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COMPaRE-PHC is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health Health Literacy & clinical practice Scientia Professor Mark Harris
Transcript of PowerPoint Presentationcompare-phc.unsw.edu.au/sites/default/files/upload/Health...Title PowerPoint...
COMPaRE-PHC is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health
Health Literacy & clinical practice
Scientia Professor Mark Harris
Basic skills in reading
and writing and the
capacity to apply
these skills in
everyday situations
Functional
literacy
More advanced
cognitive and literacy
skills, greater ability to
obtain relevant
information, derive
meaning, and apply
new information to
changing
circumstances
Communicative
literacy
Most advanced
cognitive and literacy
skills, critical analysis
of information, ability
to use information to
respond, adapt and
control life events and
situations
Critical
literacy
The degree to which individuals have the capacity to obtain,
process, and understand basic health information and
services needed to make appropriate health decisions
From Don Nutbeam April 2010 presentation,
“The evolving concept of health literacy”
Health literacy is two-way
Skills and abilities Demands/complexity HEALTH
LITERACY
Health Literacy in Australia 2006 (ABS)
Level 1: Very poor
Level 2 Insufficient: to manage
health
Level 3 Sufficient: to manage
health
Level 4/5 Proficient
Framework for health literacy and health action
Paasche-Orlow & Wolf 2007 and von Wagner et al 2009
Health
Literacy
Motivation
Knowledge &
understanding
Attitudes and beliefs
Intentions
Planning
Implementing
Health System
Accessibility
Appropriateness
Use of
health care
Patient
Provider
interaction
Self
management
behaviours
Health &
Quality
of life
Our research on health literacy
Health
Literacy
Motivation
Knowledge &
understanding
Attitudes and beliefs
Intentions
Planning
Implementing
Health System
Accessibility
Appropriateness
Use of
health care
Patient
Provider
interaction
Self
management
behaviours
Health &
Quality
of life
Health Literacy Questionnaire
• www.ophelia.net.au/bun
dles/opheliapublic/pdf/T
he-HLQ.pdf
• 44 questions that can
be either self-
administered or orally
administered. Nine
scales.
HLQ in obese patients in primary health care (Mean scores)
3.17
2.89
2.67
3.00
2.74
3.99
3.70
3.69
3.91
0.00 0.50 1.00 1.50 2.00 2.50 3.00 3.50 4.00 4.50 5.00
Feeling understood and supported by HC providers
Having sufficient info. to manage my health
Actively managing my health
Social support for health
Appraisal of health info.
Ability to actively engage with healthcare providers
Navigating the healthcare system
Ability to find good quality health info.
Understanding health info. well enough to know what to do
Brief Health Literacy Screen (BHLS)
A. How often do you have someone help you read health
information materials?
1. Never 2. Occasionally 3. Sometimes 4. Often 5. Always
B. How often do you have problems learning about your medical
condition because of difficulty understanding health information
materials?
1. Never 2. Occasionally 3. Sometimes 4. Often 5. Always
C. How confident are you filling in medical forms by yourself?
1. Extremely 2. Quite a bit 3. Somewhat 4. A little bit 5. Not at all
Total score Question C >2
HLQ by BHLS screening (BMWGP)
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
HPS HSI AMH SS CA AE NHS FHI UHI
>10
<=10
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
HPS HSI AMH SS CA AE NHS FHI UHI
LHL
HHL
Assess
Risk & low health literacy
Advise/agree
Advice, goal setting,
teachback
Assist
Referral navigation
Arrange
Follow up
Change in patient health literacy (HLQ, baseline to 6 month follow-up, BMWGP)
-0.1 0 0.1 0.2 0.3 0.4 0.5
Healthcare provider support
Having sufficient information
Actively managing health
Social support
Critical appraisal
Active engagement with healthcare providers
Navigating the healthcare system
Ability to find good health information
Reading and understanding health information
Control
Intervention
Conclusions
• PHC can play an effective role across the 5As and
working with patients with low health literacy to build
skills and manage the information demands on them.
• Pathways for referral to preventive interventions are
complex and adherence is low (<50%). We need to
provide better communication and more intensive
navigation support.
• A health literacy approach needs to be incorporated
into all provider and consumer health service
pathways.
Acknowledgements
The research reported in this presentation is a project of the Australian
Primary Health Care Research Institute, which was supported by a
grant from the Australian Government Department of Health. The
information and opinions contained in it do not necessarily reflect the
views or policy of the Australian Primary Health Care Research Institute
or the Australian Government Department of Health.
