Addressing low literacy and health literacy in clinical oncology practice.

Low functional literacy and low health literacy continue to be under-recognized and are associated with poorer patient health outcomes. Health literacy is a dynamic state influenced by how well a healthcare system delivers information and services that match patients' abilities, needs and preferences. Oncology care poses considerable health literacy demands on patients who are expected to process high stakes information about complex multidisciplinary treatment over lengths of time. Much of the information provided to patients in clinical care and research is beyond their literacy levels. In this paper, we provide an overview of currently available guidelines and resources to improve how the needs of patients with diverse literacy skills are met by cancer care providers and clinics. We present recommendations for health literacy assessment in clinical practice and ways to enhance the usability of health information and services by improving written materials and verbal communication, incorporating multimedia and culturally appropriate approaches, and promoting health literacy in cancer care settings.The paper also includes a list of additional resources that can be used to develop and implement health literacy initiatives in cancer care clinics.

[1]  D. Schillinger,et al.  An advance directive redesigned to meet the literacy level of most adults: a randomized trial. , 2007, Patient education and counseling.

[2]  Mark A. Kutner,et al.  The Health Literacy of America's Adults: Results from the 2003 National Assessment of Adult Literacy. NCES 2006-483. , 2006 .

[3]  L. G. Doak,et al.  Teaching Patients With Low Literacy Skills , 1985 .

[4]  T. Habermann,et al.  Randomized, controlled trial of an easy-to-read informed consent statement for clinical trial participation: a study of the Eastern Cooperative Oncology Group. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[5]  Eric M. Dunleavy,et al.  Literacy in Everyday Life: Results from the 2003 National Assessment of Adult Literacy. NCES 2007-490. , 2007 .

[6]  E. J. Mayeaux,et al.  Rapid estimate of adult literacy in medicine: a shortened screening instrument. , 1993, Family medicine.

[7]  E. Hahn,et al.  Bilingual health literacy assessment using the Talking Touchscreen/la Pantalla Parlanchina: Development and pilot testing. , 2009, Patient education and counseling.

[8]  A. Foltz,et al.  Get real: clinical testing of patients' reading abilities. , 1998, Cancer nursing.

[9]  Kathleen N. Lohr,et al.  A Systematic Review of the Literature , 2004 .

[10]  Tracy L. Scott,et al.  Health Literacy and Preventive Health Care Use Among Medicare Enrollees in a Managed Care Organization , 2002, Medical care.

[11]  D. Baker,et al.  Development of a brief test to measure functional health literacy. , 1999, Patient education and counseling.

[12]  David Cella,et al.  The talking touchscreen: A new approach to outcomes assessment in low literacy , 2004, Psycho-oncology.

[13]  Dan Bustillos,et al.  Social factors affecting treatment of cervical cancer: ethical issues and policy implications. , 2008, Obstetrics and gynecology.

[14]  D. Baker The meaning and the measure of health literacy , 2006, Journal of general internal medicine.

[15]  P. Butow,et al.  Promoting patient participation and shortening cancer consultations: a randomised trial , 2001, British Journal of Cancer.

[16]  Simon P. Kim,et al.  Health Literacy and Shared Decision Making for Prostate Cancer Patients with Low Socioeconomic Status , 2001, Cancer investigation.

[17]  Mark V. Williams,et al.  Test of Functional Health Literacy in Adults , 2016 .

[18]  Junling Ren,et al.  Functional health literacy and the risk of hospital admission among Medicare managed care enrollees. , 2002, American journal of public health.

[19]  J. Gazmararian,et al.  Understanding health literacy : implications for medicine and public health , 2005 .

[20]  Quality of life assessment for low literacy Latinos: a new multimedia program for self-administration. , 2003, The Journal of oncology management : the official journal of the American College of Oncology Administrators.

[21]  S. Jubelirer,et al.  Reading versus comprehension: implications for patient education and consent in an outpatient oncology clinic. , 1994, Journal of cancer education : the official journal of the American Association for Cancer Education.

[22]  David Cella,et al.  Health outcomes assessment in vulnerable populations: measurement challenges and recommendations. , 2003, Archives of physical medicine and rehabilitation.

[23]  David A. Kindig,et al.  Health literacy : a prescription to end confusion , 2004 .

[24]  J. Gazmararian,et al.  The impact of low health literacy on the medical costs of Medicare managed care enrollees. , 2005, The American journal of medicine.