title: Insights into the concept and measurement of health literacy from a study of shared decision-making in a low literacy population.
abstract: This article explores the concept and measurement of health literacy in the context of shared health decision-making. It draws upon a series of qualitative and quantitative studies undertaken in the development and evaluation of a bowel cancer screening decision aid for low literacy populations. The findings indicate that different types of health literacy (functional, interactive and critical) are required in decision-making and present a set of instruments to assess and discriminate between higher level health literacy skills required for engagement in decision-making. It concludes that greater sophistication in both the definition and measurement of health literacy in research is needed.
authors.affiliation: Psychosocial Research Group, Prince of Wales Clinical School, Prince of Wales Hospital, University of New South Wales, Australia. sian.smith@unsw.edu.au
authors.forename: Sian K
authors.initials: SK
authors.lastname: Smith
authors.forename: Don
authors.initials: D
authors.lastname: Nutbeam
authors.forename: Kirsten J
authors.initials: KJ
authors.lastname: McCaffery
mesh_terms: D003657:Decision Making; D055088:Early Detection of Cancer / Q000379:methods / Q000592:standards*; D057220:Health Literacy / Q000145:classification / Q000379:methods / Q000592:standards*; D006801:Humans; D035862:Vulnerable Populations / Q000523:psychology*
keywords: adults; bowel cancer screening; cancer screening; health literacy; intervention; low literacy; measurement; shared decision-making