JCPSLP Vol 22 No 2 2020

Table 2. Barriers and facilitators extracted from included studies

Year

First author

Barriers

Facilitators

1984 Weddig

Clinician ability to use readability measures

Use of readability measures

providing verbal explanation along with written report; consider the outcomes of providing the report; accompany jargon with an interpretation; interpret assessment scores

2004 Donaldson

Parent feeling inadequate when unable to understand the report; use of profession- specific terminology Lack of change in the way report writing is taught GP concern about patient reaction and reduced info in letter; traditional practices Limitations of readability statistics; clinician reluctance to have work reviewed

2009 Pelco

Graduate instruction on report writing

2011 Cassini

None reported

2012 Mallin

Training

2014 Makepeace

None reported

Written report an extension of the verbal explanations; specific strategies to help the child at home; outline the primary and secondary audiences for reports; clearly address the referral questions and target those initiating the assessment request

2015 Fletcher

Writer opinion may not match reader preference

None reported

2015 Roggenbuck

Lack of training

Training in medical and educational writing

Provide a glossary; access to a bank of appropriate images;

2016 Brown

Clinician time; limitations of electronic medical records; knowledge of more easily understood synonyms for medical terms

2016 Donald

None reported

Improve language used; consider report order; include prognostic information; provide precise information; include a glossary and weblinks; use graphics; writing materials with the parents (readers) in mind; rather than trying to distinguish those parents with low health literacy, the most effective method is to ensure that all parents are provided with reports that are easy to comprehend

2018 Rahill

Research-to-practice gap; lack of training; lack of exemplar reports

Ongoing professional development

2018 VandenBoom Practice setting

Practice setting; time

VandenBoom et al., 2018). This review indicates a need to address the identified barriers however it is unclear how this might be achieved. The literature reviewed revealed limited attention given to the skills and needs of the writers of allied health reports. This review revealed research conducted by a limited number of allied health professions, from a limited number of contexts. The majority of research originated from the discipline of psychology, with a particular focus on educational psychologists. Some studies included comments on ways to improve the information accessibility of allied health reports that can be generalised to other allied health professions. These suggestions included to ask readers for feedback, explain jargon, avoid reporting by subtests, include functional recommendations, and individualise the format and content of reports (Donaldson et al., 2004; Flynn & Parsons, 1994; Makepeace & Zwicker, 2014; Mastoras et al., 2011; Phelps et al., 2004; Rahill, 2018; Wiener & Kohler, 1986). However, this review demonstrates that there remains a lack of evidence-based strategies for allied health professionals aiming to improve information accessibility and reduce the health literacy demands of their reports. In order to inform evidence-based guidance on improving allied health report writing practices, future research needs to investigate strategies that enable

not reflect population diversity in terms of language and communication skills, both of which greatly impact on health literacy; and assumes a high and unrealistic degree of homogeneity in the readers of allied health reports. There is currently insufficient data from which to draw firm conclusions about the information accessibility and health literacy demands of allied health reports written by allied health professionals. Despite numerous studies mentioning information accessibility or health literacy within their reporting, none of the included studies provided a definition of health literacy, or made reference to a conceptual framework or model to illustrate their construct of either health literacy or information accessibility. As such, this aim in our review remains unanswered. None of the studies examined documents written in plain language or any other accessible formats such as Easy English, despite evidence to suggest these strategies are core components of enhanced accessibility of written information. Barriers to changing practices have persisted for allied health professionals (Rahill, 2018). Barriers including time pressures, access to resources, and conflicting employer policies, have not been reduced by advancements in research, legislation, policy, or guidance promoting more accessible allied health reports for clients (Harvey, 2006; Mastoras, Climie, McCrimmon, & Schwean, 2011;

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JCPSLP Volume 22, Number 2 2020

Journal of Clinical Practice in Speech-Language Pathology