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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 103 Research Studies Displayed
Greenzang KA, Kelly CA, Al-Sayegh H
Thinking ahead: parents' worries about late effects of childhood cancer treatment.
This study examined parental perceived likelihood, impact, and worry about late effects of treatment for childhood cancer. The authors surveyed 96 parents of pediatric cancer patients at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center within a year of diagnosis. Most parents (96%) valued information about late effects, and 93% considered late effects in their treatment decision-making. However, 24% could not recall receiving information about late effects, and only 51% felt well-prepared for potential late effects. Only one-fifth of parents consider late effects to be likely for their child, while 61% were extremely/very worried about late effects.
AHRQ-funded; HS022986.
Citation:
Greenzang KA, Kelly CA, Al-Sayegh H .
Thinking ahead: parents' worries about late effects of childhood cancer treatment.
Pediatr Blood Cancer 2021 Dec;68(12):e29335. doi: 10.1002/pbc.29335..
Keywords:
Children/Adolescents, Cancer, Education: Patient and Caregiver, Health Literacy, Caregiving
Santana S, Brach C, Harris L
Updating Health Literacy for Healthy People 2030: Defining Its Importance for a New Decade in Public Health.
The US Department of Health & Human Services (HHS) updates the Healthy People objectives each decade based on the most current science. For the development of HP2030, the HHS drew on recommendations from the Secretary's Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2030 (Secretary's Advisory Committee), an independent advisory committee of national health experts, to update the 20-year old individual-focused Healthy People definition of health literacy. This paper discusses that process.
AHRQ-authored.
Citation:
Santana S, Brach C, Harris L .
Updating Health Literacy for Healthy People 2030: Defining Its Importance for a New Decade in Public Health.
J Public Health Manag Pract 2021 Nov-Dec;27(Suppl 6):S258-S64. doi: 10.1097/phh.0000000000001324..
Keywords:
Health Literacy, Public Health, Health Promotion
Kruse J, Toledo P, Belton TB
Readability, content, and quality of COVID-19 patient education materials from academic medical centers in the United States.
The internet is a frequently used resource for providing patient education materials (PEMs). The aim of this study was to evaluate the readability, content, and quality of web-based PEMs on COVID-19 from US academic medical centers. Despite availability of web-based PEMs for COVID-19, the readability was significantly higher than the National Institute of Health and US Department of Health and Human Services recommended sixth grade reading level and actionability of PEMs was low.
AHRQ-funded; HS025267; HS026169.
Citation:
Kruse J, Toledo P, Belton TB .
Readability, content, and quality of COVID-19 patient education materials from academic medical centers in the United States.
Am J Infect Control 2021 Jun;49(6):690-93. doi: 10.1016/j.ajic.2020.11.023..
Keywords:
COVID-19, Education: Patient and Caregiver, Health Literacy, Public Health, Infectious Diseases
MacEwan SR, Gaughan A, Hefner JL
Identifying the role of inpatient portals to support health literacy: perspectives from patients and care team members.
Health literacy is a fundamental contributor to an individual's ability to self-manage their health and appropriately use health care services. Tools that positively impact health literacy therefore have potential to improve health outcomes. Inpatient portals are a tool that provides patients an opportunity to cultivate health literacy skills during hospitalization. This study investigated how inpatient portal use could impact attributes of health literacy.
AHRQ-funded; HS024091; HS024767; HS024379.
Citation:
MacEwan SR, Gaughan A, Hefner JL .
Identifying the role of inpatient portals to support health literacy: perspectives from patients and care team members.
Patient Educ Couns 2021 Apr;104(4):836-43. doi: 10.1016/j.pec.2020.09.028..
Keywords:
Health Literacy, Health Information Technology (HIT), Hospitalization, Inpatient Care
Brach C, Harris LM
Healthy People 2030 health literacy definition tells organizations: make information and services easy to find, understand, and use.
This AHRQ-authored article discusses the expanded definition of health literacy as part of the framework for the newly released HHS Healthy People 2030. The new definition includes a new organizational component that recognizes the essential role organizations that provide health-related information and services play in improving health literacy (Organizational Health Literacy). Previously health literacy was defined solely in terms of an individuals’ capacity to understand health information (now called Personal Health Literacy). The emphasis in Organizational Health Literacy is on physicians, as well as clinicians and organizational leaders to help their organizations become health literate.
