Understanding communication of health information: A lesson in health literacy for junior medical and physiotherapy students

Abstract

Best practice communication between healthcare professionals and patients involves using quality patient information leaflets (PILs). We assessed medical and physiotherapy students’ (N = 337) ability to appraise the readability, psychology theory content and quality of nine international smoking PILs. Flesch scores ranged from 52.8–79.7% (fairly difficult to fairly easy). Students identified components of the Health Belief Model (84–98%), Theory of Planned Behaviour (65–88%) and Transtheoretical Model (37–86%). Importantly, student-proposed additional theory-based content had no detrimental effect on readability scores. Overall quality scores indicated low–moderate quality. This assignment helped students critically evaluate the utility of PILs for communication.

Keywords

communication health education health promotion smoking

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References

American College of Chest Physicians (2002) How to quit using tobacco. Available at: http://accpstorage.org/newOrganization/patients/tobacco01.pdf.

Armitage

Conner

(2000) Social cognition models and health behaviour: A structured review. Psychology & Health 15: 173–189.

Baker

(2006) The meaning and the measure of health literacy. Journal of General Internal Medicine 21: 878–883.

Beauchamp

Barling

. (2010) Development and psychometric properties of the transformational teaching questionnaire. Journal of Health Psychology 15(8): 1123–1134.

Bolton Council (2006) Smoking – the facts. Available at: http://www.boltonlea.org.uk/AssetMgt/Documents/Stop%20smoking%20leaflet%20A4.pdf.

Cancer Research UK (2003) Smoking & cancer: Beat the addiction. Available at: http://www2.units.it/brancaleone/leaflet_smoking_sept03.pdf.

Charnock

Shepperd

Needham

. (1999) DISCERN: An instrument for judging the quality of written consumer health information on treatment choices. Journal of Epidemiology & Community Health 53: 105–111.

Co-ordination Group for Mutual Recognition and Decentralized Procedures – Human (CMD(h)) (2006) Annotated QRD template for MR/DC procedures.

Coulter

Ellins

Swain

. (2006) Assessing the Quality of Information to Support People in Making Decisions about Their Health and Healthcare. Oxford: Picker Institute Europe.

10.

Cummins

Prochaska

Driskell

. (2003) Development of review criteria to evaluate health behavior change websites. Journal of Health Psychology 8(1): 55–62.

11.

Doyle

Hickey

Morgan

. (2011) Promoting healthy behaviour choices: Understanding patient challenges by undertaking a personal behaviour change task. In: O’Mahoney

(ed.) Flexible Learning: Proceedings of the National Academy’s Fourth Annual Conference. Dublin: Royal College of Surgeons in Ireland: National Academy for the Integration of Research, Teaching and Learning, p. 113.

12.

European Commission (1998) A Guideline on the Readability of the Label and Package Leaflet of Medicinal Products for Human Use. Brussels: European Commission.

13.

Flesch

(1948) A new readability yardstick. Journal of Applied Psychology 32: 221–233.

14.

Garner

Ning

Francis

(2011) A framework for the evaluation of patient information leaflets. Health Expectations: An International Journal of Public Participation in Health Care and Health Policy. Epub ahead of print 18 February 2011. DOI: 10.1111/j.1369-7625.2011.00665.x.

15.

General Medical Council (2002) Tomorrow’s Doctors. UK: GMC.

16.

Glanz

Maddock

(2000) On judging models and theories: Research and practice, psychology and public health. Journal of Health Psychology 5(2): 151–154.

17.

Government of Malaysia (2011a) Cigarettes cause impotency. Available at: http://www.infosihat.gov.my/infosihat/media/Risalah/M/pdf/08_Ris_Merokok%20Mati%20Pucuk_BI.pdf.

18.

Government of Malaysia (2011b) Secondhand smoke harms children. Available at: http://www.infosihat.gov.my/infosihat/media/Risalah/A/pdf/07_Ris_Merokok%20Kanak2_BI.pdf.

19.

Government of Ontario (2011) Quit: You have it in you. Tips to make quitting easier. Available at: http://www.mhp.gov.on.ca/en/smoke-free/quit/QuitBrochure-EN.pdf.

20.

Heart & Stroke Foundation (2011) Just breathe: Becoming and remaining smoke free. Available at: http://www.heartandstroke.com/atf/cf/%7B99452D8B-E7F1-4BD6-A57D-B136CE6C95BF%7D/Just-breathe-beome-smoke-free-en.pdf.

21.

Higgs

(2008) Promoting integrative learning in first-year science. In: Higgs

McCarthy

(eds) EMERGING ISSUES II: The Changing Roles and Identities of Teachers and Learners in Higher Education. Cork: NAIRTL, University College Cork, pp. 37–50.

22.

Huber

Hutchings

(2004) Integrative learning: Mapping the terrain. Available at: http://www.carnegiefoundation.org/sites/default/files/publications/mapping-terrain.pdf.

23.

Irish Cancer Society (2011) Smoking: Get help, get unhooked. Available at: http://www.cancer.ie/sites/default/files/content-attachments/hp_get_help_get_unhooked.pdf.

24.

Irish Heart Foundation (2008) Stopping smoking for a happy and healthy heart. Available at: http://www.irishheart.ie/media/pub/informationleaflets/newbrochuresjuly08/smoking_leaflet.pdf.

25.

Kincaid

Fishburne

Rogers

. (1975) Derivation of New Readability Formulas (Automated Readability Index, Fog Count and Flesch Reading Ease Formula) for Navy Enlisted Personnel. Springfield, VA: Naval Technical Training Command, Millington, TN, Research Branch.

26.

Klein

Mowrer

(2001) Handbook of Contemporary Learning Theories. Mahwah, NJ: Lawrence Erlbaum.

27.

Kok

Schaalma

Ruiter

. (2004) Intervention mapping: Protocol for applying health psychology theory to prevention programmes. Journal of Health Psychology 9(1): 85–98.

28.

Marquette General Health System (2001) Smokers guide to better health. Available at: http://accpstorage.org/newOrganization/patients/tobacco01.pdf.

29.

Nicholls

Hankins

Hooley

. (2009) A survey of the quality and accuracy of information leaflets about skin cancer and sun-protective behaviour available from UK general practices and community pharmacies. Journal of the European Academy of Dermatology and Venereology 23: 566–569.

30.

Pander Maat

Lentz

(2010) Improving the usability of patient information leaflets. Patient Education & Counselling 80: 113–119.

31.

Redfern

Ellis

Briffa

. (2006) Development and testing of innovative patient resources for the management of coronary heart disease (CHD): A descriptive study. BMC Health Services Research 6: 95.

32.

Rees

Ford

Sheard

(2002) Evaluating the reliability of DISCERN: A tool for assessing the quality of written patient information on treatment choices. Patient Education & Counselling 47: 273–275.

33.

Simpson

Furnace

Crosby

. (2002) The Scottish doctor – learning outcomes for the medical undergraduate in Scotland: A foundation for competent and reflective practitioners. Medical Teacher 24: 136–143.

34.

US Department of Health and Human Services (2000) Healthy People 2010: Understanding and Improving Health. Washington, DC: US Government Printing Office.

35.

Williamson

Martin

(2010) Analysis of patient information leaflets provided by a district general hospital by the Flesch and Flesch-Kincaid method. International Journal of Clinical Practice 64: 1824–1831.