Relevance of graph literacy in the development of patient-centered communication tools.
OBJECTIVE
To determine the literacy skill sets of patients in the context of graphical interpretation of interactive dashboards.


METHODS
We assessed literacy characteristics of prostate cancer patients and assessed comprehension of quality of life dashboards. Health literacy, numeracy and graph literacy were assessed with validated tools. We divided patients into low vs. high numeracy and graph literacy. We report descriptive statistics on literacy, dashboard comprehension, and relationships between groups. We used correlation and multiple linear regressions to examine factors associated with dashboard comprehension.


RESULTS
Despite high health literacy in educated patients (78% college educated), there was variation in numeracy and graph literacy. Numeracy and graph literacy scores were correlated (r=0.37). In those with low literacy, graph literacy scores most strongly correlated with dashboard comprehension (r=0.59-0.90). On multivariate analysis, graph literacy was independently associated with dashboard comprehension, adjusting for age, education, and numeracy level.


CONCLUSIONS
Even among higher educated patients; variation in the ability to comprehend graphs exists.


CONCLUSIONS
Clinicians must be aware of these differential proficiencies when counseling patients. Tools for patient-centered communication that employ visual displays need to account for literacy capabilities to ensure that patients can effectively engage these resources.
Departments of Urology, University of Washington, Seattle, USA. Electronic address: jnayak@uw.edu.
Jasmir G
JG
Nayak
Group Health Research Institute, Group Health Cooperative, Seattle, USA.
Andrea L
AL
Hartzler
Departments of Urology, University of Washington, Seattle, USA.
Liam C
LC
Macleod
Department of Urology, Queen's University, Kingston, Canada.
Jason P
JP
Izard
Departments of Urology, University of Washington, Seattle, USA.
Bruce M
BM
Dalkin
Departments of Urology, University of Washington, Seattle, USA.
John L
JL
Gore
D000368:Aged; D000369:Aged, 80 and over; D001296:Audiovisual Aids; D003142:Communication; D032882:Comprehension; D003657:Decision Making; D003661:Decision Support Techniques; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D015999:Multivariate Analysis; D018802:Patient-Centered Care; D010361:Patients / Q000523:psychology*; D011471:Prostatic Neoplasms / Q000523:psychology*; D014505:Urban Population; D014861:Washington
Communication; Graph literacy; Informatics; Literacy; Patient-centered; Prostate cancer