AHRQ-authored.
Citation:
Brach C, Harris LM .
Healthy People 2030 health literacy definition tells organizations: make information and services easy to find, understand, and use.
J Gen Intern Med 2021 Apr;36(4):1084-85. doi: 10.1007/s11606-020-06384-y..
Keywords:
Health Literacy, Education: Patient and Caregiver
Eber MR, Sunstein CR, Hammitt JK
The modest effects of fact boxes on cancer screening.
Investigators explored the effects of providing participants using published fact boxes on the benefits and harms of common cancer screening procedures. They found that participants updated their beliefs about the net benefits of screening modestly, but they observed little change in participants’ stated preferences to seek screening. Those who scored higher on a numeracy test updated their beliefs about screening benefits more in response to the fact boxes than did participants who scored lower on the numeracy test.
AHRQ-funded; HS000055.
Citation:
Eber MR, Sunstein CR, Hammitt JK .
The modest effects of fact boxes on cancer screening.
J Risk Uncertain 2021 Feb;62(1):29-54. doi: 10.1007/s11166-021-09344-x..
Keywords:
Cancer, Screening, Education: Patient and Caregiver, Health Literacy
Brown W, Balyan R, Karter AJ
Challenges and solutions to employing natural language processing and machine learning to measure patients' health literacy and physician writing complexity: the ECLIPPSE study.
In the National Library of Medicine-funded ECLIPPSE Project (Employing Computational Linguistics to Improve Patient-Provider Secure Emails exchange), the researchers attempted to create novel, valid, and scalable measures of both patients' health literacy (HL) and physicians' linguistic complexity by employing natural language processing techniques and machine learning. They identified 23 challenges and associated approaches that emerged from three overarching process domains. They suggested that investigators undertaking similar research in HL or using computational linguistic methods to assess patient-clinician exchange may find their solutions helpful when designing and executing health communications research.
Citation:
Brown W, Balyan R, Karter AJ .
Challenges and solutions to employing natural language processing and machine learning to measure patients' health literacy and physician writing complexity: the ECLIPPSE study.
AHRQ-funded; HS026383..
Keywords:
Health Literacy, Electronic Health Records (EHRs), Health Information Technology (HIT), Communications, Clinician-Patient Communication
Savitz ST, Bailey SC, Dusetzina SB
Treatment selection and medication adherence for stable angina: the role of area-based health literacy.
Clinical studies show equivalent health outcomes from interventional procedures and treatment with medication only for stable angina patients. However, patients may be subject to overuse or access barriers for interventional procedures and may exhibit suboptimal adherence to medications. The objective of the study was to evaluate whether community-level health literacy was associated with treatment selection and medication adherence patterns.
AHRQ-funded; HS000032.
Citation:
Savitz ST, Bailey SC, Dusetzina SB .
Treatment selection and medication adherence for stable angina: the role of area-based health literacy.
J Eval Clin Pract 2020 Dec;26(6):1711-21. doi: 10.1111/jep.13341..
Keywords:
Medication, Patient Adherence/Compliance, Health Literacy, Heart Disease and Health, Cardiovascular Conditions
Miller BJ, Carson KA, Keller S
Educating patients on unnecessary antibiotics: personalizing potential harm aids patient understanding.
Antibiotic resistance is a public health emergency fueled by inappropriate antibiotic use. Public education campaigns often focus on global antibiotic resistance or societal harm of antibiotic misuse. In this study, the investigators administered a survey at a primary care clinic in Baltimore, MD. A total of 250 participants rated 18 statements about potential harm from antibiotics on how each statement changed their likelihood to request antibiotics for an upper respiratory tract infection.
AHRQ-funded; HS025782.
Citation:
Miller BJ, Carson KA, Keller S .
Educating patients on unnecessary antibiotics: personalizing potential harm aids patient understanding.
J Am Board Fam Med 2020 Nov-Dec;33(6):969-77. doi: 10.3122/jabfm.2020.06.200210..
