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A multimethods randomized trial found that plain language versions improved adults understanding of health recommendations
S. Sayfi, R. Charide, SA. Elliott, L. Hartling, M. Munan, L. Stallwood, NJ. Butcher, DP. Richards, JL. Mathew, J. Suvada, EA. Akl, T. Kredo, L. Mbuagbaw, A. Motilall, A. Baba, SD. Scott, M. Falavigna, M. Klugar, T. Friessová, T. Lotfi, A....
Language English Country United States
Document type Randomized Controlled Trial, Journal Article
Grant support
001
World Health Organization - International
NLK
ProQuest Central
from 2003-01-01 to 2 months ago
Nursing & Allied Health Database (ProQuest)
from 2003-01-01 to 2 months ago
Health & Medicine (ProQuest)
from 2003-01-01 to 2 months ago
Health Management Database (ProQuest)
from 2003-01-01 to 2 months ago
Public Health Database (ProQuest)
from 2003-01-01 to 2 months ago
- MeSH
- Adult MeSH
- Consumer Health Information * MeSH
- Language MeSH
- Humans MeSH
- Comprehension * MeSH
- COVID-19 Vaccines MeSH
- Patient Education as Topic * MeSH
- Health Knowledge, Attitudes, Practice * MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Randomized Controlled Trial MeSH
- Geographicals
- United States MeSH
OBJECTIVES: To make informed decisions, the general population should have access to accessible and understandable health recommendations. To compare understanding, accessibility, usability, satisfaction, intention to implement, and preference of adults provided with a digital "Plain Language Recommendation" (PLR) format vs. the original "Standard Language Version" (SLV). STUDY DESIGN AND SETTING: An allocation-concealed, blinded, controlled superiority trial and a qualitative study to understand participant preferences. An international on-line survey. 488 adults with some English proficiency. 67.8% of participants identified as female, 62.3% were from the Americas, 70.1% identified as white, 32.2% had a bachelor's degree as their highest completed education, and 42% said they were very comfortable reading health information. In collaboration with patient partners, advisors, and the Cochrane Consumer Network, we developed a plain language format of guideline recommendations (PLRs) to compare their effectiveness vs. the original standard language versions (SLVs) as published in the source guideline. We selected two recommendations about COVID-19 vaccine, similar in their content, to compare our versions, one from the World Health Organization (WHO) and one from Centers for Disease Control and Prevention (CDC). The primary outcome was understanding, measured as the proportion of correct responses to seven comprehension questions. Secondary outcomes were accessibility, usability, satisfaction, preference, and intended behavior, measured on a 1-7 scale. RESULTS: Participants randomized to the PLR group had a higher proportion of correct responses to the understanding questions for the WHO recommendation (mean difference [MD] of 19.8%, 95% confidence interval [CI] 14.7-24.9%; P < 0.001) but this difference was smaller and not statistically significant for the CDC recommendation (MD of 3.9%, 95% CI -0.7% to 8.3%; P = 0.096). However, regardless of the recommendation, participants found the PLRs more accessible, (MD of 1.2 on the seven-point scale, 95% CI 0.9-1.4%; P < 0.001) and more satisfying (MD of 1.2, 95% CI 0.9-1.4%; P < 0.001). They were also more likely to follow the recommendation if they had not already followed it (MD of 1.2, 95% CI 0.7-1.8%; P < 0.001) and share it with other people they know (MD of 1.9, 95% CI 0.5-1.2%; P < 0.001). There was no significant difference in the preference between the two formats (MD of -0.3, 95% CI -0.5% to 0.03%; P = 0.078). The qualitative interviews supported and contextualized these findings. CONCLUSION: Health information provided in a PLR format improved understanding, accessibility, usability, and satisfaction and thereby has the potential to shape public decision-making behavior.
