive redesigned meet adults literacy needs fifth grade reading level graphics useful advance care planning standard form 12th grade level enrolled 205 english spanishspeaking patients aged 50 years urban general medicine clinic randomized participants review either form main outcomes included acceptability usefulness advance care planning participants reviewed alternate form assessed form preference sixmonth completion rates forty percent enrolled participants limited literacy compared standard form redesigned form rated higher acceptability usefulness care planning p 003 particularly limited literacy participants p interaction 007 redesigned form preferred 73 participants participants randomized redesigned form completed advance directive six months 19 vs 8 p 003 95 completed redesigned form redesigned advance directive rated acceptable useful advance care planning preferred standard form also resulted higher sixmonth completion rates advance directive redesigned meet adults literacy needs may better enable patients engage advance care planning