Developing Verbal Health Literacy with Adult Learners Through Training in Shared Decision-Making

Danielle M Muscat, Heather Shepherd, Don Nutbeam, Suzanne Morony, Sian K Smith, Haryana M Dhillon, Lyndal Trevena, Andrew Hayen, Karen Luxford, Kirsten McCaffery

Research output: Contribution to journalArticlepeer-review


Background: Health literacy skills are often assessed in relation to written health materials; however, many important communications are in other formats, especially verbal communication with health care providers. Objective: This qualitative study sought to examine adult learners’ experiences of developing verbal health literacy skills within an Australian adult basic education program, and to explore verbal communication and shared decision-making as a constituent domain of health literacy. Methods: We conducted a semistructured qualitative interview study between September and November 2014 with adult learners who had participated in a single-semester health literacy program that included an integrated shared decisionmaking component. We analyzed interviews using the Framework method; a matrix-based approach to thematic analysis. A hybrid process of inductive and deductive coding was used to interpret raw data. Key Results: Interviewees were 22 students from six health literacy classes and ranged in age from 18 to 74 years (mean, 48.3). The majority were women (n = 15) and born outside Australia (n = 13). Health literacy was generally limited according to the Newest Vital Sign screening tool (n = 17). The health literacy program appeared to serve two key functions. First, it stimulated awareness that patients have the right to participate in
decision-making concerning their treatment and care. Second, it facilitated verbal skill development across the domains of functional (e.g., communicating symptoms), communicative (e.g., asking questions to extract information about treatment options), and critical (e.g., integrating new knowledge with preferences) health literacy. Conclusions: Our findings support the conceptualization of health literacy as a modifiable health asset that is subject to change and improvement as a result of deliberate intervention. Results reinforce verbal health literacy as an important component of health literacy, and draw attention to the hierarchy of verbal skills needed for consumers to become more actively involved in decisions about their health. We present a revised model of health literacy based on our findings. [Health Literacy Research and Practice.
Original languageEnglish
Pages (from-to)e257-e268
JournalHLRP: Health Literacy Research and Practice
VolumeHLRP: Health Literacy Research and Practice. 2017;1(4):e257-e268
Issue number1 (4)
Publication statusPublished - 11 Dec 2017


Dive into the research topics of 'Developing Verbal Health Literacy with Adult Learners Through Training in Shared Decision-Making'. Together they form a unique fingerprint.

Cite this