Decision Support Tools for Coronary Artery Calcium Scoring in the Primary Prevention of Cardiovascular Disease Do Not Meet Health Literacy Needs: A Systematic Environmental Scan and Evaluation

Shannon McKinn, Carys Batcup, Samuel Cornell, Natasha Freeman, Jenny Doust, Katy J. L. Bell, Gemma A. Figtree and Carissa Bonner ()
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Shannon McKinn: Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
Carys Batcup: Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
Samuel Cornell: Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
Natasha Freeman: Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
Jenny Doust: Australian Women and Girls’ Health Research Centre, School of Public Health, University of Queensland, Brisbane 4006, Australia
Katy J. L. Bell: Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
Gemma A. Figtree: Kolling Institute, University of Sydney, St Leonards 2065, Australia
Carissa Bonner: Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia

IJERPH, 2022, vol. 19, issue 18, 1-10

Abstract: A shared decision-making approach is considered optimal in primary cardiovascular disease (CVD) prevention. Evidence-based patient decision aids can facilitate this but do not always meet patients’ health literacy needs. Coronary artery calcium (CAC) scans are increasingly used in addition to traditional cardiovascular risk scores, but the availability of high-quality decision aids to support shared decision-making is unknown. We used an environmental scan methodology to review decision support for CAC scans and assess their suitability for patients with varying health literacy. We systematically searched for freely available web-based decision support tools that included information about CAC scans for primary CVD prevention and were aimed at the public. Eligible materials were independently evaluated using validated tools to assess qualification as a decision aid, understandability, actionability, and readability. We identified 13 eligible materials. Of those, only one qualified as a decision aid, and one item presented quantitative information about the potential harms of CAC scans. None presented quantitative information about both benefits and harms of CAC scans. Mean understandability was 68%, and actionability was 48%. Mean readability (12.8) was much higher than the recommended grade 8 level. Terms used for CAC scans were highly variable. Current materials available to people considering a CAC scan do not meet the criteria to enable informed decision-making, nor do they meet the health literacy needs of the general population. Clinical guidelines, including CAC scans for primary prevention, must be supported by best practice decision aids to support decision-making.

Keywords: decision making; shared; patient education; cardiovascular diseases; primary prevention; health literacy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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