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    • An advance directive redesigned to meet the literacy level of most adults: A randomized trial: Influence Statistics

      Expert Impact

      Concepts for whichthey havehas direct influence:Advance directive,Advance planning,Literacy level,Practice health,Participants randomized,Practice implications,Level adults,Adults literacy.

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      An advance directive redesigned to meet the literacy level of most adults: A randomized trial

      Abstract

      OBJECTIVE: To determine whether an advance directive redesigned to meet most adults' literacy needs (fifth grade reading level with graphics) was more useful for advance care planning than a standard form (>12th grade level).

      METHODS: We enrolled 205 English and Spanish-speaking patients, aged >/=50 years from an urban, general medicine clinic. We randomized participants to review either form. Main outcomes included acceptability and usefulness in advance care planning. Participants then reviewed the alternate form; we assessed form preference and six-month completion rates.

      RESULTS: Forty percent of enrolled participants had limited literacy. Compared to the standard form, the redesigned form was rated higher for acceptability and usefulness in care planning, Plimited literacy participants (P for interaction participants randomized to the redesigned form completed an advance directive at six months (19% vs. 8%, P=0.03); of these, 95% completed the redesigned form.

      CONCLUSIONS: The redesigned advance directive was rated more acceptable and useful for advance care planning and was preferred over a standard form. It also resulted in higher six-month completion rates.

      PRACTICE IMPLICATIONS: An advance directive redesigned to meet most adults' literacy needs may better enable patients to engage in advance care planning.

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