'It's Putting All the Burden on the Patient': A Qualitative Study of Health Literacy and Shared Decision-Making in Rural Australian Communities.

Objectives: Rural communities in Australia face significant barriers to health. Grounded in phenomenology as a research methodology, this study aimed to explore health literacy and shared decision-making in rural areas from the perspective of community members.

Design: Semi-structured interview study, with data analysed using Framework Analysis.

Decision Support Tools in Deceased Donor Kidney Transplantation: An Environmental Scan and Appraisal of Online Resources.

The pathway to deceased donor kidney transplantation involves complex risk assessment and decision-making by donor coordinators, transplant clinicians, and patients. We reviewed freely available tools designed to facilitate decision-making in the context of deceased donor kidney transplantation for usability and communication efficacy. An environmental scan was conducted using Google; search results meeting inclusion criteria were appraised by 3 independent reviewers using the International Patient Decision Aids Standards Instrument, the Patient Education Material Evaluation Tool, and the Healthcare Systems Usability Scale.

Perspectives of people with chronic illness about plain language summaries: a qualitative analysis.

People with chronic health conditions tend to look for information from a range of sources. Although information online is accessible, the quality varies and articles in scientific journals are not written for a general audience. Given this, plain language summaries (PLSs) may be a useful source of information, especially for people with chronic medical conditions.

"Your Life, Your Health: Tips and Information for Health and Well-Being": Development of a World Health Organization Digital Resource to Support Universal Access to Trustworthy Health Information.

Background: Access to trustworthy, understandable, and actionable health information is a key determinant of health and is an essential component of universal health coverage and primary health care. The World Health Organization has developed a new digital resource for the general public to improve health and well-being across different life phases and to support people in caring for themselves, their families, and their communities. The goal was to make trustworthy health information accessible, understandable, and actionable for the general public in a digital format and at the global scale.

Values, Preferences, and Risk Tolerance of People Waitlisted for a Kidney Transplant Regarding Potential Deceased Donor Organ Profiles: A Systematic Review.

Background: Incorporating the views of people waitlisted for a kidney transplant is important when clinicians consider any donor kidney offer.

Methods: We conducted a systematic review of quantitative and qualitative studies in adult patients on, or under assessment for, the kidney waitlist. We focused on views of extended criteria, increased viral (blood-borne virus), or increased cancer risk in deceased donor kidneys.

How have interventions targeting pregnant women from refugee, migrant and culturally and linguistically diverse backgrounds living in high-income countries been developed or tailored to meet community needs? A systematic scoping review of stillbirth-related literature.

Background: People from migrant, refugee and culturally and linguistically diverse backgrounds experience significant disparities in pregnancy outcomes compared to the general population, including a higher risk of stillbirth. This study aimed to identify stillbirth-related programs or interventions for pregnant women from culturally and linguistically diverse backgrounds and explore how these interventions have been developed and/or tailored for culturally and linguistically diverse women.

Methods: We searched MEDLINE, CINAHL, Embase, and Scopus for articles published from inception to 12 Jan 2023.

The Readability Study: A Randomised Trial of Health Information Written at Different Grade Reading Levels.

Background: Despite increasing attention on health literacy and the inclusion of grade reading level recommendations in guidelines, it remains unclear if lowering the grade reading level of written health information to specific target grades improves patient-related outcomes.

Objective: To assess whether grade reading level of written information affects knowledge, perceived reading ease, acceptability and trustworthiness of information and, to explore whether information written at a lower grade reading level reduces disparities in outcomes across health literacy levels.

Design: We conducted a 4-arm online randomized trial with a community sample of adults living in Australia from 31 July to 20 September 2023.

Are plain language summaries published in health journals written according to instructions and health literacy principles? A systematic environmental scan.

Background: Plain language summaries (PLSs) are easy-to-understand summaries of research articles that should follow principles of plain language and health literacy. PLS author instructions from health journals help guide authors on word count/PLS length, structure and the use of jargon. However, it is unclear whether published PLSs currently adhere to author instructions.

Online Plain Language Tool and Health Information Quality: A Randomized Clinical Trial.

Importance: Complex and ineffective health communication is a critical source of health inequity and occurs despite repeated policy directives to provide health information that is easy to understand and applies health literacy principles.

Objective: To evaluate the effectiveness of the Sydney Health Literacy Lab Health Literacy Editor, an easy-to-use online plain language tool that supports health information providers to apply health literacy guidelines to written health information.

Design, Setting, And Participants: This randomized clinical trial, conducted online in Australia from May 2023 to February 2024, included a convenience sample of health information providers with no previous experience using the Health Literacy Editor.

Health literacy and diabetes information preferences among Chinese immigrants: An Australian cross-sectional study.

Aim: Explore Australian-Chinese immigrants' health literacy and preferences and engagement with translated diabetes self-management patient education materials.

Design: The cross-sectional survey was conducted with Australian-Chinese immigrants at risk or with type 2 diabetes recruited via health services, and diabetes and community organisations.

Methods: The survey had three parts: (1) diabetes screening; (2) sociodemographic information, clinical characteristics and preferences for translated materials; and (3) Functional, Communicative and Critical Health Literacy (FCCHL) Scale.

Equity in Choosing Wisely and beyond: the effect of health literacy on healthcare decision-making and methods to support conversations about overuse.

