TY - JOUR
T1 - Communication of benefits and harms in shared decision making with patients with limited health literacy
T2 - A systematic review of risk communication strategies
AU - Richter, Romy
AU - Jansen, Jesse
AU - Bongaerts, Iris
AU - Damman, Olga
AU - Rademakers, Jany
AU - van der Weijden, Trudy
N1 - Funding Information:
This project was funded by The Netherlands Organisation for Health Research and Development (ZonMw, project number: 10060011910007). We thank the medical students Celine Vilters, Fleur Pouwels and Wais Abbaspoor who supported this work.
Funding Information:
This project was funded by The Netherlands Organisation for Health Research and Development (ZonMw, project number: 10060011910007 ). We thank the medical students Celine Vilters , Fleur Pouwels and Wais Abbaspoor who supported this work.
Publisher Copyright:
© 2023 The Authors
PY - 2023/11/1
Y1 - 2023/11/1
N2 - Objectives: Risk communication (RC), as part of shared decision making, is challenging with people with limited health literacy (LHL). We aim to provide an overview of strategies to communicate benefits and harms of diagnostic and treatment options to this group. Methods: We systematically searched PubMed, Embase, Cinahl and PsycInfo. We included 28 studies on RC in informed/shared decision making without restriction to a health setting or condition and using a broad conceptualization of health literacy. Two researchers independently selected studies and one researcher performed data extraction. We descriptively compared findings for people with LHL towards recommendations for RC. Results: Health literacy levels varied in the included studies. Most studies used experimental designs, primarily on visual RC. Findings show verbal RC alone should be avoided. Framing of risk information influences risk perception (less risky when positively framed, riskier when negatively framed). Most studies recommended the use of icon arrays. Graph literacy should be considered when using visual RC. Conclusions: The limited available evidence suggests that recommended RC strategies seem mainly to be valid for people with LHL, but more research is required. Practice implications: More qualitative research involving people with LHL is needed to gain further in-depth insights into optimal RC strategies. Protocol registration: PROSPERO ID 275022
AB - Objectives: Risk communication (RC), as part of shared decision making, is challenging with people with limited health literacy (LHL). We aim to provide an overview of strategies to communicate benefits and harms of diagnostic and treatment options to this group. Methods: We systematically searched PubMed, Embase, Cinahl and PsycInfo. We included 28 studies on RC in informed/shared decision making without restriction to a health setting or condition and using a broad conceptualization of health literacy. Two researchers independently selected studies and one researcher performed data extraction. We descriptively compared findings for people with LHL towards recommendations for RC. Results: Health literacy levels varied in the included studies. Most studies used experimental designs, primarily on visual RC. Findings show verbal RC alone should be avoided. Framing of risk information influences risk perception (less risky when positively framed, riskier when negatively framed). Most studies recommended the use of icon arrays. Graph literacy should be considered when using visual RC. Conclusions: The limited available evidence suggests that recommended RC strategies seem mainly to be valid for people with LHL, but more research is required. Practice implications: More qualitative research involving people with LHL is needed to gain further in-depth insights into optimal RC strategies. Protocol registration: PROSPERO ID 275022
KW - Limited health literacy
KW - Risk communication
KW - Shared decision making
U2 - 10.1016/j.pec.2023.107944
DO - 10.1016/j.pec.2023.107944
M3 - (Systematic) Review article
SN - 0738-3991
VL - 116
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 1
M1 - 107944
ER -