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BMC Health Services Research

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Open Access 01-12-2018 | Research article

Conceptualisation and development of the Conversational Health Literacy Assessment Tool (CHAT)

Authors: Jonathan O’Hara, Melanie Hawkins, Roy Batterham, Sarity Dodson, Richard H. Osborne, Alison Beauchamp

Published in: BMC Health Services Research | Issue 1/2018

Abstract

Background

The aim of this study was to develop a tool to support health workers’ ability to identify patients’ multidimensional health literacy strengths and challenges. The tool was intended to be suitable for administration in healthcare settings where health workers must identify health literacy priorities as the basis for person-centred care.

Methods

Development was based on a qualitative co-design process that used the Health Literacy Questionnaire (HLQ) as a framework to generate questions. Health workers were recruited to participate in an online consultation, a workshop, and two rounds of pilot testing.

Results

Participating health workers identified and refined ten questions that target five areas of assessment: supportive professional relationships, supportive personal relationships, health information access and comprehension, current health behaviours, and health promotion barriers and support.

Conclusions

Preliminary evidence suggests that application of the Conversational Health Literacy Assessment Tool (CHAT) can support health workers to better understand the health literacy challenges and supportive resources of their patients. As an integrated clinical process, the CHAT can supplement existing intake and assessment procedures across healthcare settings to give insight into patients’ circumstances so that decisions about care can be tailored to be more appropriate and effective.

Nutbeam D. Health promotion glossary. Health Promot Int. 1998;13:349–64.CrossRef

Sørensen K, Van den Broucke S, Fullam J, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:80. https://doi.org/10.1186/1471-2458-12-80.CrossRefPubMedPubMedCentral

Batterham RW, Hawkins M, Collins PA, et al. Health literacy: applying current concepts to improve health services and reduce health inequalities. Public Health. 2016;132:3–12. https://doi.org/10.1016/j.puhe.2016.01.001.CrossRefPubMed

Jordan JE, Buchbinder R, Osborne RH. Conceptualising health literacy from the patient perspective. Patient Educ Couns. 2010;79:36–42. https://doi.org/10.1016/j.pec.2009.10.001.CrossRefPubMed

Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int. 2000;15:259–67. https://doi.org/10.1093/heapro/15.3.259.CrossRef

Batterham RW, Beauchamp A, Osborne R. Health literacy. In: Quah SR, Cockerham WC, editors. Int. Encycl. Public heal. 2nd ed. Oxford: Academic; 2017. p. 428–37.CrossRef

Riegel B, Moser DK, Anker SD, et al. State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation. 2009;120:1141–63. https://doi.org/10.1161/CIRCULATIONAHA.109.192628.CrossRefPubMed

Jessup RL, Osborne RH, Beauchamp A, et al. Health literacy of recently hospitalised patients: a cross-sectional survey using the health literacy questionnaire (HLQ). BMC Health Serv Res. 2017;17:52. https://doi.org/10.1186/s12913-016-1973-6.CrossRefPubMedPubMedCentral

Baker DW, Gazmararian JA, Williams MV, et al. Health literacy and use of outpatient physician services by Medicare managed care enrollees. J Gen Intern Med. 2004;19:215–20. https://doi.org/10.1111/j.1525-1497.2004.21130.x.CrossRefPubMedPubMedCentral

10.

White S, Chen J, Atchison R. Relationship of preventive health practices and health literacy: a national study. Am J Health Behav. 2008;32:227–42. https://doi.org/10.5555/ajhb.2008.32.3.227.CrossRefPubMed

11.

Baker DW, Williams MV, Parker RM, et al. Development of a brief test to measure functional health literacy. Patient Educ Couns. 1999;38:33–42. https://doi.org/10.1016/S0738-3991(98)00116-5.CrossRefPubMed

12.

