Using co-design to develop a health literacy intervention to improve the accessibility and acceptability of cardiac services.

Abstract

Aim: To co-design a health literacy intervention to improve the accessibility of hospital-based cardiac services for underserved population groups with coronary heart disease (CHD). Method: This mixed methods, co-design study comprised three phases: identifying the problem, co-developing an intervention, and translating the intervention into practice. Data collection included focus groups, interviews, and an intervention development workshop. Participants for focus groups/interviews were recruited from four health services in Victoria, and included patients with CHD, consumers from culturally diverse communities and clinicians. Findings from focus groups/interviews were thematically analysed to identify health literacy barriers to accessibility of cardiac services. These barriers were prioritised in the workshop with consumers and clinicians. Results: Thirty-seven cardiac patients, 10 clinicians and 44 culturally diverse consumers participated in focus groups/interviews. Of these, eight cardiac patients/carers and five clinicians attended the workshop. Cardiac patients reported a lack of preparedness for hospital discharge and feeling ‘lost’ and uncertain about how to confidently manage their health at home after a cardiac event. A co-designed intervention – The Patient Discharge Action Plan – was subsequently developed that aims at improving patients' transition from hospital to home. The 2-page action plan ensures that patients know the next steps following discharge (such as follow-up appointments, cardiac rehabilitation), what to do in the event of chest pain and what to do regarding their medication. Conclusion: Using a co-design approach, a health literacy intervention was developed to improve accessibility of cardiac services. The Patient Discharge Action Plan is currently being evaluated in a pilot randomised controlled trial.