The Evidence-Based Development of an Intervention to Improve Clinical Health Literacy Practice
Low health literacy is an issue with high prevalence in the UK and internationally. It has a social gradient with higher prevalence in lower social groups and is linked with higher rates of long-term health conditions, lower self-rated health, and greater difficulty self-managing long-term health co...
Main Authors: | , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2020-02-01
|
Series: | International Journal of Environmental Research and Public Health |
Subjects: | |
Online Access: | https://www.mdpi.com/1660-4601/17/5/1513 |
id |
doaj-2cacb642e167477499dfcbcb3f6d1ea8 |
---|---|
record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gill Rowlands Bimasal Tabassum Paul Campbell Sandy Harvey Anu Vaittinen Lynne Stobbart Richard Thomson Mandy Wardle-McLeish Joanne Protheroe |
spellingShingle |
Gill Rowlands Bimasal Tabassum Paul Campbell Sandy Harvey Anu Vaittinen Lynne Stobbart Richard Thomson Mandy Wardle-McLeish Joanne Protheroe The Evidence-Based Development of an Intervention to Improve Clinical Health Literacy Practice International Journal of Environmental Research and Public Health health literacy intervention primary care feasibility study |
author_facet |
Gill Rowlands Bimasal Tabassum Paul Campbell Sandy Harvey Anu Vaittinen Lynne Stobbart Richard Thomson Mandy Wardle-McLeish Joanne Protheroe |
author_sort |
Gill Rowlands |
title |
The Evidence-Based Development of an Intervention to Improve Clinical Health Literacy Practice |
title_short |
The Evidence-Based Development of an Intervention to Improve Clinical Health Literacy Practice |
title_full |
The Evidence-Based Development of an Intervention to Improve Clinical Health Literacy Practice |
title_fullStr |
The Evidence-Based Development of an Intervention to Improve Clinical Health Literacy Practice |
title_full_unstemmed |
The Evidence-Based Development of an Intervention to Improve Clinical Health Literacy Practice |
title_sort |
evidence-based development of an intervention to improve clinical health literacy practice |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1660-4601 |
publishDate |
2020-02-01 |
description |
Low health literacy is an issue with high prevalence in the UK and internationally. It has a social gradient with higher prevalence in lower social groups and is linked with higher rates of long-term health conditions, lower self-rated health, and greater difficulty self-managing long-term health conditions. Improved medical services and practitioner awareness of a patient’s health literacy can help to address these issues. An intervention was developed to improve General Practitioner and Practice Nurse health literacy skills and practice. A feasibility study was undertaken to examine and improve the elements of the intervention. The intervention had two parts: educating primary care doctors and nurses about identifying and enhancing health literacy (patient capacity to get hold of, understand and apply information for health) to improve their health literacy practice, and implementation of on-screen ‘pop-up’ notifications that alerted General Practitioners (GPs) and nurses when seeing a patient at risk of low health literacy. Rapid reviews of the literature were undertaken to optimise the intervention. Four General Practices were recruited, and the intervention was then applied to doctors and nurses through training followed by alerts via the practice clinical IT system. After the intervention, focus groups were held with participating practitioners and a patient and carer group to further develop the intervention. The rapid literature reviews identified (i) key elements for effectiveness of doctors and nurse training including multi-component training, role-play, learner reflection, and identification of barriers to changing practice and (ii) key elements for effectiveness of alerts on clinical computer systems including ‘stand-alone’ notification, automatically generated and prominent display of advice, linkage with practitioner education, and use of notifications within a targeted environment. The findings from the post-hoc focus groups indicated that practitioner awareness and skills had improved as a result of the training and that the clinical alerts reminded them to incorporate this into their clinical practice. Suggested improvements to the training included more information on health literacy and how the clinical alerts were generated, and more practical role playing including initiating discussions on health literacy with patients. It was suggested that the wording of the clinical alert be improved to emphasise its purpose in improving practitioner skills. The feasibility study improved the intervention, increasing its potential usefulness and acceptability in clinical practice. Future studies will explore the impact on clinical care through a pilot and a randomised controlled trial. |
topic |
health literacy intervention primary care feasibility study |
url |
https://www.mdpi.com/1660-4601/17/5/1513 |
work_keys_str_mv |
