Evaluating the Health Literacy Characteristics of Question Prompt Lists on National Cancer Institute Designated Cancer Center Websites
摘要
Ineffective communication between cancer survivors and providers can contribute to health disparities. Question Prompt Lists (QPLs) help facilitate patient-provider communication; however little research has evaluated the tool. This study evaluated the characteristics of QPLs available on National Cancer Institute (NCI)-Designated Cancer Center websites. A cross-sectional content analysis was conducted on 64 NCI-Designated Cancer Center websites. Eighty-nine QPLs were coded based on the Information Literacy Framework and the National Culturally and Linguistically Appropriate Services (CLAS) Standards. The readability, actionability, understandability, clarity, and suitability of QPLs were evaluated using validated tools to determine their utility in supporting diverse cancer survivors. Thirty-nine centers (59.1%) provided a total of 89 QPLs, averaging 16.4 questions (SD ± 10.4) per list. No QPLs (0%) were created for a specific race/ethnicity or who identify with sexual and gender minority populations. Six (6.7%) were created based on age and seven (7.9%) were available in multiple languages. Common topics included diagnosis (68.5%) and treatment (79.8%). Twenty QPLs (29.2%) were available as PDFs, and most (70.8%) were not cancer-type specific. While most QPLs (76.4%) demonstrated good understandability, 62.9% had poor actionability, 82.0% exhibited superior suitability, and 92.1% had suboptimal clarity. The average readability was seventh grade. Cancer centers should develop QPLs that address diverse cultural and communication needs. Despite their importance, most QPLs lacked inclusivity. Additionally, while understandability was generally high, actionability and clarity were suboptimal, potentially limiting their effectiveness in guiding patient-provider discussions. Using validated tools before dissemination aligns with best practices to improve patient-centered care while reducing health disparities.