Effect of 'Teach-back', a simple communication tool, on disease knowledge in people with chronic hepatitis B

INTERVENTION: Participants in the intervention group received a once‐off education session prior to their routine liver clinic outpatient appointment, run by a trained investigator, using the teach‐back strategy. This session involved a discussion between the investigator and participant on the four domains of CHB – transmission, natural history, epidemiology and prevention and clinical management; supported by simple explanations and images using an educational resource specifically developed for people with low health literacy. This session continued until the participant had adequate understanding of each aspect covered, which ranged from 15‐45 minutes. Information was explained using plain language and medical jargon avoided. After covering each concept, the investigator would use teach‐back to confirm patient understanding, for example: ‘To check that I have explained the information clearly, could you please tell me how hepatitis B is spread?’. If the answers were wrong or incomplete, the investigator would re‐explain the concept and reassess until the participant understood the information. The trained investigator was a final year medical student, who had received training to facilitate the 'teach‐back' intervention from the viral hepatitis nurse. CONDITION: Chronic hepatitis B; ; Chronic hepatitis B Infection ‐ Other infectious diseases Oral and Gastrointestinal ‐ Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon PRIMARY OUTCOME: Participant’s score on a questionnaire consisting of 23 true or false questions covering four domains of HBV – transmission, natural history, epidemiology and prevention and clinical management. This was a modified, validated questionnaire from a previous study assessing understanding in patients living with chronic hepatitis B. ; ; Source of validated questionnaire: ; Hajarizadeh B, Wallace J, Richmond J, Ngo N, Enright C. Hepatitis B knowledge and associated factors among people with chronic hepatitis B. Aust NZJ Public Health. 2015;39(6):563‐568.[Baseline, immediately after intervention and 1‐month post‐intervention] SECONDARY OUTCOME: Nil[Nil] INCLUSION CRITERIA: English‐speaking patients aged 18 years or greater and diagnosed with chronic hepatitis B were eligible for the study