Weiss BD, Mays MZ, Martz W, et al. Quick assessment of literacy in primary care: the newest vital sign. Ann Fam Med. 2005;3:514–22. https://doi.org/10.1370/afm.405.CrossRefPubMedPubMedCentral

13.

Chew LD, Bradley KA, Boyko EJ. Brief questions to identify patients with inadequate health literacy. Fam Med. 2004;36:588–94. https://doi.org/10.1186/1471-2458-12-80.PubMed

14.

Starfield B, Shi L. The medical home, access to care, and insurance: a review of evidence. Pediatrics. 2004;113:1493–8. https://doi.org/10.1542/peds.113.5.S1.1493.PubMed

15.

Stewart MA. Effective physician-patient communication and health outcomes: a review. Can Med Assoc J. 1995;152:1423–33.

16.

HLS-EU consortium. Comparative report of health literacy in eight eu member states. The european health literacy survey HLS-EU. 2012. Online publication: http://www.health-literacy.eu. Accessed 24 May 2017.

17.

Jordan JE, Buchbinder R, Briggs AM, et al. The health literacy management scale (HeLMS): a measure of an individual’s capacity to seek, understand and use health information within the healthcare setting. Patient Educ Couns. 2013;91:228–35. https://doi.org/10.1016/j.pec.2013.01.013.CrossRefPubMed

18.

Wang J, Thombs BD, Schmid MR. The Swiss health literacy survey: development and psychometric properties of a multidimensional instrument to assess competencies for health. Health Expect. 2014;17:396–417. https://doi.org/10.1111/j.1369-7625.2012.00766.x.CrossRefPubMed

19.

Beauchamp A, Buchbinder R, Dodson S, et al. Distribution of health literacy strengths and weaknesses across socio-demographic groups: a cross-sectional survey using the health literacy questionnaire (HLQ). BMC Public Health. 2015;15:678. https://doi.org/10.1186/s12889-015-2056-z.CrossRefPubMedPubMedCentral

20.

Osborne RH, Batterham RW, Elsworth GR, et al. The grounded psychometric development and initial validation of the health literacy questionnaire (HLQ). BMC Public Health. 2013;13:658. https://doi.org/10.1186/1471-2458-13-658.CrossRefPubMedPubMedCentral

21.

Elsworth GR, Beauchamp A, Osborne RH. Measuring health literacy in community agencies: a Bayesian study of the factor structure and measurement invariance of the health literacy questionnaire (HLQ). BMC Health Serv Res. 2016; https://doi.org/10.1186/s12913-016-1754-2.

22.

Kolarcik P, Cepova E, Madarasova Geckova A, et al. Structural properties and psychometric improvements of the health literacy questionnaire in a Slovak population. Int J Public Health. 2017:1–14. https://doi.org/10.1007/s00038-017-0945-x.

23.

Maindal HT, Kayser L, Norgaard O, et al. Cultural adaptation and validation of the health literacy questionnaire (HLQ): robust nine-dimension Danish language confirmatory factor model. Spring. 2016;5:1232. https://doi.org/10.1186/s40064-016-2887-9.CrossRef

24.

Nolte S, Osborne RH, Dwinger S, et al. German translation, cultural adaptation, and validation of the health literacy questionnaire (HLQ). PLoS One. 2017; https://doi.org/10.1371/journal.pone.0172340.

25.

Kripalani S, Bengtzen R, Henderson LE, Jacobson TA. Clinical research in low-literacy populations: using teach-back to assess comprehension of informed consent and privacy information. IRB. 2008;30:13–9. https://doi.org/10.2307/30033265.PubMed

Title: Conceptualisation and development of the Conversational Health Literacy Assessment Tool (CHAT)
Authors: Jonathan O’Hara
Melanie Hawkins
Roy Batterham
Sarity Dodson
Richard H. Osborne
Alison Beauchamp
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-018-3037-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Conceptualisation and development of the Conversational Health Literacy Assessment Tool (CHAT)

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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