Health literacy skills for informed decision making in colorectal cancer screening: Perceptions of screening invitees and experts. (20th December 2017)

• Record Type: Journal Article
• Authors: Woudstra, Anke J.; Timmermans, Daniëlle R. M.; Uiters, Ellen; Dekker, Evelien; Smets, Ellen M. A.; Fransen, Mirjam P.
• Is Part Of: Health expectations. Volume 21:Number 3(2018)
• Page Start: 636
• Page End: 646
• Publication Date: 2017-12-20
• Subjects: colorectal cancer screening -- conceptual framework -- context‐based measurement -- health literacy -- Informed decision making; Medical policy -- Periodicals; Public health -- Periodicals; Health planning -- Periodicals; 362.105
• DOI: 10.1111/hex.12658
• Languages: English
• ISSNs: 1369-6513

Abstract

Abstract: Background: The process of informed decision making (IDM) requires an adequate level of health literacy. To ensure that all individuals have equal opportunity to make an informed decision in colorectal cancer (CRC) screening, it is essential to gain more insight into which health literacy skills are needed for IDM. Our aims were (i) to explore how individuals make a decision about CRC screening and (ii) to explore which skills are needed for IDM in CRC screening and (iii) to integrate these findings within a conceptual framework. Methods: We conducted 3 focus groups with individuals eligible for CRC screening (n = 22) and 2 focus groups with experts in the field of health literacy, oncology and decision making, including scientific researchers and health‐care professionals (n = 17). We used framework analysis to analyse our data. Results: We identified and specified ten health literacy skills, which varied from the ability to read and understand CRC screening information to the ability to weigh up pros and cons of screening for personal relevance. The skills were linked to 8 decision‐making stages in CRC screening within a conceptual framework. We found differences in perceptions between screening invitees and experts, especially in the perceived importance of CRC screening information for IDM. Conclusions: This study provides insight into the decision‐making stages and health literacy skills that are essential for IDM in CRC screening. The proposed conceptual framework can be used to inform the development of context‐based measurement of health literacy and interventions to support IDM in cancer screening.