Objective: To (a) examine whether the effect of the Choosing Wisely consumer questions on question-asking and shared decision-making (SDM) outcomes differs based on individuals' health literacy and (b) explore the relationship between health literacy, question-asking and other decision-making outcomes in the context of low value care.

Methods: Preplanned analysis of randomised trial data comparing: the Choosing Wisely questions, a SDM video, both interventions or control (no intervention). Randomisation was stratified by participant health literacy ('adequate' vs 'limited'), as assessed by the Newest Vital Sign.

Qualitative Evaluation of a Health Literacy Program for Older Adults Who Live in a Community Dwelling in Brazil.

To address current gaps in health literacy research and practice in low-resource settings, the 'Alfa-Health Program' was designed to improve health literacy in older adults who live in a community dwelling in a socioeconomically disadvantaged community in North-East Brazil. In this longitudinal qualitative study, participants were interviewed before and after participating in the group-based program that was delivered November 2017 to December 2017 in the Primary Care Health Unit. Semi-structured interviews were guided by a previously validated health literacy instrument, translated and adapted for use in Brazil.

The future of allergic rhinitis management: A partnership between healthcare professionals and patients.

Allergic rhinitis (AR) is a chronic respiratory condition that internationally continues to be burdensome and impacts quality of life. Despite availability of medicines and guidelines for healthcare providers for the optimal management of AR, optimisation of its management in the community continues to be elusive. The reasons for this are multi-faceted and include both environmental and healthcare related factors.

Systematic review of health literacy champions: who, what and how?

Health literacy is an important aspect of equitable, safe, and high-quality care. For organizations implementing health literacy initiatives, using 'change champions' appears to be a promising strategy. This systematic review aimed to identify the empirical and conceptual research that exists about health literacy champions.

Randomized Trial of the Choosing Wisely Consumer Questions and a Shared Decision-Making Video Intervention on Decision-Making Outcomes.

Background: Despite widespread use, there are few studies evaluating the consumer Choosing Wisely questions.

Methods: We evaluated the impact of the Choosing Wisely questions on consumers' decision-making outcomes. Adults living in Australia were presented with a hypothetical low-value care scenario.

Helping patient educators meet health literacy needs: End-user testing and iterative development of an innovative health literacy editing tool.

Objective: The Sydney Health Literacy Lab (SHeLL) Editor is an online text-editing tool that provides real-time assessment and feedback on written health information (assesses grade reading score, complex language, passive voice). This study aimed to explore how the design could be further enhanced to help health information providers interpret and act on automated feedback.

Methods: The prototype was iteratively refined across four rounds of user-testing with health services staff ( = 20).

Interventions to support decision-making, health literacy and self-management in ethnic-minority adults living with chronic kidney disease: a systematic review.

Optimal patient care is directed by clinical practice guidelines, with emphasis on shared decision-making. However, guidelines-and interventions to support their implementation-often do not reflect the needs of ethnic minorities, who experience inequities in chronic kidney disease (CKD) prevalence and outcomes. This review aims to describe what interventions exist to promote decision-making, self-management and/or health literacy for ethnic-minority people living with CKD, describe intervention development and/or adaptation processes, and explore the impact on patient outcomes.

Shifts in Diabetes Health Literacy Policy and Practice in Australia-Promoting Organisational Health Literacy.

Improving organisational health literacy ensures people can navigate, understand and use essential health information and services. However, systematic reviews have identified limited evidence for practical approaches to implementing such organisational change, particularly at a national level. This study aimed to (a) investigate the approach taken by an Australian national diabetes organisation-Diabetes Australia, as the administrator of the National Diabetes Services Scheme (NDSS)-to improve organisational health literacy over a 15-year-period and (b) examine the impact of organisational changes on the health literacy demands of health information.

Universal health information is essential for universal health coverage.

Universal access to health information is a human right and essential to achieving universal health coverage and the other health-related targets of the sustainable development goals. The COVID-19 pandemic has further highlighted the importance of trustworthy sources of health information that are accessible to all people, easily understood and acted on. WHO has developed , as a new digital resource for the general public which makes trustworthy health information understandable, accessible and actionable.

A feasibility study of a best practice health literacy app for Australian adults with chronic kidney disease.

Objective: To investigate feasibility of the SUCCESS app; a cross-platform e-health innovation to improve health literacy, self-management and shared decision-making among culturally-diverse Australian haemodialysis patients.

Methods: Multi-site, pre-post, mixed-methods study. Haemodialysis patients ≥18 years used the app for 12 weeks.

Integrating consumer perspectives into a large-scale health literacy audit of health information materials: learnings and next steps.

Background: Health information is less effective when it does not meet the health literacy needs of its consumers. For health organisations, assessing the appropriateness of their existing health information resources is a key step to addressing this issue. This study describes novel methods for a consumer-centred large-scale health literacy audit of existing resources and reflects on opportunities to further refine the method.

Multiple Automated Health Literacy Assessments of Written Health Information: Development of the SHeLL (Sydney Health Literacy Lab) Health Literacy Editor v1.

Producing health information that people can easily understand is challenging and time-consuming. Existing guidance is often subjective and lacks specificity. With advances in software that reads and analyzes text, there is an opportunity to develop tools that provide objective, specific, and automated guidance on the complexity of health information.