Samuel G. Smith|Christian von Wagner|Lesley McGregor|Laura M. Curtis|Elizabeth A. Wilson|Marina Serper|Michael S. Wolf
The Influence of Health Literacy on Comprehension of a Colonoscopy Preparation Information Leaflet
University College London|University College London|University College London|Northwestern University|Northwestern University
successful bowel preparation important safe efficacious costeffective colonoscopy procedures however poor preparation commonwe sought determine whether association health literacy comprehension typical written instructions prepare colonoscopy enable targeted interventions areathis crosssectional observational studythis study performed primary care clinics federally qualified health centers chicago illinoisseven hundred sixtyfour participants mean age 63 years sd 542 recruited sample mixed sociodemographic background 719 participants classified adequate health literacy scoresseven hundred sixtyfour participants presented information leaflet outlining bowel preparatory instructions colonoscopyfive questions used assess participants comprehension instructions open book testcomprehension scores bowel preparation items low mean number items correctly answered 32 sd 12 possible 5 comprehension scores overall individual item differed significantly health literacy level p 0001 controlling sex age race socioeconomic status previous colonoscopy experience multivariable model health literacy significant predictor comprehension inadequate vs adequate 02 p 0001 marginal vs adequate 02 p 0001the outcome represents simulated task actual comprehension preparation instructions participants recommended behaviorcomprehension written colonoscopy preparation leaflet generally low significantly lower among people low health literacy poor comprehension implications safety economic impact gastroenterological procedures colonoscopy therefore future interventions aim improve comprehension complex medical information reducing literacyrelated barriers