Health Literacy

Specialists:

Connie Arnold, PhDAssociate Professor of

Medicine

Terry Davis, PhDProfessor of Medicine and

Pediatrics

1

Health Literacy : the Intersection of Patient skills and System Demands

Skills/ability

of patient

s

Demands/complexityof health

information and system

Health Literacy

* US DHHS, May 27, 2010. (www.health.gov/communication/HLactionplan)

• IOM Report (2004)• 90 million adults have trouble understanding/acting on

health information

• Healthy People 2020• Improve health communication (plain language materials)

• Joint Commission (2007)• Patients must be given information they understand

High school dropout rate in LA 29%

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47% graduates go on to a 4 year college

43% need remedial classes

Only 3 of 5 TOPS students graduate college in 6 years

Low Literacy is a National Problem(National Adult Literacy Survey)

National Institute for Literacy 1998; National Adult Literacy Survey 1993 Tables 1.1.A 1.1B 1.2 A1.2 B

02 0

> 30%

20% to 30%

15% to 20%

< 15%

% Adults with Level 1 Literacy Skills

22% U.S. Adults are Level 1

Adults > 65 (49%), Chronic Illness (42%) African-American (41%) Hispanic (52%)

Low Literacy Rates By Parish% Adults with Level 1

Literacy Skills

01

> 30%

20% to 30%

15% to 20%

10% to 15%

< 10%

No EstimateAvailable

National Institute for Literacy 199828% Louisiana Adults are Level 1 5

Literacy Definition (Requirements) Expand With Increasing Demands Of Society

“…at a level needed to function on the job and in society.”

National Literacy Act, 1991; S. White, Project Director NAALS 2016 6

Communicate

Math Skills

Literacy

WriteProblem Solving

ReadInternet Skills

Numeracy: A Hidden ProblemUnderstanding Food Labels

• You drink this whole bottle of soda. How many grams of total carbohydrates does it contain?

• 67.5 grams• 32% answered correctly• 200 primary care patients

– 73% private insurance– 67% at least some college– 78% read > 9th grade– 37% math > 9th grade

Rothman R, Am J Prev Med, 2006

VideoIts easy to make a mistake

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Health Information Needs To Be Improved – We can Help

Oral Communication:• Not clear to patient• Too much medical jargon• Not focused on what patient needs to know and do

Patient Education is often NOT:• Easy to read, understand, act on• Organized from patient’s perspective• Focused on behavior as well as knowledge

Questionnaires are often:• Not clearly understood• Likert format can be confusing

Consent and HIPAA Documents are:• Too long, too much information, too complex

7 Steps to Improve Oral Communication

1. Slow down

2. Avoid medical jargon, use living room language

3. Limit information – write brief take home information

4. Focus on need to know and do. Patients also need to know the benefits of what they are doing.

5. Use pictures, teaching tools (pamphlets, brown bag medications)

6. Repeat and summarize information

7. Teach back/show back to confirm understanding

Guides focused on:• Patient not disease• ‘Need to know and do’

Help patients change health behavior:• Increase knowledge and confidence

managing disease• Help patients solve self-care problems

Over 5 million copies have been distributed by the American College of Physicians Foundation

A Good Model for Patient Education

Pictures Can be Good Teaching ToolsPatients may not understand or use measurements

Health Literacy Consultation

We can help you:

• Develop questionnaires that patients can understand.

• Lower the reading level and simplify Consent and HIPAA Documents.

• Develop patient education and health information that is understandable and actionable.

• Enhance oral communication.