Improving Health Literacy Responsiveness: A Randomized Study on the Uptake of Brochures on Doctor-Patient Communication in Primary Health Care Waiting Rooms
Abstract
:1. Introduction
1.1. The Waiting Room as an Opportunity for Improving Health Literacy Responsiveness
1.2. Narrative Health Education Materials, in Particular Photo Stories
1.3. Exposure to Health Information Materials as a Condition for Effectiveness
1.4. Aims of the Study
2. Materials and Methods
2.1. Setting
2.2. Patients
2.3. Intervention Materials: Three Brochures
2.4. Procedure and Measurements
Outcome Measures
2.5. Analysis
3. Results
3.1. Background Characteristics of Sample
3.2. Number of Brochures Noticed, Browsed and Taken per Brochure
3.2.1. Observations
3.2.2. Interviews
3.3. Participants’ Responses per Brochure
4. Discussion
4.1. Strengths and Limitations
4.2. Implications for Practice
4.3. Implications for Research
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Primary Health Care Practice A | Primary Health Care Practice B | Primary Health Care Practice C | ||
---|---|---|---|---|
week 1 | Monday | Non-narrative | Photo stories | Existing |
Tuesday | Photo stories | Existing | Non-narrative | |
Wednesday | Existing | Non-narrative | Photo stories | |
Thursday | Non-narrative | Photo stories | Existing | |
Friday | Photo stories | Existing | Non-narrative | |
week 2 | Monday | Existing | Non-narrative | Photo stories |
Tuesday | Non-narrative | Photo stories | Existing | |
Wednesday | Photo stories | Existing | Non-narrative | |
Thursday | Existing | Non-narrative | Photo stories | |
Friday | Non-narrative | Photo stories | Existing | |
week 3 | Monday | Photo stories | Existing | Non-narrative |
Tuesday | Existing | Non-narrative | Photo stories | |
Wednesday | Non-narrative | Photo stories | Existing | |
Thursday | Photo stories | Existing | Non-narrative | |
Friday | Existing | Non-narrative | Photo stories |
Primary Health Care Practice A | Primary Health Care Practice B | Primary Health Care Practice C | |
---|---|---|---|
Number of registered patients | 14,157 | 5284 | 4465 |
Male/female (%) | 49.2%/50.8% | 49.4%/50.6% | 48.4%/51.6% |
Age range | 0–100 | 0–100 | 0–99 |
Number of GPs | 8 | 7 | 3 |
Number of other health professionals (nurses etc.) | 23 | 8 | 6 |
Average number of GP visits per week | circa 500 | circa 350 | circa 250 |
Waiting room characteristics | Large space, where people can enter at two points; many tables with space for leaflets | Medium large space; reading table with space for leaflets | Small space with little room for information leaflets; displays on a small side table and in the window sills. |
Did you notice this brochure? | |||
Yes | No | Total | |
Photo stories | 59 (48.4%) | 63 (51.6%) | 122 |
Non-narrative | 39 (30.5%) | 89 (69.5%) | 128 |
Existing | 37 (26.4%) | 103 (73.6%) | 140 |
Did you browse this brochure? (only asked if people had noticed the brochure) | |||
Yes | No | Total | |
Photo stories | 18 (30.5%) | 41 (69.5%) | 59 |
Non-narrative | 14 (35.9%) | 25 (64.1%) | 39 |
Existing | 16 (43.2%) | 21 (56.8%) | 37 |
Did you take this brochure with you? (only asked if people had noticed the brochure) | |||
Yes | No | Total | |
Photo stories | 7 (11.9%) | 52 (88.1%) | 59 |
Non-narrative | 3 (8.1%) | 34 (91.9%) | 37 (2 missing values) |
Existing | 8 (21.6%) | 29 (78.4%) | 37 |
Not browsing the brochure (N = 87), because of… | |||
Situation-related factors | Self-related factors | ||
Motivation | Opportunity | Motivation | Opportunity |
Too many brochures available (PSV:2; NNV:0; EB:0) | Not enough time (PSV:4; NNV:5; EB:2) | Other activities/attention elsewhere, e.g., reading something else, watching children, looking at smartphone, just sitting (PSV:11; NNV:0; EB:7) | Too stressed, distracted, tired or ill (PSV:0; NNV:4; EB:4) |
Placing suggested other target group (PSV:1) | Not within reach, too many people in waiting room (PSV:3; NNV:2; EB:4) | Not interested, not relevant, no need, information already known (PSV:13; NNV:12; EB:9) | No reading glasses (PSV:1; NNV:2; EB:1) |
Not a typical reader of brochures (PSV:3; NNV:2; EB:1) | Insufficient Dutch language proficiency (PSV:1; NNV:0; EB:0) | ||
Only read the front cover (PSV:0; NNV:5; EB:0) | |||
No particular reason/did not consider/don’t know (PSV:4; NNV:1; EB:1) | |||
Browsing the brochure (N = 48), because of | |||
Situation-related factors | Self-related factors | ||
