Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Gen Intern Med. 2010 May;25 Suppl 2:S126-9. doi: 10.1007/s11606-009-1211-6.

Cancer risk communication with low health literacy patients: a continuing medical education program.

Author information

  • 1Division of General Internal Medicine & Geriatrics, Tulane University School of Medicine, New Orleans, LA 70112, USA. eprice@tulane.edu

Abstract

BACKGROUND:

Low health literacy (HL) is an important risk factor for cancer health disparities.

OBJECTIVE:

Describe a continuing medical education (CME) program to teach primary care physicians (PCP) cancer risk communication and shared decision-making (SDM) with low HL patients and baseline skills assessment.

DESIGN:

Cluster randomized controlled trial in five primary care clinics in New Orleans, LA.

PARTICIPANTS:

Eighteen PCPs and 73 low HL patients overdue for cancer screening.

INTERVENTION:

Primary care physicians completed unannounced standardized patient (SP) encounters at baseline. Intervention physicians received SP verbal feedback; academic detailing to review cancer screening guidelines, red flags for identifying low HL, and strategies for effective counseling; and web-based tutorial of SP comments and checklist items hyperlinked to reference articles/websites.

MAIN MEASURES:

Baseline PCP self-rated proficiency, SP ratings of physician general cancer risk communication and SDM skills, patient perceived involvement in care.

RESULTS:

Baseline assessments show physicians rated their proficiency in discussing cancer risks and eliciting patient preference for treatment/decision-making as "very good". SPs rated physician exploration of perceived cancer susceptibility, screening barriers/motivators, checking understanding, explaining screening options and associated risks/benefits, and eliciting preferences for screening as "satisfactory". Clinic patients rated their doctor's facilitation of involvement in care and information exchange as "good". However, they rated their participation in decision-making as "poor".

DISCUSSION:

The baseline skills assessment suggests a need for physician training in cancer risk communication and shared decision making for patients with low HL. We are determining the effectiveness of teaching methods, required resources and long-term feasibility for a CME program.

PMID:
20352506
[PubMed - indexed for MEDLINE]
PMCID:
PMC2847095
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for Springer Icon for PubMed Central
    Loading ...
    Write to the Help Desk