Keywords:
Antimicrobial Stewardship, Antibiotics, Education: Patient and Caregiver, Medication, Respiratory Conditions, Health Literacy
Han G, Mayer M, Canner J
Development, implementation and evaluation of an online course on evidence-based healthcare for consumers.
This paper evaluated the effectiveness of an online self-paced course on evidence-based health care (EBHC) offered through the Johns Hopkins Bloomberg School of Public Health for the general public. Data was analyzed for participants who registered for the course from May 31, 2007 to December 31, 2018 (n = 15,606). 11,522 participants completed the “Before” evaluation and 4899 completed the “After” evaluation. The primary outcome looked for was improvement in self-reported confidence on EBHC-related topics after completion of the course. The overall mean change in confidence levels was +1.27 on a scale of 1 to 5. The mean changed by topic ranged from +1.00 to +1.90.
AHRQ-funded; HS016868.
Citation:
Han G, Mayer M, Canner J .
Development, implementation and evaluation of an online course on evidence-based healthcare for consumers.
BMC Health Serv Res 2020 Oct 8;20(1):928. doi: 10.1186/s12913-020-05759-5..
Keywords:
Evidence-Based Practice, Education: Patient and Caregiver, Health Literacy
Dos Santos Marques IC, Theiss LM, Baker SJ
Low health literacy exists in the inflammatory bowel disease (IBD) population and is disproportionately prevalent in older African Americans.
This study assessed the prevalence of low health literacy rates among adult patients with inflammatory bowel disease (IBD) in a diverse population and identified risk factors for low health literacy. IBD patients at a single institution from November 2017 to May 2018 were assessed for health literacy using the Newest Vital Sign (NWS). Secondary outcomes were length-of-stay (LOS) and 30-day readmissions after surgery. There were 175 patients surveyed who were 59% female, 23% African Americans, 91% with Crohn’s disease, and mean age was 46. Overall the low health literacy rate was 24%, with African Americans having a higher prevalence (47.5%) versus 17.0% for white IBD patients. Low health literacy was associated with older age and African American race. There were no significant differences between LOS and readmissions rates by health literacy levels.
AHRQ-funded; HS023009.
Citation:
Dos Santos Marques IC, Theiss LM, Baker SJ .
Low health literacy exists in the inflammatory bowel disease (IBD) population and is disproportionately prevalent in older African Americans.
Crohns Colitis 360 2020 Oct;2(4). doi: 10.1093/crocol/otaa076..
Keywords:
Elderly, Health Literacy, Digestive Disease and Health, Racial / Ethnic Minorities, Chronic Conditions
Shah S, Gilson AM, Jacobson N
Understanding the factors influencing older adults' decision-making about their use of over-the-counter medications-a scenario-based approach.
The potential risks of over-the-counter (OTC) medications are often aggravated in vulnerable populations, such as older adults. The elevated patterns of older-adult OTC medication use do not necessarily translate into a greater understanding of these medications or their safety implications. The objective of this study was to assess how older adults' knowledge, beliefs, and attitudes informed their decision-making regarding OTC use.
AHRQ-funded; HS024490.
Citation:
Shah S, Gilson AM, Jacobson N .
Understanding the factors influencing older adults' decision-making about their use of over-the-counter medications-a scenario-based approach.
Pharmacy 2020 Sep 18;8(3). doi: 10.3390/pharmacy8030175..
Keywords:
Elderly, Decision Making, Medication, Medication: Safety, Patient Safety, Health Literacy
Yoo-Jeong M, Schnall R
Accuracy of self-reports of HIV viral load status and risk factors for inaccurate reporting of viral suppression among racial/ethnic minority persons living with HIV.
The goal of this study was to assess the relationship between health literacy and self-reported viral load (VL) among racial/ethnic minority people living with HIV (PLWH). A cross-sectional analysis of baseline data was collected from three research projects aimed to improve outcomes in PLWH. Recruitment was done through flyers and social media websites. The investigators found that about half of their participants inaccurately reported their VL and that sexual minority individuals were more likely to inaccurately self-report their VL.
AHRQ-funded; HS025071.
Citation:
Yoo-Jeong M, Schnall R .
