BOSTON – A training program aimed at helping healthcare providers better communicate clinical information to low-health-literacy oncology patients achieved high satisfaction rates, researchers said here.
In addition, paired T-tests used to measure pre- and post-change scores ranged from 13-52 and 29-63 (Cronbach's alpha=0.62-0.86), respectively, across the curriculum's four modules. Improvement in all modules led to statistically significant composite scores (P<0.005), Martinez-Donate told MedPage Today at the annual meeting of the American Public Health Association.
Approximately 80 million Americans (36%) lack the necessary skills to read, understand, and act on healthcare information, Martinez-Donate noted, adding that physician-champions are critical to successful health literacy training and implementation.
In the Rural Oncology Literary Enhancement Study (ROLES), published in the Journal of Cancer Education, Martinez-Donate and colleagues developed and evaluated a pilot health literacy curriculum for providers and oncology staff at two rural hospitals.
Modules covered the following areas:
- Understanding health literacy and implications for patient care
- Ensuring patient understanding
- Communicating numbers to enhance decision-making
- Applying health literacy to joint agenda settings and written communication
Martinez-Donate and colleagues tailored the training to meet the needs participants identified in a formative assessment. Self-administered pre- and post-training surveys were used to independently assess each module, and to evaluate learning and intent to incorporate best practices.
The training module was tested on 115 non-unique participants (23-37 per module). They included physicians (14%), nurses (64%) and other oncology staff (21%).
Because cancer patients experience numerous literacy barriers and navigation needs, interventions to increase provider awareness and skills in rural oncology settings are as necessary as they are feasible and effective, according to Martinez-Donate.
"Quality improvement is an ongoing process," she said, adding that academic/community partnerships work well together to transform healthcare systems. However, she continued, change also requires an increasingly more aware and committed leadership, willing to invest in a more prepared workforce.
According to Martinez-Donate, results from the pilot study underscore the need for interventions to improve patient-provider education and communication. However, it will take support at the highest levels to get buy-in on training from busy doctors, and future evaluations will examine the impact of this training on cancer care.
This pilot study had a number of limitations. They included possible selection bias; small sample size; no short- or long-term follow-up on how, or if, the new knowledge was put to use; and possible differences in how, where, when, and who taught the curriculum modules. Other limitations include the study's pre-/post-design, self-reported data, provider-only data, and new, unvalidated testing instruments.
This study was funded by the University of Wisconsin School of Medicine and Public Health Wisconsin Partnership Program, the University of Wisconsin Carbone Cancer Center, and Wisconsin Literacy.
Martinez-Donate reported no financial conflicts of interest.
The American Public Health AssociationSource Reference: Martinez-Donate AP, et al "Effectiveness of a health literacy training curriculum for providers and staff at rural oncology clinics: Results from the rural oncology literacy enhancement study (ROLES)" APHA 2013; Abstract 3062.0
Journal of Cancer EducationSource Reference: Martinez-Donate AP, et al "Identifying health literacy and health system navigation needs among rural cancer patients: Findings from the rural oncology literacy enhancement study (ROLES)" J Canc Educ 2013; 28; 573-581.