SLIDE 1
HEALTH LITERACY:
IMPORTANCE IN PARTNERS
SLIDE 2 WHAT DOES PARTNERS DO?
¡ Creates research agenda ¡ Determines research priorities ¡ Conducts meaningful research to fill knowledge gaps ¡ Distributes research results
q Everything is patient-centered using plain, easy to understand language
SLIDE 3 WHY ARE WE TALKING ABOUT HEALTH LITERACY?
¡ These slides are for new PARTNERS members, especially patients and families. ¡ PARTNERS wants to be “health literate” so all people can benefit and learn from our
work.
¡ We need your help to be sure we are health literate. This is why we are talking about
health literacy with you today.
q Once you know more about this topic, you can help us find ways to improve.
SLIDE 4 COMMUNICATION BARRIERS
¡ People have differing levels:
q Education q Literacy (ability to read) q Language
¡ Health literacy: the ability to
q Get, process, understand basic health information and services q Make good health care choices q Work through and access health care system
SLIDE 5
HEALTH CARE SYSTEM MEANS . . .
¡ Doctor’s office ¡ Hospital ¡ Pharmacy ¡ Insurance ¡ Referrals ¡ Any experience related to your health
SLIDE 6 USING HEALTH LITERACY STRATEGIES
¡ “You cannot tell by looking.” Don’t assume. A person may still have a hard time with health
information even if they
q did well in school q speak well q present themselves well
¡ Reading ability does not equal understanding ¡ Worry can make it hard to take care of yourself and your family ¡ Everyone benefits from clear communication
SLIDE 7 USING HEALTH LITERACY STRATEGIES
¡ Health literacy also means knowing how to navigate (access) the health care system ¡ This includes knowing
q when to call q who to call q where to go
¡ Providers need to make this information clear!
SLIDE 8 NATIONAL ASSESSMENT OF ADULT READING SKILLS
¡ National study of health literacy skills of
US adults
q
Looked at both reading and math skills
q
Focused on health-related materials and tasks
q
Found 1 in 3 adults had trouble with health literacy skills
SLIDE 9
2004 REPORT ON HEALTH LITERACY
¡ Health information is harder to understand than it needs to be ¡ Providers (doctors, nurses, others) need health literacy training
SLIDE 10
MISMATCHED COMMUNICATION
¡ Provider job: Give information ¡ Patient job: Understand, remember, and
act on information
SLIDE 11 DEMANDS ON PATIENTS ARE INCREASING…
¡ Preventive care ¡ Shots ¡ Self assessment of health status ¡ Self-treatment ¡ Health care use
q When to go to clinic/ER q Scheduling referrals and follow-up q Insurance
SLIDE 12 AND THE PROCESS IS BECOMING MORE COMPLEX
Health Literacy and Patient Safety: AMA Foundation, 2007
PP – Prior to seeing physician ED – Emergency Department F/U – Follow up HCP – Health care professional
Isn’t this confusing?
SLIDE 13 MEDICINE ERRORS
¡ When asked, “How would you take
this medicine?”
¡ 46% (almost half) did not understand
instructions on more than one label
Davis TC , et al. Annals Int Med 2006
SLIDE 14 MEDICINE ERRORS
¡ When asked, “How would you take
this medicine?”
¡ 38% (4 out of 10) with adequate literacy
missed at least 1 label
Davis TC , et al. Annals Int Med 2006
SLIDE 15 “SHOW ME HOW MANY PILLS YOU WOULD TAKE IN 1 DAY”
John Smith Dr. Red Take two tablets by mouth twice daily. Humibid LA 600mg 1 refill
SLIDE 16 SHOW ME . . .
