Abstract
BackgroundIt has been suggested that health literacy may impact the use of decision aids (DAs) among patients facing difficult decisions. Embedded in the pilot test of a questionnaire, this study aimed to measure the association between health literacy and pregnant women’s intention to use a DA to decide about prenatal screening. We recruited a convenience sample of 45 pregnant women in three clinical sites (family practice teaching unit, birthing center and obstetrical ambulatory care clinic). We asked participating women to complete a self-administered questionnaire assessing their intention to use a DA to decide about prenatal screening and assessed their health literacy levels using one subjective and two objective scales.ResultsTwo of the three scales discriminated between levels of health literacy (three numeracy questions and three health literacy questions). We found a positive correlation between pregnant women’s intention to use a DA and subjective health literacy (Spearman coefficient, Rho 0.32, P = 0.04) but not objective health literacy (Spearman coefficient, Rho 0.07, P = 0.65). Hence subjective health literacy may affect the intention to use a DA among pregnant women facing a decision about prenatal screening.ConclusionSpecial attention should be given to pregnant women with lower health literacy levels to increase their intention to use a DA and ensure that every pregnant women can give informed and value-based consent to prenatal screening.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2141-0) contains supplementary material, which is available to authorized users.
Highlights
It has been suggested that health literacy may impact the use of decision aids (DAs) among patients facing difficult decisions
DAs are tools that foster shared decision-making by supporting patients and their health professionals as they attempt to agree on a decision point, discuss evidence and clarify what is most important for the patient [4,5,6,7]
Two recently completed studies on factors influencing the implementation of decision aids in prenatal care suggested that the main factors that influence the use of a DA by health professionals were a positive appraisal of the DA, its availability in the office, and colleagues’ approval [11]; and that main factors influencing pregnant women’s use of a DA were the opinion of her partner, the presentation of the DA by the health professional and a discussion, and having never before encountered a DA [12]
Summary
It has been suggested that health literacy may impact the use of decision aids (DAs) among patients facing difficult decisions. DAs have been shown to produce favorable decision outcomes for patients [8, 9], there is a consensus that they have not been routinely implemented in care in general [5] This is due to various barriers, including lack of training in how to use decision support, a lack of trust in or agreement with the content of the DA, or the belief among health professionals that patients do not want decisional responsibility when facing difficult diagnoses [5]. This holds true for the implementation of decision aids in prenatal care [10]. Many factors are thought to affect their effective implementation [13] and previous research has hypothesized that patient health literacy could be one such factor [14]
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