Using Photo Stories to Support Doctor-Patient Communication: Evaluating a Communicative Health Literacy Intervention for Older Adults.

Ruth Koops Van ‘T Jagt,Sijmen A Reijneveld,Carel Jansen,Sophie Spoorenberg,Sonia Lippke,Andrea F De Winter,Shu Ling Tan,John Hoeks

doi:10.3390/ijerph16193726

Abstract

Older adults often have limited health literacy and experience difficulties in communicating about their health. In view of the need for efficacious interventions, we compared a narrative photo story booklet regarding doctor-patient communication with a non-narrative but otherwise highly similar brochure. The photo story booklet included seven short picture-based stories about themes related to doctor-patient communication. The non-narrative brochure had comparable pictures and layout and dealt with the same themes, but it did not include any stories. We conducted two Randomized Controlled Trials (RCTs) among older adults with varying levels of health literacy: one RCT in Germany (N = 66) and one RCT in the Netherlands (N = 54); the latter one was followed by an in-depth interview study among a subset of the participants (81.5%; n = 44). In the RCTs, we did not find significant differences between the photo story booklet and the non-narrative brochure. In the interview study, a majority of the participants expressed a preference for the photo story booklet, which was perceived as recognizable, relevant, entertaining and engaging. We conclude that photo story booklets are a promising format but that there is room for improving their effectiveness.

Highlights

Low levels of health literacy (HL) have frequently been associated with poor health outcomes [1,2].Adults with limited health literacy experience more difficulties in participating in care consultations, ask fewer questions and report less patient-centered communication [3]
We developed a narrative- and picture-based health literacy intervention, including seven very short photo stories on themes that older adults frequently mentioned during focus group discussions on doctor-patient communication
We assessed whether older adults preferred the photo story booklet or the non-narrative brochure we used, and we investigated the reasons for possible differences in preferences

Summary

Introduction

Low levels of health literacy (HL) have frequently been associated with poor health outcomes [1,2]. Adults with limited health literacy experience more difficulties in participating in care consultations, ask fewer questions and report less patient-centered communication [3]. Successful doctor-patient communication [4], for instance about shared decision making [5], critically depends on sufficient levels of communicative and general health literacy [6,7] and has been shown to be associated with patient satisfaction, clinical outcomes and adherence [8,9]. The negative consequences of low health literacy may. Res. Public Health 2019, 16, 3726; doi:10.3390/ijerph16193726 www.mdpi.com/journal/ijerph

Methods

Discussion

Conclusion