Incorporating health literacy in education for socially disadvantaged adults: an Australian feasibility study.

Background: Adult education institutions have been identified as potential settings to improve health literacy and address the health inequalities that stem from limited health literacy. However, few health literacy interventions have been tested in this setting.

Methods: Feasibility study for an RCT of the UK Skilled for Health Program adapted for implementation in Australian adult education settings.

Evaluation of an Australian health literacy training program for socially disadvantaged adults attending basic education classes: study protocol for a cluster randomised controlled trial.

Background: People with low literacy and low health literacy have poorer health outcomes. Literacy and health literacy are distinct but overlapping constructs that impact wellbeing. Interventions that target both could improve health outcomes.

The Breathing for Life Trial: a randomised controlled trial of fractional exhaled nitric oxide (FENO)-based management of asthma during pregnancy and its impact on perinatal outcomes and infant and childhood respiratory health.

Background: Asthma exacerbations are common during pregnancy and associated with an increased risk of adverse perinatal outcomes. Adjusting asthma treatment based on airway inflammation rather than symptoms reduces the exacerbation rate by 50 %. The Breathing for Life Trial (BLT) will test whether this approach also improves perinatal outcomes.

The influence of the 'cancer effect' on young women's responses to overdiagnosis in cervical screening.

Objectives: To examine the 'cancer effect' (higher risk perceptions and negative emotion in cancer-related contexts) on young women's responses to overdiagnosis (identification and treatment of inconsequential disease) in cervical cancer screening.

Methods: In a randomised experimental study, 168 women aged 17-24 read 1 of 4 texts outlining benefits and harms of cervical cancer screening or a fictitious non-cancer screening test; each presented with or without overdiagnosis information. Screening intentions and psychosocial outcomes were measured (T1).

General Practitioners' Experiences of, and Responses to, Uncertainty in Prostate Cancer Screening: Insights from a Qualitative Study.

Background: Prostate-specific antigen (PSA) testing for prostate cancer is controversial. There are unresolved tensions and disagreements amongst experts, and clinical guidelines conflict. This both reflects and generates significant uncertainty about the appropriateness of screening.

The evaluation of a question prompt list for attention-deficit/hyperactivity disorder in pediatric care: A pilot study.

Background: Of the available treatment options for attention-deficit/hyperactivity disorder (ADHD), the use of medications remains the most controversial and it is often difficult for parents to make decisions about treatment. Provision of relevant, reliable information about treatment during consultations may help address parents' concerns about treatment options. Question prompt lists are structured lists of disease and treatment-specific questions intended for use by patients during consultations to encourage communication with clinicians.

Listening to both sides: A qualitative comparison between patients with hepatitis C and their healthcare professionals' perceptions of the facilitators and barriers to hepatitis C treatment adherence and completion.

This qualitative study compares and contrasts the perspectives of healthcare professionals who treat hepatitis C with those of patients in treatment. Comparative analysis of semi-structured interviews with 20 healthcare professionals and 20 patients undergoing treatment for hepatitis C concluded that patients and healthcare professionals disagreed on the source of communication breakdowns, but both felt that individualised clinical information improved adherence. Stigma was recognised as a barrier to treatment adherence by both patients and healthcare professionals.

The differential effects of presenting uncertainty around benefits and harms on treatment decision making.

Objective: The study aimed to determine the effects of presenting uncertainty of quantitative risk information about medication harms and benefits on intention to take medication and psychosocial outcomes.

Methods: 147 participants were randomized into four hypothetical scenarios: (1) harm/benefit presented as point-estimates, (2) harm as point/benefit as range, (3) harm as range/benefit as point, (4) harm/benefit as ranges. We assessed participants' intention to take medication, understanding, decisional conflict, and perceived benefit and harm.

How different terminology for ductal carcinoma in situ impacts women's concern and treatment preferences: a randomised comparison within a national community survey.

Objective: There have been calls to remove 'carcinoma' from terminology for in situ cancers such as ductal carcinoma in situ (DCIS), to reduce overdiagnosis and overtreatment. We investigated the effect of describing DCIS as 'abnormal cells' versus 'pre-invasive breast cancer cells' on women's concern and treatment preferences.

Setting And Participants: Community sample of Australian women (n=269) who spoke English as their main language at home.

How different terminology for ductal carcinoma in situ (DCIS) impacts women's concern and management preferences: A qualitative study.

Objective: There are increasing rates of mastectomy and bi-lateral mastectomy in women diagnosed with ductal carcinoma in situ (DCIS). To help women avoid decisions that lead to unnecessary aggressive treatments, there have been recent calls to remove the cancer terminology from descriptions of DCIS. We investigated how different proposed terminologies for DCIS affect women's perceived concern and management preferences.

The influence of asthma control on psychosocial outcomes for pregnant women with asthma.

Objective: To investigate the relationship between asthma control and psychosocial outcomes in pregnant women with asthma.

