Lockhart J, Stellefson M L, Turner L W, Mkuu R S, Mehra B, Leeper J
, Atlanta, GA, USA.
Department of Health Science, The University of Alabama, Tuscaloosa, AL, USA.
J Cancer Educ. 2025 Jun 30. doi: 10.1007/s13187-025-02675-2.
Ineffective communication between cancer survivors and providers can contribute to health disparities. Question Prompt Lists (QPLs) help facilitate patient-provider communication; however little research has evaluated the tool. This study evaluated the characteristics of QPLs available on National Cancer Institute (NCI)-Designated Cancer Center websites. A cross-sectional content analysis was conducted on 64 NCI-Designated Cancer Center websites. Eighty-nine QPLs were coded based on the Information Literacy Framework and the National Culturally and Linguistically Appropriate Services (CLAS) Standards. The readability, actionability, understandability, clarity, and suitability of QPLs were evaluated using validated tools to determine their utility in supporting diverse cancer survivors. Thirty-nine centers (59.1%) provided a total of 89 QPLs, averaging 16.4 questions (SD ± 10.4) per list. No QPLs (0%) were created for a specific race/ethnicity or who identify with sexual and gender minority populations. Six (6.7%) were created based on age and seven (7.9%) were available in multiple languages. Common topics included diagnosis (68.5%) and treatment (79.8%). Twenty QPLs (29.2%) were available as PDFs, and most (70.8%) were not cancer-type specific. While most QPLs (76.4%) demonstrated good understandability, 62.9% had poor actionability, 82.0% exhibited superior suitability, and 92.1% had suboptimal clarity. The average readability was seventh grade. Cancer centers should develop QPLs that address diverse cultural and communication needs. Despite their importance, most QPLs lacked inclusivity. Additionally, while understandability was generally high, actionability and clarity were suboptimal, potentially limiting their effectiveness in guiding patient-provider discussions. Using validated tools before dissemination aligns with best practices to improve patient-centered care while reducing health disparities.
癌症幸存者与医疗服务提供者之间的无效沟通可能会导致健康差距。问题提示清单（QPLs）有助于促进医患沟通；然而，对该工具的研究较少。本研究评估了美国国立癌症研究所（NCI）指定癌症中心网站上可用的QPLs的特征。对64个NCI指定癌症中心网站进行了横断面内容分析。根据信息素养框架和国家文化与语言适宜性服务（CLAS）标准，对89个QPLs进行了编码。使用经过验证的工具评估QPLs的可读性、可操作性、易懂性、清晰度和适用性，以确定它们在支持不同癌症幸存者方面的效用。39个中心（59.1%）共提供了89个QPLs，每个清单平均有16.4个问题（标准差±10.4）。没有针对特定种族/族裔或性取向和性别少数群体的QPLs（0%）。有6个（6.7%）是根据年龄创建的，7个（7.9%）有多种语言版本。常见主题包括诊断（68.5%）和治疗（79.8%）。20个QPLs（29.2%）以PDF格式提供，大多数（70.8%）不是特定癌症类型的。虽然大多数QPLs（76.4%）表现出良好的易懂性，但62.9%的可操作性较差，82.0%的适用性较好，92.1%的清晰度欠佳。平均可读性为七年级水平。癌症中心应开发能够满足不同文化和沟通需求的QPLs。尽管它们很重要，但大多数QPLs缺乏包容性。此外，虽然易懂性总体较高，但可操作性和清晰度欠佳，这可能会限制它们在指导医患讨论方面的有效性。在传播之前使用经过验证的工具符合最佳实践，可改善以患者为中心的护理，同时减少健康差距。
