Assessing oral literacy demand in genetic counseling dialogue: Preliminary test of a conceptual framework

Debra Roter, Lori Ann Hamby Erby, Susan M Larson, Lee Ellington

Research output: Contribution to journalArticle

Abstract

Health literacy deficits affect half the American patient population and are linked to poor health, ineffective disease management and high rates of hospitalization. Restricted literacy has also been linked with less satisfying medical visits and communication difficulties, particularly in terms of the interpersonal and informational aspects of care. Despite growing attention to these issues by researchers and policy makers, few studies have attempted to conceptualize and assess those aspects of dialogue that challenge persons with low literacy skills, i.e., the oral literacy demand within medical encounters. The current study uses videotapes and transcripts of 152 prenatal and cancer pretest genetic counseling sessions recorded with simulated clients to develop a conceptual framework to explore oral literacy demand and its consequences for medical interaction and related outcomes. Ninety-six prenatal and 81 cancer genetic counselors-broadly representative of the US National Society of Genetic Counselors-participated in the study. Key elements of the conceptual framework used to define oral literacy demand include: (1) use of unfamiliar technical terms; (2) general language complexity, reflected in the application of Microsoft Word grammar summary statistics to session transcripts; and, (3) structural characteristics of dialogue, including pacing, density, and interactivity. Genetic counselor outcomes include self-ratings of session satisfaction, informativeness, and development of rapport. The simulated clients rated their satisfaction with session communication, the counselor's effective use of nonverbal skills, and the counselor's affective demeanor during the session. Sessions with greater overall technical term use were longer and used more complex language reflected in readability indices and multi-syllabic vocabulary (measures averaging p

Original languageEnglish (US)
Pages (from-to)1442-1457
Number of pages16
JournalSocial Science and Medicine
Volume65
Issue number7
DOIs
StatePublished - Oct 2007

Fingerprint

literacy
Genetic Counseling
conceptual framework
counseling
counselor
dialogue
demand
Language
technical language
Communication
cancer
Health Literacy
Videotape Recording
communication
Vocabulary
counseling session
Disease Management
Administrative Personnel
interactive media
language

Keywords

  • Communication
  • Genetic counseling
  • Health literacy
  • Oral literacy
  • Patient-provider
  • USA

ASJC Scopus subject areas

  • Economics and Econometrics
  • Public Health, Environmental and Occupational Health
  • Social Psychology
  • Development
  • Health(social science)

Cite this

Assessing oral literacy demand in genetic counseling dialogue : Preliminary test of a conceptual framework. / Roter, Debra; Erby, Lori Ann Hamby; Larson, Susan M; Ellington, Lee.

In: Social Science and Medicine, Vol. 65, No. 7, 10.2007, p. 1442-1457.

Research output: Contribution to journalArticle

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