Accuracy of self-reports of HIV viral load status and risk factors for inaccurate reporting of viral suppression among racial/ethnic minority persons living with HIV.
AIDS Patient Care STDS 2020 Sep;34(9):369-72. doi: 10.1089/apc.2020.0099..
Keywords:
Human Immunodeficiency Virus (HIV), Racial / Ethnic Minorities, Health Literacy
Lindly O, Crossman M, Eaves M
Health literacy and health outcomes among children with developmental disabilities: a systematic review.
This systematic literature review focused on the impact of health literacy on health outcomes of children with developmental disabilities (DDs). A review of the literature of most of the major scientific databases was conducted. Out of 2,768 unique records identified, 53 full text articles were reviewed and four articles were included. The associations of family health literacy with health outcomes among children with DDs were mixed. Future research was recommended.
AHRQ-funded; HS000063.
Citation:
Lindly O, Crossman M, Eaves M .
Health literacy and health outcomes among children with developmental disabilities: a systematic review.
Am J Intellect Dev Disabil 2020 Sep 1;125(5):389-407. doi: 10.1352/1944-7558-125.5.389..
Keywords:
Children/Adolescents, Health Literacy, Disabilities, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Liu LH, Garrett SB, Li J
Patient and clinician perspectives on a patient-facing dashboard that visualizes patient reported outcomes in rheumatoid arthritis.
The authors’ goal was to develop a rheumatoid arthritis (RA) 'dashboard' that could facilitate conversations about patient-reported outcomes (PROs) and that would be acceptable to a wide range of patients, including English and Spanish speakers and patients with adequate or limited health literacy. Using focus groups and principles of human-centered design, they created an RA dashboard that was well-accepted among patients and clinicians. They indicated that the ability to customize the data display was important for tailoring the dashboard to patients with diverse needs and preferences, with special attention to be given to feasibility concerns voiced by clinicians.
AHRQ-funded; HS025405.
Citation:
Liu LH, Garrett SB, Li J .
Patient and clinician perspectives on a patient-facing dashboard that visualizes patient reported outcomes in rheumatoid arthritis.
Health Expect 2020 Aug;23(4):846-59. doi: 10.1111/hex.13057..
Keywords:
Arthritis, Health Information Technology (HIT), Patient and Family Engagement, Clinician-Patient Communication, Communications, Health Literacy
Payán DD, Maggard-Gibbons M, Flórez KR
Taking Care of Yourself and Your Risk for Breast Cancer (CUIDARSE): a randomized controlled trial of a health communication intervention for Latinas.
Latinas in the United States are more likely to be diagnosed with late-stage breast cancer (BC) compared to non-Latinas. Literacy-appropriate and culturally sensitive cancer communication interventions can help address existing racial/ethnic BC disparities. In this study, the investigators formatively developed a new BC prevention brochure for Spanish-speaking Latinas (≥35 years) and conducted a randomized controlled trial of a health communication intervention for Latinas.
AHRQ-funded; HS019264.
Citation:
Payán DD, Maggard-Gibbons M, Flórez KR .
Taking Care of Yourself and Your Risk for Breast Cancer (CUIDARSE): a randomized controlled trial of a health communication intervention for Latinas.
Health Educ Behav 2020 Aug;47(4):569-80. doi: 10.1177/1090198120920529..
Keywords:
Cancer: Breast Cancer, Cancer, Racial / Ethnic Minorities, Health Literacy, Education: Patient and Caregiver, Cultural Competence, Health Promotion, Communications, Women, Community-Based Practice
Brach C, Borsky A
How the U.S. Agency for Healthcare Research and Quality promotes health literate health care.
This AHRQ-authored study traces the history of the AHRQ Health Literacy Action Plan to promote health literate health care delivery systems. This Plan has been developed and implemented for almost 15 years and serves as the framework for AHRQ’s efforts to 1) Develop measures; 2) Improve the evidence base and create implementation tools; 3) Create and support change; 4) Disseminate and transfer knowledge and tools; and 5) Practice what we preach.
AHRQ-authored.
Citation:
Brach C, Borsky A .
How the U.S. Agency for Healthcare Research and Quality promotes health literate health care.
