Introduction
Health literacy in adolescents and young adults with cancer (AYAs) is acquired and used via the social networks that surround AYAs, including clinicians and family members. Distributed health literacy is a potential resource for building health literacy in AYAs. We propose that network meetings represent a system-based approach that have the potential to facilitate distributed health literacy in AYA networks and aimed to adapt this to the Australian context through the development of the AYA-DHL framework.
Methods
The Danish model of Nurse-chaired AYA Network Meetings (Olsen, 2018) aims to engage the social system surrounding AYAs. Informed by our previous empirical work, and using a co-design methodology, we expanded this model to include a distributed health literacy framework. This was an iterative process involving health literacy and AYA experts and potential end-users (i.e., AYA nursing staff).
Results
The initial stages of the AYA-DHL framework development indicate that network meetings are an appropriate method to facilitate distributed health literacy in the Australian context. The original Nurse-chaired AYA Network Meetings were modified to support distributed health literacy by embedding the following distributed health literacy skills into the standard agenda (Olsen, 2018): i) shared understanding of cancer pathology and treatment; ii) family member involvement in day-to-day illness management; iii) AYA-family-clinician communication; iv) family deliberation of treatment options; and v) shared decision-making.
Conclusion
Recognising clinical and family systems surrounding an AYA represents a valuable insight to developing system-based approaches to address health literacy. The model of Nurse-chaired AYA Network Meetings has been adapted to facilitate distributed health literacy in the Australian context. Future directions involve piloting the AYA-DHL framework to obtain evidence on its feasibility and acceptability in the Australian context.