Improving Health Literacy Responsiveness: A Randomized Study on the Uptake of Brochures on Doctor-Patient Communication in Primary Health Care Waiting Rooms.

John C J Hoeks,Sijmen A Reijneveld,Andrea F De Winter,Ruth Koops Van ’T Jagt,Ellen Van Leeuwen,Carel J M Jansen

doi:10.3390/ijerph18095025

Abstract

Presenting attractive and useful health education materials in waiting rooms can help improve an organization’s health literacy responsiveness. However, it is unclear to what extent patients may be interested in health education materials, such as brochures. We conducted a three-week field study in waiting rooms of three primary care centers in Groningen. Three versions of a brochure on doctor-patient communication were randomly distributed, 2250 in total. One version contained six short photo stories, another version was non-narrative but contained comparable photos, and the third version was a traditional brochure. Each day we counted how many brochures were taken. We also asked patients (N = 471) to participate in a brief interview. Patients who consented (N = 390) were asked if they had noticed the brochure. If yes (N = 135), they were asked why they had or had not browsed the brochure, and why they had or had not taken it. Interview responses were categorized by two authors. Only 2.9% of the brochures were taken; no significant association with brochure version was found. Analysis of the interview data showed that the version with the photo narrative was noticed significantly more often than the non-narrative version or the traditional version. These results suggest that designing attractive and comprehensible health materials is not enough. Healthcare organizations should also create effective strategies to reach their target population.

Highlights

We assessed the uptake of three different versions of a brochure on doctor-patient communication, uptake being defined in terms of numbers of brochures that were noticed, browsed, and taken from the waiting rooms
A narrative version of the brochure, a non-narrative version containing explicit advice on the same topic, and a traditional version issued by the Dutch Patient Consumers Federation, containing explicit advice on doctor-patient communication, were distributed across health care practices according to a Latin square design, with daily change of the brochure on display, leading to a balanced random offer of all three brochures; see Table 1
We found no significant association between brochure version and observed number of copies taken from all practices combined: Photo Stories Version: 23, Non-Narrative Version: 20; Existing Brochure: 23 (chisquare(2) = 0.27; p = 0.87)

Summary

Introduction

The Waiting Room as an Opportunity for Improving Health Literacy Responsiveness. The effectiveness of interventions aimed at improving health outcomes depends on multiple factors. These factors include an individual’s personal characteristics, and the individual’s social context, the skills and abilities of the health professionals who are involved, the health system as a whole, and, crucially, the quality of the communication between the individual and the health professional [1]. By quality of communication we understand the extent to which senders manage to choose the content and form of their messages so that their intentions are well understood by recipients, and the extent to which recipients manage to interpret the messages correctly so that they can respond appropriately [2].

Methods

Results

Discussion

Conclusion