Addressing health literacy in patient decision aids

Table 5 Summary of Review I Findings Relative to PtDA Goal 3: to support patient involvement and communication among lower literacy consumers

Effect of health literacy on involvement and communication
	No. of Studies	Summary of Findings
Preferences for participation in decision making / patient activation	3 [36–38]	Lower preference for involvement among lower health literacy patients.
	1 [39]	Patient activation associated with lower numeracy not health literacy.
Question asking	2 [40, 41]	Less question asking among those with lower communicative HL. More clarification questions asked (indicating lack of understanding)
Level of involvement	2 [40, 42]	Patients with lower communicative health literacy reported less involvement. Less mutuality observed between doctors and lower health literacy patients
Communication quality / Patient centered care	6 [36, 43, 44, 46–48]	Less patient centered care among lower health literacy patients in 5 studies with adjusted analyses. 1 study reported effects varied by how numeracy was measured.
	3 [31, 40, 48]	Effects on communication quality (satisfaction and perceived quality) varied.
Effect of health literacy intervention studies on involvement and communication
	No. of Studies	Summary of Findings
	None	Not applicable

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