Marco Boonstra

160 lives and to help them prepare for consultations. GoYK also supports patients to maintain healthier behaviours in the long term and to teach professionals to tailor communication to the needs of patients with LHL[15]. We evaluated the effectiveness of GoYK, compared to care-as-usual. We assessed the effects on self-management of health behaviours, patient activation, clinical parameters, quality of consultations, and on professionals’ use of health literacy communication strategies. Additionally, we assessed the use and usefulness of, and satisfaction with the intervention. METHODS The CONSORT checklist guided the reporting of this study. This study was registered in the ‘Overview of Medical Research in the Netherlands’ (nr: 23167) and approved by the Medical Ethical Committee of the University Medical Center Groningen (nr: 201900534). DESIGN AND SETTING We conducted a two-armed, non-blinded, quasi-experimental study within general practices and nephrology clinics in the Netherlands. Most Dutch residents are registered with a general practitioner, who usually treats patients with mild to moderate CKD. Patients with more severe CKD are referred to nephrology clinics. PARTICIPANTS AND SAMPLING Two practices and three clinics provided GoYK, whereas two practices and two clinics provided care-as-usual. We recruited patients with mild to severe CKD (CKD stages 2-4) and professionals from December 2020 until September 2021. Eligible patients were ≥18 years, had ≥3 months of CKD based on estimated glomerular filtration rate (eGFR), and had regular consultations with participating professionals. Patients with kidney failure and major cognitive or life-threatening conditions, and professionals with previous health literacy training were excluded. Professionals were approached by email and selected eligible patients from their electronic patients records. 430 patients received an information letter and consent form during consultations or at their home addresses. At variance

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