Marco Boonstra

24 Figure 1.3 Overview of this thesis with research phases, chapter numbers, methods and study aims. Chapter 2: Systematic review Summarizing the evidence on factors potentially mediating the relation between LHL and health outcomes, and on the effectiveness of health literacy interventions customized to CKD patients. Chapter 3: Longitudinal qualitative study Exploring experiences with and barriers for self-management, from the perspectives of both CKD patients with LHL and health care professionals. PHASE 1 IDENTIFYING POTENTIAL TARGETS AND STRATEGIES FOR OUR HEALTH LITERACY INTERVENTION Chapter 5: Quasi-experimental study 1) Assessing the effect of the intervention on self-management of health behaviors, patient activation, clinical parameters, quality of consultations, and the health care professionals’ use of health literacy strategies. 2) Evaluating the use and usefulness of, and satisfaction with the intervention. Chapter 6: Cost-utility analysis using a Markov model Investigating the cost-effectiveness of the intervention, compared to care-as-usual, via a reduction in CKD progression. PHASE 3 ASSESSING THE EFFECTIVENESS AND COST-EFFECTIVENESS OF OUR HEALTH LITERACY INTERVENTION Chapter 4: Intervention Mapping, combined with co-creation methods 1) Determining the objectives and strategies for a multi-component intervention targeting CKD patients with LHL and health care professionals. 2) Designing, developing and evaluating the intervention to meet the needs of the target groups. PHASE 2 DEVELOPING OUR HEALTH LITERACY INTERVENTION Provided promising intervention targets and strategies for the next study phase. Provided the final intervention, Grip on Your Kidneys.

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