Improving Health Literacy of Elective Procedures in Pediatric Otolaryngology

Introduction: In the pediatric otolaryngology setting, health literacy of patients and guardians has been shown to be overall highly proficient but has never been examined at the level of understanding of the actual procedures being considered or performed. The aim of this study is to identify if the addition of supplementary material, such as video or written resources, to the consent process can improve a patient's or guardian’s health literacy about the considered procedure.

Methods: Data were prospectively collected from 115 patients and guardians seen in our pediatric otolaryngology clinic from April 18, 2022 to December 20, 2022. The participants underwent a verbal consent process for one of three elective clinic procedures or a verbal explanation for one of three operative procedures, given by the same provider. Afterward, they completed a 6-question baseline test based on the information. They were then randomized to watch a 2-minute video or read a written summary based on the procedure, then the resources were switched. They answered the same 6-questions after viewing each resource which were randomly presented. All tests were scored based on accuracy using an ordinal scale of 1-6. Resource preference was also collected. Wilcoxon signed-rank tests were run to analyze differences in scores after the addition of supplementary resources.

Results: Of 115 participants, 77.4% (89/115) were guardians of those undergoing the procedure, with 73.9% (85/115) of the cohort having completed a high school education. The Wilcoxon signed-rank test indicated that post-resource assessment scores were statistically significantly higher (p < 0.0001) than pre-test scores. Additionally, 86.1% (98/115) stated they preferred the addition of a video to the consent process, with 33.1% (38/115) also preferring the addition of a written resource.

Conclusions: The addition of video or written resources significantly improves understanding of elective procedures. The development of specific video and written resources can supplement the consent process and ensure decision-makers have adequate health literacy for informed decision-making.