Stud Health Technol Inform 2020 Jun 25;269:313-23. doi: 10.3233/shti200046..
Keywords:
Health Literacy, Healthcare Delivery, Health Services Research (HSR), Implementation
Lyles CR, Nelson EC, Frampton S
Using electronic health record portals to improve patient engagement: research priorities and best practices.
This literature review identified 53 studies published from September 2013 to June 2019 that informed best practices and priorities for future research on patient engagement with electronic health record (EHR) data through patient portals. While 90% of health care systems now offer patient portals, only 15-30% of patients use them to access their physicians or health care systems. Studies reviewed mostly involved outpatient settings and fell into 3 major categories: interventions to increase use of patient portals, usability testing of portal interfaces, and documentation of patient and clinician barriers to portal use. Limited health or digital literacy impacted patients’ use of portals. Clinicians reported a lack of workflows to support patient engagement through portals.
AHRQ-funded; HS023558.
Citation:
Lyles CR, Nelson EC, Frampton S .
Using electronic health record portals to improve patient engagement: research priorities and best practices.
Ann Intern Med 2020 Jun 2;172(11 Suppl):S123-s29. doi: 10.7326/m19-0876..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement, Evidence-Based Practice, Health Literacy, Clinician-Patient Communication
Dos Santos Marques IC, Herbey II, Theiss LM
Understanding the surgical experience for African-Americans and Caucasians with enhanced recovery.
The purpose of this study was to use qualitative methods to better understand the surgical experience for African-American and Caucasian patients in the setting of an enhanced recovery program (ERP). Findings showed that African-American and Caucasian surgical patients have varied surgical experiences even under an ERP. All patients, however, valued the ability to obtain, process, and understand health information during the surgical process. These elements define "health literacy" and suggest the importance of providing health literacy-sensitive care in surgery.
AHRQ-funded; HS023009.
Citation:
Dos Santos Marques IC, Herbey II, Theiss LM .
Understanding the surgical experience for African-Americans and Caucasians with enhanced recovery.
J Surg Res 2020 Jun;250:12-22. doi: //10.1016/j.jss.2019.12.034..
Keywords:
Surgery, Racial / Ethnic Minorities, Patient Experience, Disparities, Health Literacy, Education: Patient and Caregiver
Tsai J, Huang M, Rosenheck RA
A randomized controlled trial of video psychoeducation for electroconvulsive therapy in the United States.
Electroconvulsive therapy (ECT) is a highly effective psychiatric treatment that remains largely underutilized. Patient psychoeducation about ECT may improve uptake of this treatment. This randomized controlled trial compared two forms of psychoeducation about ECT: video psychoeducation and an informational brochure. The investigators found that both the video psychoeducation and brochure groups showed significantly more positive perceptions and knowledge about ECT following the intervention, with no significant differences between groups.
AHRQ-funded; HS023000.
Citation:
Tsai J, Huang M, Rosenheck RA .
A randomized controlled trial of video psychoeducation for electroconvulsive therapy in the United States.
Psychiatr Serv 2020 Jun;71(6):562-69. doi: 10.1176/appi.ps.201900448..
Keywords:
Behavioral Health, Health Literacy, Education: Patient and Caregiver
Canedo JR, Wilkins CH, Senft N
Barriers and facilitators to dissemination and adoption of precision medicine among Hispanics/Latinos.
This study examined barriers to dissemination and adoption of precision medicine among the Hispanic/Latino population. Six focus groups and a demographic survey in English and Spanish was developed. Forty-one self-identified Hispanics/Latinos from diverse countries participated in the study. The participants had never heard of precision medicine and barriers to adoption and dissemination included lack of health insurance, distrust of government, immigration status, financial burden, limited English proficiency, low literacy levels, lack of information and lack of transportation. Facilitators included family support, information provided in Spanish, use of plain language and graphics and trust in healthcare providers and institutions. The authors recommend culturally- and linguistically-tailored, low-literacy educational material about precision medicine in English and Spanish.
AHRQ-funded; HS026122.
Citation:
Canedo JR, Wilkins CH, Senft N .
