Open AccessHealth literacy skills for informed decision making in colorectal cancer screening: Perceptions of screening invitees and experts
Author(s) -
Woudstra Anke J.,
Timmermans Daniëlle R. M.,
Uiters Ellen,
Dekker Evelien,
Smets Ellen M. A.,
Fransen Mirjam P.
Publication year - 2018
Publication title -
health expectations
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.314
H-Index - 74
eISSN - 1369-7625
pISSN - 1369-6513
DOI - 10.1111/hex.12658
Subject(s) - health literacy , focus group , context (archaeology) , psychological intervention , medicine , medical education , relevance (law) , health care , conceptual framework , decision aids , patient participation , psychology , family medicine , nursing , alternative medicine , pathology , political science , law , paleontology , philosophy , epistemology , marketing , economics , business , biology , economic growth
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.