Why Does Health Literacy Matter?

©2019 Envolve, Inc. All rights reserved. MKT SF-5 July 2019

EnvolveHealth.com

Communications Members Can Understand

EnvolveHealth.com©2019 Envolve, Inc. All rights reserved. MKT SF-5 July 2019

Table of Contents I. WHY DOES HEALTH LITERACY MATTER? .......................................4

II. HEALTH LITERACY CHECKLIST: CONTENT, LANGUAGE, WRITING STYLE .......................................... 5

III. HEALTH LITERACY CHECKLIST: LEARNING, STIMULATION, MOTIVATION .......................................... 5

IV. HEALTH LITERACY CHECKLIST: LAYOUT, TYPOGRAPHY, IMAGES .................................................... 6

V. HEALTH LITERACY CHECKLIST: AWARENESS OF INTENDED AUDIENCE NEEDS .................................. 6

4©2019 Envolve, Inc. All rights reserved. MKT SF-5 July 2019

Why Does Health Literacy Matter?

More than just a buzzword, health literacy describes a very real problem. Only about 12 percent of Americans in the U.S. have “proficient” health literacy, according to the U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion

What does it mean to be proficient in health literacy? It means that an individual can use an application to calculate his or her share of health insurance costs incurred for a year.

On the other end of the spectrum, 35% of U.S. residents have basic or below basic health literacy. This costs the nation as much as $238 billion a year through unnecessary utilization, noncompliance, poor navigation of the healthcare system, negative health outcomes, and more.

Health literacy isn’t only about being able to read. It also involves an understanding of charts and graphs, measurements, time, and other concepts not easily measured in a person’s reading level. It also requires the ability to understand and communicate information about health and healthcare services in order to make decisions about often serious health matters that affect individuals and families.

The Health Literacy Checklist, employed by Envolve, ensures member communications are clearly written, effectively presented and actionable. It takes into account health literacy best practices and techniques, as well as some unique factors aligning with Envolve’s drive to understand a person’s health status and life barriers to deliver personalized education, guidance and support to help them achieve positive, lasting lifestyle changes.

Health literacy is the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions.

— Patient Protection and Affordable Care Act of 2010

5©2019 Envolve, Inc. All rights reserved. MKT SF-5 July 2019

Health Literacy Checklist: Content, Language, Writing Style

Health Literacy Checklist: Learning, Stimulation, Motivation

One primary component of the Envolve checklist is ensuring that content is concise and plain using easy-to-understand grammar. Two examples of questions addressed when considering content, language and writing style include:

DOES THE VOCABULARY THROUGHOUT EMPHASIZE USE OF COMMON WORDS? IF DIFFICULT WORDS ARE USED, ARE THEY WELL DEFINED?

It’s important to use words that readers will understand. An article about hypertension, for instance, needs to make clear that the condition being discussed is the same thing as “high blood pressure.” On the other hand, some tough words are vital for patients to know. A lot of diabetes terms, for instance — including the word diabetes itself — are going to be difficult or unfamiliar at first or second glance. Other important but challenging words include insulin, glucose or ketones. Still individuals with diabetes need to know what these and other words mean.

ARE SENTENCES STRUCTURED FOR EASY UNDERSTANDING OF CONTEXT AND CATEGORIES?

Structure sentences to help readers file new information. Some less-confident readers may have trouble grasping the key message of a sentence like “Milk, yogurt and cheese are good sources of calcium.” Instead, put the context of the message first: “Good sources of calcium are milk, yogurt and cheese.” It’s as if the information is going to be put into a filing cabinet. The reader knows the drawer is “calcium,” and then the folders inside it are “milk, yogurt and cheese.”

The Envolve checklist also focuses on the importance of member learning, stimulation and motivation as core components of member-facing communications. It helps guide the creation of material that engages and involves members on their journey toward better health. An example of a question in this section of the checklist:

IS THERE A CALL FOR THE READER TO INTERACT WITH THE MATERIAL?

Research shows that when a person is instructed to write, say, show or do something in response to new information, they are much more likely to recall the information. A person might be asked to list what they should do and who to call when asthma symptoms act up. Another tool might be a chart listing some specific, small steps the member will take toward a larger goal of getting more exercise. It’s even been found that useful interaction can be as simple as providing a spot for a person to write his or her name on a booklet.

6©2019 Envolve, Inc. All rights reserved. MKT SF-5 July 2019

Health Literacy Checklist: Layout, Typography, Images

Health Literacy Checklist: Awareness of Intended Audience Needs

The checklist category on layout, typography, and images covers best practices for the layout and design of written materials. Each of these work to ensure readers comprehend the information and engage with the content. Here is another question to consider health literacy:

IS THE LAYOUT CLEAN, SIMPLE AND EASY TO FOLLOW?

Many of the design guidelines follow common sense: If there is an image that goes along with a newsletter article it should be on the same page as the article it accompanies. Text should flow consistently through columns from left to right. Any boxes with additional information should appear near the information they are meant to assist with. Fonts and text size should

be selected based on the ease of reading. Most of the design guidelines for creating health-literate materials can be explained by one research finding: if the material looks hard to read, people tend to think whatever is being described is hard to do. This creates friction for the individual, which can lead to significant barriers to sustainable, positive health behavior change.

This category enables the creation of materials that are relevant and useful. Health communications need to be culturally competent and include principles from the field of usability. A question to consider for each unique audience is:

HAVE THE AUTHORS ANTICIPATED AND ADDRESSED THE MAIN QUESTIONS READERS MAY HAVE?

Health communicators have found that asking themselves a few quick questions early on in the development of a written product can highlight the areas where problems might be found and where more research, or actually testing material out with the intended audience, can be useful.

When it comes to health information, it helps to know that the material is relevant and useful to the reader, the language can be comprehended, and that readers know

what to do with it. A Body Mass Index (BMI) chart is not a good fit, for example, if the first question asked by readers is “What is a BMI?” If the reader doesn’t have that information in mind, then it will be harder to explain important information when a reader is looking for the definition of body mass index. Only when the core concepts are understood is it appropriate to take the next step – such as educating someone on how to calculate his or her BMI.

8©2019 Envolve, Inc. All rights reserved. MKT SF-5 July 2019©2019 Envolve, Inc. All rights reserved. . MKT SF-5 July 2019