What is health literacy and how can we measure it? Laura Mackey, - - PowerPoint PPT Presentation

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May 09, 2023 130 likes •343 views

What is health literacy and how can we measure it? Laura Mackey, BSc Physiotherapy, PhD Student UCD School of Public Health, Physiotherapy and Sports Science UCD School of Public Health, Scoil na Slinte Poibl, na Physiotherapy and

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Scoil na Sláinte Poiblí, na Fisiteiripe agus Eolaíocht an Daonra UCD UCD School of Public Health, Physiotherapy and Population Science

What is health literacy and how can we measure it?

Laura Mackey, BSc Physiotherapy, PhD Student

UCD School of Public Health, Physiotherapy and Sports Science

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Presentation Aims

Overview and definition of health literacy.
Understand the evolving nature of health literacy

– definitions to conceptual frameworks.

Impact of low health literacy.
Health literacy assessment tools.
Management strategies in a clinical setting.

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Health Literacy Definitions

‘the degree to which individuals have the capacity to
btain, process & understand basic information & services

needed to make appropriate decisions about their health’

(IOM, 2004).

‘the cognitive & social skills which determine the motivation

and ability of individuals to gain access to, understand & use information in ways which promote and maintain good health’ (WHO, 1998).

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Health Literacy – Clinical Perspective

Patient skills/capacities

Prior knowledge
Understanding
Confidence
Decision-making
Motivation
Cognitive skills

HCP skills/capacities

Language used
Communication
Assessment
Written material
HL Interventions
Building/signage

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Models/Conceptual Frameworks

Baker, 2006
Paasche-Orlow and Wolf, 2007
Nutbeam, 2008
Von Wagner et al, 2009
Sorensen et al, 2012
Squiers et al, 2012

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Paasche-Orlow & Wolf, 2007

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Squiers et al, 2012

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HLS-EU Survey

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Why Health Literacy?

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Self-management

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Examples

https://www.youtube.com/watch?v=p-

x8XgfGwDs

https://www.youtube.com/watch?v=QUS-

qy2jV1U

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Healthcare professionals’ role..

Educators

Communicate effectively with patients.
Traditional passive approach vs. Biopsychosocial.
Need patients to ‘buy’ into our treatment strategies.
Via:
Self-management development.
Motivation, desire, and volition.
Shared decision making.
Goal orientated treatments.

+ HEALTH LITERACY DEVELOPMENT.

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Who is at risk?

Older adults.
Lower SES.
Lower educational attainment.
Ethnic minorities.
Non-English speaking.
Beware!! – higher education does not always

suggest adequate health literacy.

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Common Red Flags..

‘I forgot my glasses…’
‘I’ll take the form home with me…’
‘My son sorts all that stuff out for me…’

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How to assess?

Validated tools:
Test of Functional Health Literacy in Adults

(TOFHLA) (Parker et al, 1995).

Rapid Estimate of Adult Literacy in Medicine

(REALM) (Davis & Crouch, 1991).

Newest Vital Sign (NVS) (Weiss et al, 2006).
Patient’s understanding of their condition?
Gut instinct – leads to overestimation of health literacy

in patients? (Mackert et al, 2011).

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Short test of functional health literacy (s-TOFHLA) (Baker et al, 1999). 4 sections:

Modified cloze

procedure.

Reading comprehension.
Numeracy skills.

Administration time:

7 minutes.

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Rapid Estimate of Adult Literacy in Medicine (REALM) (Davis & Crouch, 1991). 66 words:

Reading

comprehension.

Pronunciation.

Administration time:

3 - 7 minutes.

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The Newest Vital Sign (NVS) (Weiss et al, 2006). 6 questions:

reading

comprehension

quantitative capacity
cognitive capacities

(i.e. critical thinking) Administration time:

3 minutes

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Interventions

Plain English documents.
Teach back method.
Signage in hospitals / clinics.
Individual and/or group based education or

counselling services (Taggart et al, 2011).

? HL-sensitive interventions in COPD (Kiser et al,

2011), and Coronary Artery Disease (Eckman et al, 2012).

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In conclusion

Health Literacy….

Umbrella term for patient characteristics and attributes,

that are necessary for the subsequent development of health related skills.

These skills enable people to build their knowledge, more

skills, and potential to make positive and sustainable health behaviour changes of their own volition.

May be modifiable from patients’ experiences in health

care settings

Healthcare professionals can positively facilitate this with

suitable interventions and strategies.

Recognising low health literacy is important.