Barriers and facilitators to dissemination and adoption of precision medicine among Hispanics/Latinos.
BMC Public Health 2020 May 1;20(1):603. doi: 10.1186/s12889-020-08718-1..
Keywords:
Racial / Ethnic Minorities, Cultural Competence, Health Literacy, Education: Patient and Caregiver, Clinician-Patient Communication
Johnson A, Broughton S, Aponte-Soto L
Participatory genomic testing can effectively disseminate cardiovascular pharmacogenomics concepts within federally qualified health centers: a feasibility study.
Researchers assessed feasibility of an educational program designed to enhance stakeholder knowledge and perceptions of pharmacogenomics at a federally qualified health center. Twenty providers and 10 community members were recruited for a feasibility study via convenience sampling. The researchers determined that a pharmacogenomics educational program tailored for an underrepresented community was feasible and acceptable; outcomes will advise methodology for larger implementation studies.
AHRQ-funded; HS019461.
Citation:
Johnson A, Broughton S, Aponte-Soto L .
Participatory genomic testing can effectively disseminate cardiovascular pharmacogenomics concepts within federally qualified health centers: a feasibility study.
Ethn Dis 2020 Apr;30(Suppl 1):167-76. doi: 10.18865/ed.30.S1.167..
Keywords:
Genetics, Cardiovascular Conditions, Community-Based Practice, Community Partnerships, Health Literacy, Education: Patient and Caregiver
Davis SN, Wischhusen JW, Sutton SK
Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans.
This study examined the frequency of limited health literacy and demographic and psychosocial factors associated with limited health literacy in a sample of older black Americans. The participants enrolled in a community-based intervention to promote colorectal cancer screening and completed baseline surveys that assessed their health literacy using the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R) test, CRC awareness, cancer fatalism, Preventive Health Model (PHM) constructs, and demographics. Findings showed that limited health literacy was associated with multiple complex factors. Recommendations include interventions to incorporate patient health literacy and low-literacy materials that can be delivered through multiple channels.
AHRQ-funded; HS026120.
Citation:
Davis SN, Wischhusen JW, Sutton SK .
Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans.
Patient Educ Couns 2020 Feb;103(2):385-91. doi: 10.1016/j.pec.2019.08.026..
Keywords:
Health Literacy, Racial / Ethnic Minorities, Elderly, Screening, Cancer: Colorectal Cancer, Cancer, Prevention
Chang ME, Baker SJ, Dos Santos Marques IC, ME, Baker SJ, Dos Santos Marques IC
Health literacy in surgery.
Health literacy has not been well-studied in surgery but likely plays an important role. In this article, the authors reviewed current research on health literacy in surgery to help understand where we are now and where we need to go. They found that low health literacy is common and there need to be more ways to address it in surgery.
AHRQ-funded; HS023009.
Citation:
Chang ME, Baker SJ, Dos Santos Marques IC, ME, Baker SJ, Dos Santos Marques IC .
Health literacy in surgery.
Health Lit Res Pract 2020 Feb 11;4(1):e46-e65. doi: 10.3928/24748307-20191121-01..
Keywords:
Health Literacy, Surgery
Owodunni OP, Haut ER, Shaffer DL
Using electronic health record system triggers to target delivery of a patient-centered intervention to improve venous thromboembolism prevention for hospitalized patients: is there a differential effect by race?
Venous thromboembolism (VTE) is a leading cause of preventable harm, and disparities observed in prevention practices. In this study, the investigators examined the impact of a patient-centered VTE education bundle on the non-administration of preventive prophylaxis by race. The investigators found that the patient education materials, developed collaboratively with a diverse group of patients, improved patient's understanding and the importance of VTE prevention through prophylaxis.
AHRQ-funded; HS024547.
Citation:
Owodunni OP, Haut ER, Shaffer DL .
Using electronic health record system triggers to target delivery of a patient-centered intervention to improve venous thromboembolism prevention for hospitalized patients: is there a differential effect by race?
PLoS One 2020 Jan 16;15(1):e0227339. doi: 10.1371/journal.pone.0227339..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Blood Clots, Prevention, Inpatient Care, Health Literacy, Education: Patient and Caregiver