Centre for Development of Best Practices in Health Yaoundé Central Hospital Yaoundé Cameroon
Centre for Immunization Readiness Public Health Agency of Canada Ottawa Ontario K1A 0K9 Canada
Cochrane Child Health University of Alberta Edmonton Alberta Canada
Cochrane South Africa South African Medical Research Council Capetown South Africa
Department of Anesthesia McMaster University Hamilton Ontario Canada
Department of Biology Faculty of Science University of Ottawa Ottawa Ontario K1N 6N5 Canada
Department of Biomedical Sciences Humanitas University Milan Italy
Department of Family Medicine Western University London Ontario Canada
Department of Health Sciences Faculty of Medicine Masaryk University Brno Czech Republic
Department of Internal Medicine American University of Beirut Beirut Lebanon
Department of Pediatrics McMaster University Hamilton Ontario Canada
Department of Psychiatry University of Toronto Toronto Ontario M5T 1R8 Canada
Experts Consortium for COVID 19 Advisor to Government of Slovak Republic Bratislava Slovak Republic
Faculty of Nursing University of Alberta Edmonton Alberta Canada
Five02 Labs Inc Toronto Ontario Canada
Institute of Health Information and Statistics of the Czech Republic Prague Czech Republic
Postgraduate Institute of Medical Education and Research Chandigarh India
Schulich School of Medicine and Dentistry Western University London Ontario N6A 5C1 Canada
References provided by Crossref.org
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- $a Sayfi, Shahab $u Department of Biology, Faculty of Science, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada; Schulich School of Medicine & Dentistry, Western University, London, Ontario N6A 5C1, Canada; Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada
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- $a A multimethods randomized trial found that plain language versions improved adults understanding of health recommendations / $c S. Sayfi, R. Charide, SA. Elliott, L. Hartling, M. Munan, L. Stallwood, NJ. Butcher, DP. Richards, JL. Mathew, J. Suvada, EA. Akl, T. Kredo, L. Mbuagbaw, A. Motilall, A. Baba, SD. Scott, M. Falavigna, M. Klugar, T. Friessová, T. Lotfi, A. Stevens, M. Offringa, HJ. Schünemann, K. Pottie
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- $a OBJECTIVES: To make informed decisions, the general population should have access to accessible and understandable health recommendations. To compare understanding, accessibility, usability, satisfaction, intention to implement, and preference of adults provided with a digital "Plain Language Recommendation" (PLR) format vs. the original "Standard Language Version" (SLV). STUDY DESIGN AND SETTING: An allocation-concealed, blinded, controlled superiority trial and a qualitative study to understand participant preferences. An international on-line survey. 488 adults with some English proficiency. 67.8% of participants identified as female, 62.3% were from the Americas, 70.1% identified as white, 32.2% had a bachelor's degree as their highest completed education, and 42% said they were very comfortable reading health information. In collaboration with patient partners, advisors, and the Cochrane Consumer Network, we developed a plain language format of guideline recommendations (PLRs) to compare their effectiveness vs. the original standard language versions (SLVs) as published in the source guideline. We selected two recommendations about COVID-19 vaccine, similar in their content, to compare our versions, one from the World Health Organization (WHO) and one from Centers for Disease Control and Prevention (CDC). The primary outcome was understanding, measured as the proportion of correct responses to seven comprehension questions. Secondary outcomes were accessibility, usability, satisfaction, preference, and intended behavior, measured on a 1-7 scale. RESULTS: Participants randomized to the PLR group had a higher proportion of correct responses to the understanding questions for the WHO recommendation (mean difference [MD] of 19.8%, 95% confidence interval [CI] 14.7-24.9%; P < 0.001) but this difference was smaller and not statistically significant for the CDC recommendation (MD of 3.9%, 95% CI -0.7% to 8.3%; P = 0.096). However, regardless of the recommendation, participants found the PLRs more accessible, (MD of 1.2 on the seven-point scale, 95% CI 0.9-1.4%; P < 0.001) and more satisfying (MD of 1.2, 95% CI 0.9-1.4%; P < 0.001). They were also more likely to follow the recommendation if they had not already followed it (MD of 1.2, 95% CI 0.7-1.8%; P < 0.001) and share it with other people they know (MD of 1.9, 95% CI 0.5-1.2%; P < 0.001). There was no significant difference in the preference between the two formats (MD of -0.3, 95% CI -0.5% to 0.03%; P = 0.078). The qualitative interviews supported and contextualized these findings. CONCLUSION: Health information provided in a PLR format improved understanding, accessibility, usability, and satisfaction and thereby has the potential to shape public decision-making behavior.
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- $a Charide, Rana $u Department of Health Research Methods, Evidence and Impact, Michael G. DeGroote Cochrane Canada and GRADE Centres, McMaster University, 1280 Main St. W., Hamilton, Ontario L8S 4K1, Canada
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