Health LiteracyElisha Brownfield 7/23/15

Health LiteracyThe degree to which an individual has the

capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions

Health LiteracyNearly 9 out of 10 adults have difficulty

using the everyday health information that is routinely available in our healthcare facilities, retail outlets, media and communities.

Health LiteracyWithout clear information and an

understanding of the information's importance, people are more likely to: skip necessary medical tests, end up in the emergency room more often, and have a harder time managing chronic diseases

like diabetes or high blood pressure.2

How is Health Literacy Measured?

TOFHLA (S-TOFHLA) – A modified Cloze method to assess reading and numerical comprehension

REALM – Brief word recognition testNewest Vital Sign – A 3 minute screening tool

for use in clinical settings

Effects of low Health Literacy• Difficulty taking medications appropriately and

interpreting labels and health messages•  Higher rates of hospitalization, emergency care visits and lower rates of flu immunizations•   Less health knowledge and comprehension of health information•     Are more likely to report their health as poor •     In particular, seniors' limited health literacy is associated with worse health status and quality of life and early mortality

Approximately 45% of high school graduates have limited health literacy

Factors associated with Low Health Literacy

How do we cause problems?• Use of technical or medical terminology.

pandemic, immunize, transmit, influenza, and prevalence  

• Reliance on print communication – written instructions as a single source of communication.

• Focusing on information rather than actions.  

• Limited awareness of cultural differences.

What Can I Do?Use plain language and slow down. Make sure you are

understood (Teach Back)

Use a caring tone of voice and attitude.

Break it down into short statements.

Focus on the 2 or 3 most important concepts

Give instructions that are participatory and user-centered.

Consider the current literacy level of the patient population

Teach Back●Asking patients to repeat in their own

words what they need to know or do, in a non-shaming way.

●NOT a test of the patient, but of how well you explained a concept.

●A chance to check for understanding and, if necessary, re-teach the information.

Teach BackAsk patients to demonstrate

understanding“What will you tell your spouse about your condition?”“I want to be sure I explained everything clearly, so can you

please explain it back to me so I can be sure I did.”“Show me what you would do.”

Chunk and checkSummarize and check for understanding throughout, don’t wait until the end.

Do NOT ask . . . “Do you understand?”

What Can I Do? Pictures Orally delivered health information Studies find narratives can lead to cancer-relevant belief and behavior

change (Green, M.C., 2006) and to be more effective than statistical evidence on some patient outcomes (Mazor et al., 2007).

Grouping information into meaningful “chunks” of reasonable size Practical, science-based advice on explaining risks using numbers

rather than words alone (10 out of 100) Every risk communication is processed both cognitively and

emotionally….Success in a risk communication must be measured not only by what recipients know but by how they feel.

ResourcesCdc.govKutner, M., Greenberg, E., Jin , Y., & Paulsen, C. (

2006 ). The health literacy of America's adults: Results from the 2003 National Assessment of Adult Literacy (NCES 2006-483).

Rudd, R . E., Anderson, J . E., Oppenheimer, S., & Nath , C. (2007). Health literacy: An update of public health and medical literature. In J. P. Comi ngs, B. Garner, & C. Smith. (E ds.), Review of adult learning and literacy (vol . 7) (pp 175–204). Mahwa h, NJ: Lawrence Erlbaum Associates.