Improving health literacy: informed decision-making rather than informed consent for CT scans in children

Contrary to popular belief, a patient’s signature on a piece of paper does not constitute informed consent. This article describes the ethical framework of consent in the context of the larger process of informed decision making. The elements of informed consent are examined in practical terms. Common pitfalls are addressed, with strategies to help anticipate and resolve possible dilemmas. These important tools are integral to all levels of medical decision making, including those at the end of life. (J Am Podiatr Med Assoc 94(2): 198-205, 2004)

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Knowledge and Informed Decision-Making about Population-Based Colorectal Cancer Screening Participation in Groups with Low and Adequate Health Literacy

Gastroenterology Research and Practice ◽

10.1155/2016/7292369 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 10

Author(s):

M. L. Essink-Bot ◽

E. Dekker ◽

D. R. M. Timmermans ◽

E. Uiters ◽

M. P. Fransen

Keyword(s):

Colorectal Cancer ◽

Decision Making ◽

Health Literacy ◽

Decisional Conflict ◽

Informed Decision ◽

Informed Decision Making ◽

Crc Screening ◽

Adequate Health Literacy ◽

Screening Participation ◽

Intention To Participate

Objective. To analyze and compare decision-relevant knowledge, decisional conflict, and informed decision-making about colorectal cancer (CRC) screening participation between potential screening participants with low and adequate health literacy (HL), defined as the skills to access, understand, and apply information to make informed decisions about health.Methods. Survey including 71 individuals with low HL and 70 with adequate HL, all eligible for the Dutch organized CRC screening program. Knowledge, attitude, intention to participate, and decisional conflict were assessed after reading the standard information materials. HL was assessed using the Short Assessment of Health Literacy in Dutch. Informed decision-making was analyzed by the multidimensional measure of informed choice.Results. 64% of the study population had adequate knowledge of CRC and CRC screening (low HL 43/71 (61%), adequate HL 47/70 (67%),p>0.05). 57% were informed decision-makers (low HL 34/71 (55%), adequate HL 39/70 (58%),p>0.05). Intention to participate was 89% (low HL 63/71 (89%), adequate HL 63/70 (90%)). Respondents with low HL experienced significantly more decisional conflict (25.8 versus 16.1;p=0.00).Conclusion. Informed decision-making about CRC screening participation was suboptimal among both individuals with low HL and individuals with adequate HL. Further research is required to develop and implement effective strategies to convey decision-relevant knowledge about CRC screening to all screening invitees.

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Health literacy skills for informed decision making in colorectal cancer screening: Perceptions of screening invitees and experts

Health Expectations ◽

10.1111/hex.12658 ◽

2017 ◽

Vol 21 (3) ◽

pp. 636-646 ◽

Cited By ~ 6

Author(s):

Anke J. Woudstra ◽

Daniëlle R. M. Timmermans ◽

Ellen Uiters ◽

Evelien Dekker ◽

Ellen M. A. Smets ◽

...

Keyword(s):

Colorectal Cancer ◽

Decision Making ◽

Health Literacy ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Literacy Skills ◽

Informed Decision ◽

Informed Decision Making

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7.G. Skills building seminar: Promoting health literacy to facilitate informed decision-making by developing fact boxes

European Journal of Public Health ◽

10.1093/eurpub/ckx187.516 ◽

2017 ◽

Vol 27 (suppl_3) ◽

Author(s):

◽

Keyword(s):

Decision Making ◽

Health Literacy ◽

Informed Decision ◽

Informed Decision Making

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Informed Decision Making Trumps Informed Consent for Medical Imaging with Ionizing Radiation

Radiology ◽

10.1148/radiol.11111421 ◽

2012 ◽

Vol 262 (1) ◽

pp. 11-14 ◽

Cited By ~ 48

Author(s):

James A. Brink ◽

Marilyn J. Goske ◽

John A. Patti

Keyword(s):

Decision Making ◽

Informed Consent ◽

Medical Imaging ◽

Ionizing Radiation ◽

Informed Decision ◽

Informed Decision Making

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The Role of Health Literacy in Explaining the Relation between Educational Level and Decision Making about Colorectal Cancer Screening

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16234644 ◽

2019 ◽

Vol 16 (23) ◽

pp. 4644

Author(s):

Anke J. Woudstra ◽

Ellen M. A. Smets ◽

Mathilde G. E. Verdam ◽

Mirjam P. Fransen

Keyword(s):

Colorectal Cancer ◽

Decision Making ◽

Health Literacy ◽

Structural Equation ◽

Decisional Conflict ◽

Informed Decision ◽

Informed Decision Making ◽

Descriptive Norm ◽

Injunctive Norm ◽

Crc Screening

Little is known about why educational inequalities exist in informed decision making in colorectal cancer (CRC) screening. Insight into the role and impact of health literacy is essential for intervention development. This study investigates associations between health literacy and informed decision making in CRC screening and explores to what extent health literacy mediates the association between education and informed decision making in CRC screening. In total, 696 individuals eligible for CRC screening (55–75 years of age) were recruited from online panels and filled in an online questionnaire at T0 (n = 696), T1 (n = 407) and T2 (n = 327). A hypothetical mediation model was tested using structural equation modelling. Outcomes included CRC knowledge, CRC screening knowledge, attitude, injunctive norm, descriptive norm, risk perception, self-efficacy, decisional conflict and decisional certainty. Health literacy domains included Comprehension, Application, Numeracy and Communication. Comprehension, Application and Numeracy, were found to mediate the association between education and knowledge about CRC and CRC screening, injunctive norm, descriptive norm, decisional conflict and decisional certainty. In light of these findings, targeting multiple health literacy domains in decision-support interventions is essential for facilitating informed decision making in CRC screening.

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