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Med Decis Making. 2010 Jan-Feb;30(1):35-44. doi: 10.1177/0272989X09342279. Epub 2009 Aug 19.

The challenge of shared decision making among patients with lower literacy: a framework for research and development.

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Screening and Test Evaluation Program, School of Public Health, Centre for Medical Psychology and Evidence-based Decision Making, University of Sydney, Australia.


There have been major advances in techniques to increase patient involvement in health decisions with the benefits of greater involvement and shared decision making now widely recognized. However, there has been little attention in the development of tools and strategies to support patient participation among adults with lower literacy, a group with poor health knowledge, limited involvement in health decisions, and poor health outcomes. The authors put forward a framework to consider the different stages of shared health decision making and the tasks and skills required to achieve each stage. They consider where current research exists in the decision making literature and where more is needed if adults with limited literacy are to be better engaged in shared decision making in health care.

[Indexed for MEDLINE]

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