Methods: Secondary analysis (N = 221) of a randomized controlled trial of treatment adjustments, based on fractional exhaled nitric oxide versus clinical guideline-based algorithms. Psychosocial variables included generic and asthma-specific quality of life (SF12, AQLQ-M), illness perceptions (BIPQ), perceived control (PCAQ), perceived risk of side effects (PRSE) and anxiety (STAI-6).

Systematic review of clinical practice guidelines recommendations about primary cardiovascular disease prevention for older adults.

Background: Clinical care for older adults is complex and represents a growing problem. They are a diverse patient group with varying needs, frequent presence of multiple comorbidities, and are more susceptible to treatment harms. Thus Clinical Practice Guidelines (CPGs) need to carefully consider older adults in order to guide clinicians.

Development and field testing of a consumer shared decision-making training program for adults with low literacy.

Objective: Given the scarcity of shared decision-making (SDM) interventions for adults with low literacy, we created a SDM training program tailored to this population to be delivered in adult education settings.

Methods: Formative evaluation during program development included a review of the problem and previous efforts to address it, qualitative interviews with the target population, program planning and field testing.

Results: A comprehensive SDM training program was developed incorporating core SDM elements.

Is the "Heart Age" Concept Helpful or Harmful Compared to Absolute Cardiovascular Disease Risk? An Experimental Study.

Background: Cardiovascular disease (CVD) prevention guidelines are generally based on the absolute risk of a CVD event, but there is increasing interest in using 'heart age' to motivate lifestyle change when absolute risk is low. Previous studies have not compared heart age to 5-year absolute risk, or investigated the impact of younger heart age, graphical format, and numeracy.

Objective: Compare heart age versus 5-year absolute risk on psychological and behavioral outcomes.

Public Opinions about Overdiagnosis: A National Community Survey.

Background: Despite evidence about the "modern epidemic" of overdiagnosis, and expanding disease definitions that medicalize more people, data are lacking on public views about these issues. Our objective was to measure public perceptions about overdiagnosis and views about financial ties of panels setting disease definitions.

Methods: We conducted a 15 minute Computer Assisted Telephone Interview with a randomly selected community sample of 500 Australians in January 2014.

What do you think overdiagnosis means? A qualitative analysis of responses from a national community survey of Australians.

Objective: Overdiagnosis occurs when someone is diagnosed with a disease that will not harm them. Against a backdrop of growing evidence and concern about the risk of overdiagnosis associated with certain screening activities, and recognition of the need to better inform the public about it, we aimed to ask what the Australian community understood overdiagnosis to mean.

Design, Setting And Participants: Content analysis of verbatim responses from a randomly sampled community telephone survey of 500 Australian adults, between January and February 2014.

How Often Do Patients with Localized Melanoma Attend Follow-Up at a Specialist Center?

Background: Post-treatment follow-up for patients with American Joint Committee on Cancer (AJCC) stage I/II melanoma is believed to be important for early detection of disease recurrence and new primary melanomas, but comes with costs to both patients and healthcare providers. We aimed to determine how frequently a cohort of patients attended follow-up after surgical treatment at one Specialist Center.

Methods: We used prospectively collected data from the Melanoma Institute Australia (MIA) for patients with AJCC stage I/II melanoma diagnosed between January 2008 and December 2011.

Readability evaluation of Internet-based patient education materials related to the anesthesiology field.

Study Objective: The main objective of the current investigation was to assess the readability of Internet-based patient education materials related to the field of anesthesiology. We hypothesized that the majority of patient education materials would not be written according to current recommended readability grade level.

Setting: Online patient education materials describing procedures, risks, and management of anesthesia-related topics were identified using the search engine Google (available at www.

Use of a decision aid including information on overdetection to support informed choice about breast cancer screening: a randomised controlled trial.

Background: Mammography screening can reduce breast cancer mortality. However, most women are unaware that inconsequential disease can also be detected by screening, leading to overdiagnosis and overtreatment. We aimed to investigate whether including information about overdetection of breast cancer in a decision aid would help women aged around 50 years to make an informed choice about breast screening.

Readability of Written Materials for CKD Patients: A Systematic Review.

Background: The "average" patient has a literacy level of US grade 8 (age 13-14 years), but this may be lower for people with chronic kidney disease (CKD). Current guidelines suggest that patient education materials should be pitched at a literacy level of around 5th grade (age 10-11 years). This study aims to evaluate the readability of written materials targeted at patients with CKD.

The Hepatitis C treatment experience: Patients' perceptions of the facilitators of and barriers to uptake, adherence and completion.

Objective: This study explores the perceptions of patients receiving treatment for Hepatitis C to determine what factors influence their decision to commence treatment, ability to maintain adherence and complete their treatment program.

Design: Semi-structured interview techniques were used in a qualitative study of 20 patients undergoing treatment for Chronic Hepatitis C (CHC).

Main Outcome Measures: To explore patients' perceived barriers and facilitators of Hepatitis C treatment adherence and completion.