Qualitative insights into the experience of teaching shared decision making within adult education health literacy programmes for lower‐literacy learners

Abstract

BackgroundEnhancing health literacy can play a major role in improving healthcare and health across the globe. To build higher‐order (communicative/critical) health literacy skills among socially disadvantaged Australians, we developed a novel shared decision making (SDM) training programme for adults with lower literacy. The programme was delivered by trained educators within an adult basic education health literacy course.ObjectiveTo explore the experience of teaching SDM within a health literacy programme and investigate whether communicative/critical health literacy content meets learner needs and teaching and institutional objectives.Design and participantsQualitative interview study with 11 educators who delivered the SDM programme. Transcripts were analysed using the Framework approach; a matrix‐based method of thematic analysis.ResultsTeachers noted congruence in SDM content and the institutional commitment to learner empowerment in adult education. The SDM programme was seen to offer learners an alternative to their usual passive approach to healthcare decision making by raising awareness of the right to ask questions and consider alternative test/treatment options. Teachers valued a structured approach to training building on foundational skills, with language reinforcement and take‐home resources, but many noted the need for additional time to develop learner understanding and cover all aspects of SDM. Challenges for adult learners included SDM terminology, computational numerical risk tasks and understanding probability concepts.Discussion and conclusions SDM programmes can be designed in a way that both supports teachers to deliver novel health literacy content and empowers learners. Collaboration between adult education and healthcare sectors can build health literacy capacity of those most in need.

Learners’ experience and perceived impact of a health literacy program in adult basic education: a qualitative study

“…This study forms part of a larger program of work evaluating the impact of our adult education health literacy training program. 12,13,[15][16][17][18] Combined, our results add to the growing evidence that adult basic education institutions have potential to develop transferable health literacy skills among socially disadvantaged groups. These qualitative findings further support theories of adult learning, which posit that adult learners are motivated to learn when they understand the relevance of the content to their daily lives.…”

A Qualitative Study of the Development of Health Literacy Capacities of Participants Attending a Community-Based Cardiovascular Health Programme

“…Research has highlighted the need to move beyond a focus on functional health literacy capacities in order to gain a greater insight into how the social and cultural context of individuals’ lives can facilitate the development of health literacy capacities, [ 12 , 15 , 16 ]. Some recent studies have examined this in adult-based educational settings [ 17 , 18 ]. This paper draws on the health literacy model developed by Sørensen et al [ 5 ] to explore the different dimensions of health literacy within healthcare, disease prevention and health promotion settings.…”

Investigation of factors influencing the implementation of two shared decision-making interventions in contraceptive care: a qualitative interview study among clinical and administrative staff

“…However, these attitudes may not be supported by emerging literature. Recent investigations from Australia suggest that generic question sets alone, like those used in our video and prompt card, are not sufficient to support shared decision-making among adults with low literacy [31] and additional strategies may be required to improve understanding of SDM terms and probability concepts [32].…”