163 Secondary outcomes for patients Health literacy – 10 items of the All Aspects of Health Literacy Scale (AAHLS) by Chinn et al. (2013). The AAHLS provides a total score between 10 and 30. Patients had LHL when they scored ≤25. Quality of the consultation – Based on the communication framework of Haes and Bensing (2009), we developed four statements with 5-point Likert scales asking if patients felt understood, could ask questions and share emotions, and if professionals listened well. For each statement, we calculated the percentage of patients agreeing as a measure for quality. A fifth item asked to select topics discussed during a consultation. We calculated the number of lifestyle topics. CKD clinical parameters – We obtained eGFR, blood pressures and BMI. Patients with a systolic blood pressure ≥140 or diastolic blood pressure ≥90 were classified as hypertensive. Outcomes for professionals The primary outcome for professionals was self-reported use of health literacy communication strategies. We asked 31 questions within domains: gathering information, providing information, shared decision-making and enabling self-management. Each item contained 7-point Likert scales (neveralways). Sixteen items were from Kaper et al (2018). We added fifteen items, in line with our intervention objectives. The secondary outcome was health literacy knowledge. We asked 6 items with 7-point Likert scales from Kaper et al (2018). Background characteristics For patients, we collected data on sex, age, education, marital status, years of CKD, smoking, and co-morbidities. For professionals, data included sex, age, profession, health setting, experience, expected contact with LHL patients, and communication education. Process evaluation In the intervention group, we asked patients about the use (yes/no) and the usefulness of (useful, neutral, not useful), and the satisfaction with (yes/no, and grading 1-10) GoYK. Professionals answered questions on usefulness and satisfaction, and statements with 1-7 Likert scales, to check if they expected to use the taught strategies in the future.
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