¡ Studies have shown that people who are able to say or read instructions correctly may
still make mistakes when they carry out the instructions
¡ The gap is largest among people with low literacy ¡ For example, “Take 2 tablets by mouth twice daily”
q 7 out of 10 people with low literacy read the pill label correctly q 3 or 4 out of 10 could correctly show how to take the pills
Davis TC , et al. Annals Int Med 2006
SLIDE 17
STRATEGIES TO IMPROVE UNDERSTANDING
SLIDE 18
STRATEGIES TO IMPROVE PATIENT UNDERSTANDING
¡ Focus on “need-to-know” & “need-to-do” ¡ Use Teach-Back Method ¡ Show how / draw pictures ¡ Use clearly written materials
SLIDE 19
FOCUS ON “NEED-TO-KNOW” & “NEED-TO-DO”
¡ What do families need to know/do…? ¡ When they want to enroll in a study ¡ When they want to volunteer ¡ When they want to share personal details for a registry
SLIDE 20 FOCUS ON “NEED-TO-KNOW” & “NEED-TO-DO”
¡ What do families need to know/do…?
q
When they want to enroll in a study
q
When they want to volunteer
q
When they want to share personal details for a registry
SLIDE 21 TEACH-BACK: A WAY TO MAKE SURE BOTH PEOPLE IN A DISCUSSION UNDERSTAND EACH OTHER
¡ In teach-back, you describe in your
- wn words what was discussed. For
example:
q Details about consent q Participation
Understanding Re-explain if needed
Check understanding
Explain
SLIDE 22 UNDERSTANDING
¡ Do not use these questions:
q Do you understand? q Do you have any questions?
SLIDE 23 “SHOW ME”
¡ Most health drawings too complex
q Doctor drawings often very good (not too complex)
¡ Pictures/actually doing the process is most helpful to patient with low literacy & visual
learners
SLIDE 24 PLAIN LANGUAGE
¡ Plain language is wording your audience can understand the first time they read or
hear it. (Think of “living room” talk.)
¡ Language that is plain to one set of readers may not be plain to others. ¡ Written material is in plain language if your audience can:
q Find what they need q Understand what they find q Use what they find to meet their needs
www.plainlanguage.gov/whatisPL/
SLIDE 25 PLAIN LANGUAGE TECHNIQUES
¡ There are many things that can help you achieve this goal. Among the most common
are:
q
Logical organization with the reader in mind
q
“You” and other pronouns
q
Active voice
q
Short sentences
q
Common, every day words
q
Easy to read design
www.plainlanguage.gov/whatisPL/
SLIDE 26 EXAMPLES OF PLAIN LANGUAGE
¡ Annually ¡ Arthritis ¡ Cardiovascular ¡ Dermatologist ¡ Diabetes ¡ Hypertension
Plain Language What ideas do you have?
The Plain Language Thesaurus for Health Communications
SLIDE 27 EXAMPLES OF PLAIN LANGUAGE
¡ Annually ¡ Arthritis ¡ Cardiovascular ¡ Dermatologist ¡ Diabetes ¡ Hypertension Plain Language ¡ Yearly or every year ¡ Pain in joints ¡ Having to do with the heart ¡ Skin doctor ¡ Elevated sugar in the blood ¡ High blood pressure
The Plain Language Thesaurus for Health Communications
SLIDE 28 PATIENT EDUCATION: WHAT WE KNOW
¡ Written materials alone are not enough ¡ Patients want both spoken and written information ¡ Focus should be “need-to-know” & “need-to do” ¡ Patients with low literacy often ask fewer questions ¡ It can help to bring a family member and medicines to appointments ¡ Technology can also help
IOM: Report on Health Literacy 2004, Berkman et al. AHRQ Report 2004
SLIDE 29
SUMMARY
¡ Focus on need to know and need to do ¡ Teach-Back ¡ Show, draw pictures, use models ¡ Use plain language
SLIDE 30
RESOURCES
¡ 2nd edition of the AHRQ toolkit ¡ NC Program on Health Literacy ¡ Medline Plus Dictionary ¡ The Plain Language Thesaurus for Health Communications
SLIDE 31 ACKNOWLEDGMENTS
¡ These slides were adapted from the AHRQ Health Literacy Universal Precautions
Toolkit
¡ Most of the content was created by:
¡ T
erry Davis, PhD
¡ With additions by Darren DeWalt, MD, MPH, Ashley Hink, MPH, Victoria Hawk, RD, MPH,
Angela Brega, PhD, Natabhona Mabachi, PhD
