title: Influencing health equity: role of the effective consumer scale in measuring skills and abilities in a middle income country.
abstract: The 2008 World Health Report emphasizes the need for patient-centered primary care service delivery models in which patients are equal partners in the planning and management of their health. It is argued that this involvement will lead to improved management of disease, improved health outcomes and patient satisfaction, better informed decision-making, increased compliance with healthcare decisions, and better resource utilization. This article investigates the domains captured by the Effective Consumer Scale (EC-17) in relation to vulnerable population groups that experience health inequity. Particular focus is paid to the domain of health literacy as an area fundamental to patients' involvement in managing their condition and negotiating the healthcare system. In examining the possible influence of Outcome Measures in Rheumatology Clinical Trials (OMERACT) on health equity, we used the recent translation and validation of the EC-17 scale into Spanish and tested Argentina as an example. Future plans to use the EC-17 with vulnerable groups include formal collaboration and needs assessment with the community to tailor an intervention to meet its needs in a culturally relevant manner. Some systematic reviews have questioned whether interventions to improve effective consumer skills are appropriate in vulnerable populations. We propose that these populations may have the most to gain from such interventions since they might be expected to have relatively lower skills and health literacy than other groups.
authors.affiliation: Department of Medicine, Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada. trader@uottawa.ca
authors.forename: Tamara
authors.initials: T
authors.lastname: Rader
authors.forename: Erin
authors.initials: E
authors.lastname: Ueffing
authors.forename: Ezequiel
authors.initials: E
authors.lastname: Garcia-Elorrio
authors.forename: Leanne
authors.initials: L
authors.lastname: Idzerda
authors.forename: Agustin
authors.initials: A
authors.lastname: Ciapponi
authors.forename: Vilma
authors.initials: V
authors.lastname: Irazola
authors.forename: Vivian
authors.initials: V
authors.lastname: Welch
authors.forename: Anne
authors.initials: A
authors.lastname: Lyddiatt
authors.forename: Beverley
authors.initials: B
authors.lastname: Shea
authors.forename: Stanton
authors.initials: S
authors.lastname: Newman
authors.forename: Richard
authors.initials: R
authors.lastname: Osborne
authors.forename: Peter S
authors.initials: PS
authors.lastname: Tugwell
mesh_terms: D001118:Argentina; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D006262:Health; D057220:Health Literacy; D006801:Humans; D007802:Language; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000592:standards; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires