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.

Skeptical reactions to breast cancer screening benefits and harms: Antecedents, consequences, and implications for screening communication.

Objective: When people receive information about the benefits and harms of mammography screening, they do not always accept it at face value and instead express skepticism. The purpose of this research was to identify the psychological drivers of this skepticism. Two theory-driven hypotheses were considered: One hypothesis proposes that skeptical reactions reflect a psychological defense against information that is emotionally aversive.

Australian and Canadian clinicians' views and application of 'carbon health literacy': a qualitative study.

Background: Clinical care contributes to at least 50% of the greenhouse gas (GHG) emissions of healthcare. This includes the 40% of healthcare that is harmful or low value, adding avoidable emissions without improving health or quality of care. Clinicians are well-placed to mitigate emissions associated with the provision of clinical care.

Australian private healthcare staff perspectives on patient reported experience measures (PREMs): a qualitative interview study.

Objective: Patient reported experience measures (PREMs) are common tools utilised in hospitals to support quality improvements, allow consumers to provide feedback on care experiences and can be used to support consumers' hospital selections. This study aimed to understand the views and opinions of private hospital staff on PREM use and the utility of PREMs as a consumer decision-making tool.

Method: Qualitative, semi-structured interview study conducted via telephone between March-June 2023.

Perspectives of international experts and the Danish citizens on the 'relevant knowledge' that citizens need for making informed choices about participation in cancer screening: Qualitative study.

Objectives: This study aimed to investigate the perspectives of international experts and Danish citizens on relevant knowledge about population-based breast, colorectal and cervical cancer screening.

Methods: This was a qualitative interview study with focus group interviews with experts and Danish citizens eligible for breast, colorectal and/or cervical cancer screening. Data were collected using semi-structured interview guides, audio-recorded and transcribed verbatim.

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.

User-driven instructions reduce errors in child restraint use: a randomised controlled trial in Sydney, Australia.

Background And Objectives: Crash injury risk is reduced when a child correctly uses an appropriate restraint; however, incorrect restraint use remains widespread. The aim of this study was to determine whether product information developed using a user-driven approach increases correct child restraint use.

Methods: We conducted a two-arm double-blinded parallel randomised controlled trial in New South Wales, Australia 2019-2021.

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.

Developing an Educational Resource Aimed at Improving Adolescent Digital Health Literacy: Using Co-Design as Research Methodology.

Background: Adolescence is a key developmental period that affects lifelong health and is impacted by adolescents regularly engaging with digital health information. Adolescents need digital health literacy (DHL) to effectively evaluate the quality and credibility of such information, and to navigate an increasingly complex digital health environment. Few educational resources exist to improve DHL, and few have involved adolescents during design.

Exploring the factors impacting choice and quality of overnight private hospital stays and consumer perspectives on patient reported experience measures (PREMs) in Australia: a qualitative interview study.

Objectives: Patient reported experience measures (PREMs) are tools often utilised in hospitals to support quality improvements and to provide objective feedback on care experiences. Less commonly PREMs can be used to support consumers choices in their hospital care. Little is known about the experience and views of the Australian consumer regarding PREMs nor the considerations these consumers have when they need to make decisions about attending hospital.

Mammography Screening Preferences Among Screening-Eligible Women in Their 40s : A National U.S. Survey.

Background: The U.S. Preventive Services Task Force (USPSTF) recently changed its recommendation for mammography screening from informed decision making to biennial screening for women aged 40 to 49 years.

Use of digital patient decision-support tools for atrial fibrillation treatments: a systematic review and meta-analysis.

Objectives: To assess the effects of digital patient decision-support tools for atrial fibrillation (AF) treatment decisions in adults with AF.

Study Design: Systematic review and meta-analysis.

Eligibility Criteria: Eligible randomised controlled trials (RCTs) evaluated digital patient decision-support tools for AF treatment decisions in adults with AF.

Development of a patient decision aid for children and adolescents following anterior cruciate ligament rupture: an international mixed-methods study.

Aim: To develop and user test an evidence-based patient decision aid for children and adolescents who are considering anterior cruciate ligament (ACL) reconstruction.

Design: Mixed-methods study describing the development of a patient decision aid.

Setting: A draft decision aid was developed by a multidisciplinary steering group (including various types of health professionals and researchers, and consumers) informed by the best available evidence and existing patient decision aids.

Randomized Trial of Information for Older Women About Cessation of Breast Cancer Screening Invitations.

Background: Older women receive no information about why Australia's breast screening program (BreastScreen) invitations cease after 74 years. We tested how providing older women with the rationale for breast screening cessation impacted informed choice (adequate knowledge; screening attitudes aligned with intention).

Methods: In a three-arm online randomized trial, eligible participants were females aged 70-74 years who had recently participated in breast screening (within 5 years), without personal breast cancer history, recruited through Qualtrics.

Qualitative and Quantitative Evaluation of an Innovative Primary and Secondary Diabetes Clinic in Western Sydney.

Introduction: Western Sydney Diabetes (WSD) established an innovative diabetes service in May 2020, using virtual and in-person care, linking primary care with the diabetes specialist team. This study evaluated the service's feasibility using qualitative and quantitative methods.

Method: Evaluation included: 1) thematic analysis of interviews and workshops with patients and health professionals (n = 28); 2) quantitative analysis of records of patients admitted July 2020-June 2021 (n = 110).

Development of the Reporting Infographics and Visual Abstracts of Comparative studies (RIVA-C) checklist and guide.

People often use infographics (also called visual or graphical abstracts) as a substitute for reading the full text of an article. This is a concern because most infographics do not present sufficient information to interpret the research appropriately and guide wise health decisions. The Reporting Infographics and Visual Abstracts of Comparative studies (RIVA-C) checklist and guide aims to improve the completeness with which research findings of comparative studies are communicated and avoid research findings being misinterpreted if readers do not refer to the full text.

Attitudes, knowledge and practice regarding the anti-müllerian hormone test among general practitioners and reproductive specialists: A cross-sectional study.

Objective: To describe clinicians' attitudes, knowledge and practice relating to the anti-müllerian hormone (AMH) test.

Design: Cross-sectional nationwide survey.

Setting: Australia.

Clinical Observation, Management and Function Of low back pain Relief Therapies (COMFORT): A cluster randomised controlled trial protocol.

Introduction: Low back pain (LBP) is commonly treated with opioid analgesics despite evidence that these medicines provide minimal or no benefit for LBP and have an established profile of harms. International guidelines discourage or urge caution with the use of opioids for back pain; however, doctors and patients lack practical strategies to help them implement the guidelines. This trial will evaluate a multifaceted intervention to support general practitioners (GPs) and their patients with LBP implement the recommendations in the latest opioid prescribing guidelines.

New Frontiers in Health Literacy: Using ChatGPT to Simplify Health Information for People in the Community.

Background: Most health information does not meet the health literacy needs of our communities. Writing health information in plain language is time-consuming but the release of tools like ChatGPT may make it easier to produce reliable plain language health information.

Objective: To investigate the capacity for ChatGPT to produce plain language versions of health texts.

Screening for cancer beyond recommended upper age limits: views and experiences of older people.

Background: Internationally, screening programmes and clinical practice guidelines recommend when older adults should stop cancer screening using upper age limits, but it is unknown how older adults view these recommendations.

Objective: To examine older adults' views and experiences about continuing or stopping cancer screening beyond the recommended upper age limit for breast, cervical, prostate and bowel cancer.

Design: Qualitative, semi-structured interviews.