AT gillrowlands theevidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT bimasaltabassum theevidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT paulcampbell theevidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT sandyharvey theevidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT anuvaittinen theevidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT lynnestobbart theevidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT richardthomson theevidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT mandywardlemcleish theevidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT joanneprotheroe theevidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT gillrowlands evidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT bimasaltabassum evidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT paulcampbell evidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT sandyharvey evidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT anuvaittinen evidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT lynnestobbart evidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT richardthomson evidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT mandywardlemcleish evidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice AT joanneprotheroe evidencebaseddevelopmentofaninterventiontoimproveclinicalhealthliteracypractice |
_version_ |
1725868033005584384 |
spelling |
doaj-2cacb642e167477499dfcbcb3f6d1ea82020-11-24T21:54:16ZengMDPI AGInternational Journal of Environmental Research and Public Health1660-46012020-02-01175151310.3390/ijerph17051513ijerph17051513The Evidence-Based Development of an Intervention to Improve Clinical Health Literacy PracticeGill Rowlands0Bimasal Tabassum1Paul Campbell2Sandy Harvey3Anu Vaittinen4Lynne Stobbart5Richard Thomson6Mandy Wardle-McLeish7Joanne Protheroe8Population Health Sciences Institute, Baddiley Clark Buildig, Newcastle University, Newcastle upon Tyne NE2 4AX, UKPopulation Health Sciences Institute, Baddiley Clark Buildig, Newcastle University, Newcastle upon Tyne NE2 4AX, UKFaculty of Medicine and Health Sciences, Keele University, Staffordshire ST5 5BG, UKPatient Research Ambassador, (North East and North Cumbria) and Voice Research Advisor, Voice, Newcastle upon Tyne NE1 4BF, UKPopulation Health Sciences Institute, Baddiley Clark Buildig, Newcastle University, Newcastle upon Tyne NE2 4AX, UKPopulation Health Sciences Institute, Baddiley Clark Buildig, Newcastle University, Newcastle upon Tyne NE2 4AX, UKPopulation Health Sciences Institute, Baddiley Clark Buildig, Newcastle University, Newcastle upon Tyne NE2 4AX, UKCommunity Health and Learning Foundation, currently Reaching People, 15 Wellington Street, Leicester LE1 6HH, UKFaculty of Medicine and Health Sciences, Keele University, Staffordshire ST5 5BG, UKLow health literacy is an issue with high prevalence in the UK and internationally. It has a social gradient with higher prevalence in lower social groups and is linked with higher rates of long-term health conditions, lower self-rated health, and greater difficulty self-managing long-term health conditions. Improved medical services and practitioner awareness of a patient’s health literacy can help to address these issues. An intervention was developed to improve General Practitioner and Practice Nurse health literacy skills and practice. A feasibility study was undertaken to examine and improve the elements of the intervention. The intervention had two parts: educating primary care doctors and nurses about identifying and enhancing health literacy (patient capacity to get hold of, understand and apply information for health) to improve their health literacy practice, and implementation of on-screen ‘pop-up’ notifications that alerted General Practitioners (GPs) and nurses when seeing a patient at risk of low health literacy. Rapid reviews of the literature were undertaken to optimise the intervention. Four General Practices were recruited, and the intervention was then applied to doctors and nurses through training followed by alerts via the practice clinical IT system. After the intervention, focus groups were held with participating practitioners and a patient and carer group to further develop the intervention. The rapid literature reviews identified (i) key elements for effectiveness of doctors and nurse training including multi-component training, role-play, learner reflection, and identification of barriers to changing practice and (ii) key elements for effectiveness of alerts on clinical computer systems including ‘stand-alone’ notification, automatically generated and prominent display of advice, linkage with practitioner education, and use of notifications within a targeted environment. The findings from the post-hoc focus groups indicated that practitioner awareness and skills had improved as a result of the training and that the clinical alerts reminded them to incorporate this into their clinical practice. Suggested improvements to the training included more information on health literacy and how the clinical alerts were generated, and more practical role playing including initiating discussions on health literacy with patients. It was suggested that the wording of the clinical alert be improved to emphasise its purpose in improving practitioner skills. The feasibility study improved the intervention, increasing its potential usefulness and acceptability in clinical practice. Future studies will explore the impact on clinical care through a pilot and a randomised controlled trial.https://www.mdpi.com/1660-4601/17/5/1513health literacyinterventionprimary carefeasibility study |