'Teach-back' is a simple communication tool that improves disease knowledge in people with chronic hepatitis B - a pilot randomized controlled study.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Communication* ; Health Knowledge, Attitudes, Practice*; Hepatitis B, Chronic/*epidemiology ; Patient Education as Topic/*methods; Adult ; Australia/epidemiology ; Female ; Humans ; Male ; Middle Aged ; Pilot Projects ; Surveys and Questionnaires

Background: The low diagnosis rate and poor access to clinical care among people with CHB is a major barrier to reducing HBV-related morbidity and mortality in Australia. One explanation for this is a lack of disease-specific knowledge among people living with CHB. Health literacy has been shown to be important for maximising engagement with medical care and adherence to recommended management. The 'teach-back' communication strategy has been shown to improve patient understanding in other clinical areas. This study aims to assess disease-specific knowledge; and evaluate the efficacy of the teach-back strategy for improving HBV knowledge, compared to a standard medical consultation.
Method: A randomized pilot study was conducted between February and June 2017. Participants were recruited from the liver clinic at an inner-city tertiary hospital. English-speaking patients aged ≥18 years and diagnosed with CHB were eligible for the study. Participants were randomised to a control group (medical specialist appointment) and intervention group (teach-back). Knowledge was assessed at baseline, immediately post-intervention and at one month using a validated questionnaire. Participants in the intervention group received a one-on-one teach-back session about CHB. The main outcome measure was a combined knowledge score of the domains assessed - transmission, natural history, epidemiology and prevention and clinical management.
Results: Seventy participants were recruited (control n = 32, teach-back n = 38). Mean baseline knowledge score was 19.1 out of 23 with 55 (79%) participants scoring ≥17.3 (defined as high knowledge) (7). Sub-analysis of CHB knowledge domains identified focal deficits concerning transmission and whether HBV is curable. Knowledge scores were found to be positively associated with English proficiency and antiviral treatment experience (p < 0.05). Teach-back was associated with a significant increase in CHB knowledge at early recall (22.5 vs 18.7, p < 0.001) and at 1-month follow-up (21.9 vs 18.7, p < 0.001); there was no improvement in CHB knowledge associated with standard clinical consultant (early recall: 19.6 vs 19.4, p = 0.49, one-month follow-up: 19.5 vs 19.4, p = 0.94).
Conclusion: In a tertiary hospital liver clinic population, baseline knowledge about CHB was good, but there were focal deficits concerning transmission and potential for cure. Teach-back was associated with improvement in CHB knowledge and it is a simple communication tool suitable for incorporation into a standard medical consultation.

Med J Aust. 2012 Nov 5;197(9):492-3. (PMID: 23121582)
Prim Care Diabetes. 2013 Jul;7(2):111-8. (PMID: 23195913)
J Hepatol. 2006 Oct;45(4):529-38. (PMID: 16879891)
Patient Educ Couns. 2015 May;98(5):565-71. (PMID: 25620074)
J Commun Healthc. 2015 Mar;8(1):10-21. (PMID: 26617669)
J Gen Intern Med. 2004 Dec;19(12):1228-39. (PMID: 15610334)
J Cardiovasc Nurs. 2013 Mar-Apr;28(2):137-46. (PMID: 22580624)
J R Soc Med. 2003 May;96(5):219-22. (PMID: 12724430)
BMC Infect Dis. 2014 Oct 23;14:537. (PMID: 25338513)
J Health Commun. 2012;17 Suppl 3:294-302. (PMID: 23030577)
J Gen Intern Med. 2012 Oct;27(10):1317-25. (PMID: 22592354)
Aust N Z J Public Health. 2015 Jun;39(3):255-9. (PMID: 25716519)
Aust Fam Physician. 2009 Mar;38(3):144-7. (PMID: 19283256)
Ann Intern Med. 2011 Jul 19;155(2):97-107. (PMID: 21768583)
Arch Intern Med. 2003 Jan 13;163(1):83-90. (PMID: 12523921)
Aust Fam Physician. 2013 Apr;42(4):225-31. (PMID: 23550250)
Aust N Z J Public Health. 2015 Dec;39(6):563-8. (PMID: 26095536)
J Health Commun. 2011;16 Suppl 3:89-102. (PMID: 21951245)
Intern Med J. 2012 May;42(5):491-6. (PMID: 22151101)
Nurs Outlook. 2011 Mar-Apr;59(2):85-94. (PMID: 21402204)
Aust N Z J Public Health. 2013 Oct;37(5):416-22. (PMID: 24090323)

Keywords: Cirrhosis; Communication; Education; HBV; Health literacy; Liver; Teach-back; This study has been retrospectively registered with the Australian and New Zealand Trials Registry on 29th March 2019 - ACTRN12619000512123.

Date Created: 20191025 Date Completed: 20191219 Latest Revision: 20240721

20240721

PMC6813056

10.1186/s12889-019-7658-4

31647001