An Evaluation of the Impact of a Health Literacy Educational Package for Community Pharmacists and Pharmacy Staff in Australia

Duncan, Gregory; Swinburne, Glen; Hussainy, Safeera Yasmeen; Namara, Kevin P. Mc; Stewart, Kay; Emmerton, Lynne

doi:10.1016/j.sapharm.2014.07.025

Cited by 2 publications

(3 citation statements)

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“…Call duration is an important metric for call centres and it will be important to examine this in future work. Some nurses self-reported that Teach-Back helped to close an interaction with a caller[ 26 ]; previous work also indicated Teach-Back can help manage consultation time [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

A stepped wedge cluster randomised trial of nurse-delivered Teach-Back in a consumer telehealth service

et al. 2018

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ObjectiveTo evaluate the impact of Teach-Back on communication quality in a national telephone-based telehealth service, for callers varying in health literacy.DesignCross-sectional stepped wedge cluster randomised trial with continuous recruitment, short (fixed) exposure and blinded outcome assessors. Nurses were stratified by hours worked and randomised into training groups using a computer generated sequence.SettingAn Australian national pregnancy and parenting telephone helpline.InterventionComplex intervention involving a single 2-hour group Teach-Back training session, combined with ongoing nurse self-reflection on their communication following each call and each shift.ParticipantsParticipants were 637 callers to the telephone helpline aged 18–75 (87% female), of whom 127 (13%) had inadequate health literacy (measured with the Single Item Literacy Screener); and 15 maternal and child health nurses with 15 years’ experience on average.MeasuresPrimary outcome was a modified subscale of the Health Literacy Questionnaire, ‘having sufficient information to manage health’. Secondary caller outcomes included caller confidence, perceived actionability of information and nurse effort to listen and understand. Nurse outcomes were perceptions of their communication effectiveness.ResultsOver a 7 week period, 376 surveyed callers received usual care and 261 Teach-Back. Ratings on the primary outcome increased over time (OR 1.17, CI 1.01 to 1.32, p = 0.03) but no independent Teach-Back effect was observed. A consistent pattern suggests that, compared with usual care, Teach-Back helps callers with inadequate health literacy feel listened to (OR 2.3, CI 0.98 to 5.42, p = 0.06), confident to act (OR 2.44, CI 1.00 to 5.98, p = 0.06), and know what steps to take (OR 2.68, CI 1.00 to 7.17, p = 0.06). Nurse perceptions of both their own communication effectiveness (OR = 2.31; CI 1.38 to 3.86, p<0.0001), and caller understanding (OR = 2.56; CI 1.52 to 4.30, p<0.001) both increased with Teach-Back. No harms were reported.ConclusionsTeach-Back appears to benefit telephone health service users with inadequate health literacy, but the extent of this is unclear due to smaller numbers of lower literacy participants. Improving caller ratings over time are likely due to increasing nurse communication competence.

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Section: Discussionmentioning

confidence: 99%

A stepped wedge cluster randomised trial of nurse-delivered Teach-Back in a consumer telehealth service

et al. 2018

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“…This study adds to existing research that Teach-Back enhances health care communication, yet the decision to use it is largely influenced by provider comfort with the technique (Duncan et al, 2015), complexity of the information conveyed (Turner et al, 2009), time available (Jager & Wynia, 2012), and (parents') divided attention (Badaczewski et al, 2017). There were no negative reports of Teach-Back among the eight callers that explicitly recalled it; positive reports are consistent with previous research with parents, who interpreted Teach-Back as demonstrating caring and did not find it demeaning or insulting (Badaczewski et al, 2017).…”

Section: Discussionmentioning

confidence: 98%

“…One study of pediatricians reported that limited time, volume and complexity of information, and divided attention of parents were barriers to using advanced communication techniques such as Teach-Back (Turner et al, 2009). Other studies in face-to-face clinical settings reported that health professionals found Teach-Back phrasing unnatural or discomforting to use, making it difficult to implement (Badaczewski et al, 2017; Duncan et al, 2015). Managing these barriers will be important for any Teach-Back implementation.…”

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Experiences of Teach-Back in a Telephone Health Service

Morony¹,

Weir²,

Duncan³

et al. 2017

HLRP: Health Literacy Research and Practice

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Background: Asking patients to “Teach-Back” information during a health care consultation is widely recommended, yet little is known about patient and provider experiences using this method. Teach-Back has not previously been evaluated in a consumer telephone health service, a situation in which low health literacy can be especially difficult to identify. Objective: This study sought to explore telenurse experiences using Teach-Back at a maternal and child health helpline, supplemented with caller experiences. Method: After training maternal and child health nurses to use Teach-Back ( n = 15), we interviewed nurses and callers to the helpline service. We used semi-structured guides to conduct focus groups and telephone interviews and analyzed transcripts of nurse and caller data using the Framework method. This qualitative study forms part of a randomized controlled trial of Teach-Back involving 637 callers. Key Results: Nurses ( n = 13) reported Teach-Back was helpful to invite questions from callers, summarize information, review action plans, and close calls. Some found it helpful to empower and calm (anxious) callers. Nurses reported they did not always use Teach-Back, either because it was not appropriate or they felt uncomfortable with phrasing. Comfort with using Teach-Back tended to improve with practice. Perceived effect on call duration was mixed. We report sample Teach-Back strategies used by nurses, including the lead-in phrase “just before you go…,” which was considered helpful for initiating Teach-Back at close of a call. Caller reports of Teach-Back were limited ( n = 8) but mostly positive. Conclusions: Teach-Back is a simple communication technique that can be used in a consumer telehealth service to confirm caller understanding and actions to take, and in some cases it may also reduce caller anxiety. Further research on caller experiences and objective impact on call duration is needed. [ Health Literacy Research and Practice . 2017;1(4):e173–e181.] Plain Language Summary: Low health literacy can be difficult to identify, especially over the telephone. Asking callers to summarize important information and agreed actions (known as Teach-Back) could help telehealth providers confirm understanding. We interviewed nurses operating a maternal and child health helpline and callers about their experiences with Teach-Back. Findings support Teach-Back for telehealth and suggest Teach-Back can also reduce caller anxiety.

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An Evaluation of the Impact of a Health Literacy Educational Package for Community Pharmacists and Pharmacy Staff in Australia

Cited by 2 publications

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A stepped wedge cluster randomised trial of nurse-delivered Teach-Back in a consumer telehealth service

A stepped wedge cluster randomised trial of nurse-delivered Teach-Back in a consumer telehealth service

Experiences of Teach-Back in a Telephone Health Service

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