title: Health literacy in pregnant women facing prenatal screening may explain their intention to use a patient decision aid: a short report.
abstract: BACKGROUND
  It has been suggested that health literacy may impact the use of decision aids (DAs) among patients facing difficult decisions. Embedded in the pilot test of a questionnaire, this study aimed to measure the association between health literacy and pregnant women's intention to use a DA to decide about prenatal screening. We recruited a convenience sample of 45 pregnant women in three clinical sites (family practice teaching unit, birthing center and obstetrical ambulatory care clinic). We asked participating women to complete a self-administered questionnaire assessing their intention to use a DA to decide about prenatal screening and assessed their health literacy levels using one subjective and two objective scales.
  
  
  RESULTS
  Two of the three scales discriminated between levels of health literacy (three numeracy questions and three health literacy questions). We found a positive correlation between pregnant women's intention to use a DA and subjective health literacy (Spearman coefficient, Rho 0.32, P = 0.04) but not objective health literacy (Spearman coefficient, Rho 0.07, P = 0.65). Hence subjective health literacy may affect the intention to use a DA among pregnant women facing a decision about prenatal screening.
  
  
  CONCLUSIONS
  Special attention should be given to pregnant women with lower health literacy levels to increase their intention to use a DA and ensure that every pregnant women can give informed and value-based consent to prenatal screening.
authors.affiliation: Canada Research Chair in Shared Decision Making and Knowledge Translation, Public Health and Practice-Changing Research Group, Centre Hospitalier Universitaire de Québec Research Centre, Hôpital St-François d'Assise, 10 rue Espinay, D6-737, Quebec City, QC, G1L 3L5, Canada.
authors.forename: Agathe
authors.initials: A
authors.lastname: Delanoë
authors.affiliation: Canada Research Chair in Shared Decision Making and Knowledge Translation, Public Health and Practice-Changing Research Group, Centre Hospitalier Universitaire de Québec Research Centre, Hôpital St-François d'Assise, 10 rue Espinay, D6-737, Quebec City, QC, G1L 3L5, Canada.
authors.forename: Johanie
authors.initials: J
authors.lastname: Lépine
authors.affiliation: Canada Research Chair in Shared Decision Making and Knowledge Translation, Public Health and Practice-Changing Research Group, Centre Hospitalier Universitaire de Québec Research Centre, Hôpital St-François d'Assise, 10 rue Espinay, D6-737, Quebec City, QC, G1L 3L5, Canada.
authors.forename: Maria Esther
authors.initials: ME
authors.lastname: Leiva Portocarrero
authors.affiliation: Canada Research Chair in Shared Decision Making and Knowledge Translation, Public Health and Practice-Changing Research Group, Centre Hospitalier Universitaire de Québec Research Centre, Hôpital St-François d'Assise, 10 rue Espinay, D6-737, Quebec City, QC, G1L 3L5, Canada.
authors.forename: Hubert
authors.initials: H
authors.lastname: Robitaille
authors.affiliation: Canada Research Chair in Shared Decision Making and Knowledge Translation, Public Health and Practice-Changing Research Group, Centre Hospitalier Universitaire de Québec Research Centre, Hôpital St-François d'Assise, 10 rue Espinay, D6-737, Quebec City, QC, G1L 3L5, Canada.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Turcotte
authors.affiliation: Obstetrics and Gynecology Department, Faculty of Medicine, Université Laval, 1050, avenue de la Médecine, Quebec City, QC, Canada.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Lévesque
authors.affiliation: Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Road, Ottawa, ON, Canada.
authors.forename: Brenda J
authors.initials: BJ
authors.lastname: Wilson
authors.affiliation: Quebec Centre of Excellence on Aging, CHU de Québec Research Centre, 1050, chemin Sainte-Foy, Quebec City, QC, Canada.
authors.forename: Anik M C
authors.initials: AM
authors.lastname: Giguère
authors.affiliation: Canada Research Chair in Shared Decision Making and Knowledge Translation, Public Health and Practice-Changing Research Group, Centre Hospitalier Universitaire de Québec Research Centre, Hôpital St-François d'Assise, 10 rue Espinay, D6-737, Quebec City, QC, G1L 3L5, Canada. France.Legare@mfa.ulaval.ca.|Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, 1050, avenue de la Médecine, Quebec City, QC, Canada. France.Legare@mfa.ulaval.ca.
authors.forename: France
authors.initials: F
authors.lastname: Légaré
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000941:ethics; D003657:Decision Making / Q000941:ethics*; D003661:Decision Support Techniques; D004314:Down Syndrome / Q000175:diagnosis / Q000523:psychology*; D005194:Family Practice / Q000941:ethics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D007258:Informed Consent / Q000523:psychology; D033182:Intention; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000941:ethics* / Q000523:psychology; D011792:Quebec; D011795:Surveys and Questionnaires
keywords: Down syndrome; Health literacy; Patient decision aid; Patient involvement; Screening and diagnostic tests; Shared decision making