Motivation | Opportunity | Motivation | Opportunity |
Within reach (PSV:2; NNV:0; EB:0) | Interested/curious/relevant topic (PSV:9; NNV:5; EB:4) | ||
Someone else mentioned brochure (PSV:1; NNV:0; EB:0) | Killing time (PSV:4; NNV:1; EB:2) | ||
Brochure stood out/great appeal compared to other brochures (PSV:1; NNV:3; EB:2) | Great appeal brochure (PSV:3; NNV:1; EB:0) | ||
Overheard interviewer (PSV:0; NNV:0; EB:1) | Always looking at brochures (PSV:0; NNV:0; EB:1) | ||
Noticed brochure being put down (PSV:0; NNV:0; EB:1) |
Not taking the brochure (N = 115), because of… | |||
Situation-related factors | Self-related factors | ||
Motivation | Opportunity | Motivation | Opportunity |
Not my GP (PSV:1; NNV:0; EB:0) | Not enough time (PSV:2; NNV:0; EB:1) | No interest/need/relevance (PSV:13; NNV:20; EB:15) | Too stressed/distracted/tired/ill: (PSV:1; NNV:0; EB:3) |
Not within reach/waiting room too busy (PSV:2; NNV:0; EB:1) | Reading it was sufficient (PSV:7; NNV:1; EB:0) | Too difficult (PSV:1; NNV:0; EB:0) | |
Couldn’t see what it was about (PSV:0; NNV:1; EB:0) | Attention elsewhere (PSV:2; NNV:0; EB:0) | Left it for other people to read (PSV:1; NNV:0; EB:0) | |
Not the type of person to take brochures (PSV:1; NNV:0; EB:1) | No reading glasses (PSV:0; NNV:0; EB:1) | ||
No particular reason/did not consider/don’t know (PSV:8; NNV:5; EB:5) | |||
Taking the brochure (N = 18), because of… | |||
Situation-related factors | Self-related factors | ||
Motivation | Opportunity | Motivation | Opportunity |
Interested/curious/relevant (PSV:2; NNV:0; EB:1) | To read again further/at (PSV:2; NNV:1; EB:1) | ||
Took it for someone else (PSV:2; NNV:0; EB:1) |
PSV (N = 18) | Motivation | Comprehensibility | Possible Impact on Behavior | Other |
---|---|---|---|---|
Positive comments | Not to be missed (1) Fun (4) Attractive (3) Made curious (1) Interesting (1) | Clear, understandable (16) Clear pictures (3) Good font size (1) Accessible (1) | Striking content (1) Beneficial (1) Useful (2) Recognizable situations (5) Thought provoking (2) Important content (2) Great for shy people (1) | Neutral (8) Good brochure (1) |
Negative comments | Childish (2) Commercial (1) Old-fashioned (1) | Too simple (1) | Already informed/no need (5) | |
NNV (N = 14) | Motivation | Comprehensibility | Possible impact on behavior | Other |
Positive comments | Interesting (1) Nice (1) Really beautiful (1) Notable, distinct (1) | Clear, understandable (3) Understandable language (3) Clear pictures (1) | Useful (2) Great for people who do not visit doctors regularly (1) Informative (1) Realistic situations (1) | Neutral (3) Good (1) Positive (1) |
Negative comments | Not interesting (2) Stinks (1) | |||
EB (N = 16) | Motivation | Comprehensibility | Possible impact on behavior | Other |
Positive comments | Distinct/funny cartoon (4) Made curious (1) Colorful (1) Good headline (1) | Good font size (2) Clear, understandable (4) Simple (1) Accessible (2) Good size (1) | Useful (3) Refreshes memory (1) Well prepared after reading (1) Good to draw people’s attention to this topic (2) Good content (1) | Good (1) Neutral (1) Okay (1) |
Negative comments | - | - | - | - |
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Jansen, C.J.M.; Koops van ’t Jagt, R.; Reijneveld, S.A.; van Leeuwen, E.; de Winter, A.F.; Hoeks, J.C.J. Improving Health Literacy Responsiveness: A Randomized Study on the Uptake of Brochures on Doctor-Patient Communication in Primary Health Care Waiting Rooms. Int. J. Environ. Res. Public Health 2021, 18, 5025. https://doi.org/10.3390/ijerph18095025
Jansen CJM, Koops van ’t Jagt R, Reijneveld SA, van Leeuwen E, de Winter AF, Hoeks JCJ. Improving Health Literacy Responsiveness: A Randomized Study on the Uptake of Brochures on Doctor-Patient Communication in Primary Health Care Waiting Rooms. International Journal of Environmental Research and Public Health. 2021; 18(9):5025. https://doi.org/10.3390/ijerph18095025
Chicago/Turabian StyleJansen, Carel J. M., Ruth Koops van ’t Jagt, Sijmen A. Reijneveld, Ellen van Leeuwen, Andrea F. de Winter, and John C. J. Hoeks. 2021. "Improving Health Literacy Responsiveness: A Randomized Study on the Uptake of Brochures on Doctor-Patient Communication in Primary Health Care Waiting Rooms" International Journal of Environmental Research and Public Health 18, no. 9: 5025. https://doi.org/10.3390/ijerph18095025