Kirsten McCaffery|Margaret Holmes?Rovner|Sian K Smith|David R. Rovner|Don Nutbeam|Marla L. Clayman|Karen Kelly?Blake|Michael S. Wolf|Stacey Sheridan
Addressing health literacy in patient decision aids
University of Sydney|Michigan State University|UNSW Sydney|Prince of Wales Hospital|Michigan State University|University of Southampton|Northwestern University|Michigan State University|Northwestern University|University of North Carolina at Chapel Hill
effective use patient decision aid ptda affected users health literacy ptdas characteristics systematic reviews relevant literature guide ptda developers attend health literacy needs patients reviews reported aimed assess 1 effects health literacy numeracy selected decisionmaking outcomes b effects interventions designed mitigate influence lower health literacy decisionmaking outcomes 2 extent existing ptdas account health literacy b tested lower health literacy populations reviewed literature evidence relevant two aims highquality systematic reviews existed summarized evidence reviews unavailable conducted systematic reviews aim 1 existing systematic review ptda trials lower health literacy associated lower patient health knowledge 14 16 eligible studies fourteen studies reported practical design strategies improve knowledge lower health literacy patients systematic review studies reported values clarity per se 2 lower health literacy related higher decisional uncertainty regret lower health literacy associated less desire involvement 3 studies less questionasking 2 less patientcentered communication 4 studies effects measures patient involvement mixed one study assessed effects health literacy intervention outcomes showed using video improve salience health states reduced decisional uncertainty aim 2 review 97 trials 3 ptdas overtly addressed needs lower health literacy users 90 trials user health literacy readability ptda reported however increases knowledge informed choice reported studies health literacy needs addressed lower health literacy affects key decisionmaking outcomes existing ptdas addressed needs lower health literacy users specific effects ptdas designed mitigate influence low health literacy unknown attention needs patients lower health literacy indicated ensure ptdas appropriate lower well higher health literacy patients