Development and field testing of a consumer shared decision-making training program for adults with low literacy.
OBJECTIVE
Given the scarcity of shared decision-making (SDM) interventions for adults with low literacy, we created a SDM training program tailored to this population to be delivered in adult education settings.


METHODS
Formative evaluation during program development included a review of the problem and previous efforts to address it, qualitative interviews with the target population, program planning and field testing.


RESULTS
A comprehensive SDM training program was developed incorporating core SDM elements. The program aimed to improve students' understanding of SDM and to provide them with the necessary skills (understanding probabilistic risks and benefits, personal values and preferences) and self-efficacy to use an existing set of questions (the AskShareKnow questions) as a means to engage in SDM during healthcare interactions.


CONCLUSIONS
There is an ethical imperative to develop SDM interventions for adults with lower literacy. Generic training programs delivered direct-to-consumers in adult education settings offer promise in a national and international environment where too few initiatives exist.


CONCLUSIONS
Formative evaluation of the program offers practical insights into developing consumer-focused SDM training. The content of the program can be used as a guide for future efforts to engage consumers in SDM.
The Screening and Test Evaluation Program (STEP), Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), Sydney School of Public Health, The University of Sydney, NSW, Australia.
Danielle M
DM
Muscat
The Screening and Test Evaluation Program (STEP), Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), Sydney School of Public Health, The University of Sydney, NSW, Australia.
Suzanne
S
Morony
Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), Sydney School of Public Health, The University of Sydney, NSW, Australia; Psycho-Oncology Co-Operative Research Group (PoCoG), School of Psychology, The University of Sydney, NSW, Australia.
Heather L
HL
Shepherd
Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, NSW, Australia.
Sian K
SK
Smith
Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), Concord Clinical School, The University of Sydney, NSW, Australia; School of Psychology, The University of Sydney, NSW, Australia.
Haryana M
HM
Dhillon
The Screening and Test Evaluation Program (STEP), Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), Sydney School of Public Health, The University of Sydney, NSW, Australia.
Lyndal
L
Trevena
School of Public Health and Community Medicine, University of New South Wales, NSW, Australia.
Andrew
A
Hayen
Patient-Based Care, Clinical Excellence Commission, NSW, Australia.
Karen
K
Luxford
University of Southampton, Southampton, UK.
Don
D
Nutbeam
The Screening and Test Evaluation Program (STEP), Sydney School of Public Health, The University of Sydney, NSW, Australia; Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), Sydney School of Public Health, The University of Sydney, NSW, Australia. Electronic address: kirsten.mccaffery@sydney.edu.au.
Kirsten
K
McCaffery
D000328:Adult; D003142:Communication; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D057220:Health Literacy / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D000067010:Literacy; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods / Q000458:organization & administration*; D010358:Patient Participation; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D016730:Program Development; D036301:Qualitative Research
AskShareKnow; Consumers; Development; Health literacy; Intervention; Low literacy; Patient-centred healthcare; Question asking; Shared decision making; Training