Health Literacy: End the Confusion Illinois Department of Human Services Bureau of Family Nutrition January 16, 2007 Health Literacy: End the Confusion Presented by Bindi Desai-Lessing & Ginny Belt Regional Nutritionist Consultants Division of Community Health and Prevention Objectives Describe potential misconceptions and prejudices towards those with low health literacy. Identify the impact on health outcomes if health messages are communicated inadequately. Identify the importance of effective verbal and written health education. 1
Objectives Demonstrate methods for assessing literacy of written materials. List 2-3 techniques to provide information to those with low health literacy. Health Literacy is: The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Avoid this! Which of these people has low health literacy? 2
Vulnerable Populations Elderly Minority Immigrants People with chronic mental and/or physical conditions Low income Reasons for Low Health Literacy Lack of educational opportunity (high school level or lower) Learning disabilities Cognitive skills decline in older adults Use it or lose it Who should help? Anyone involved in: health promotion and protection disease prevention and early screening health care maintenance policy making 3
Identifying Possible Low Health Literacy Bring family member or friend to assist them Ask other clients in waiting room questions Copy actions of others Forms are incomplete or incorrectly completed Do not ask questions, become withdrawn Make comments like: I will take this home and read it or I forgot my glasses. Impact of Poor Health Communication on Health Outcomes Inadequate or no health care received More medication and treatment errors Increased healthcare costs Impact of Low Literacy on Asthma, Diabetes and Cancer Poorer knowledge of asthma and improper metered inhaler use Worse glycemic control and higher rates of retinopathy Higher cancer incidence, mortality and poorer quality of life 4
Skills Needed for Health Literacy Verbally Literate Skills Needed for Health Literacy Verbally Literate Visually Literate What may be confusing about this? A parent of an overweight child is given a copy of their child s growth chart from a Head Start office without explanation. An immigrant parent with limited English skills is given an immunization schedule for their one year old without explanation. An elderly person with hypertension is told to reduce sodium and given a food label at a health fair without explanation. 5
Growth Chart Food Label 6
Skills Needed for Health Literacy Verbally Literate Visually Literate Computer Literate Skills Needed for Health Literacy Verbally Literate Visually Literate Computer Literate Information Literate Skills Needed for Health Literacy Verbally Literate Visually Literate Computer Literate Information Literate Numerically Literate 7
Characteristics of Plain Language Common everyday words, unless technical terms are necessary Personal pronouns like we and you Active voice Easy to read features Plain Language: BEFORE When the process of freeing a vehicle that has been stuck results in ruts or holes, the operator will fill the rut or hole created by such activity before removing the vehicle from the immediate area. http://www.plainlanguage.gov/examples/before_after/wordiness.cfm Plain Language: AFTER If you make a hole while freeing a stuck vehicle, you must fill the hole before you drive away. 8
The Year s Best Headlines 2003 Red Tape Holds Up New Bridges New Study of Obesity Looks for Larger Test Group Kids Make Nutritious Snacks Chef Throws His Heart into Helping Feed Needy Local High School Dropouts Cut in Half Hospitals are Sued by 7 Foot Doctors http://www.plainlanguage.gov/examples/humor/headlines.cfm Read this passage: Children younger then 1 year of age should never consume honey. Some parents dip a pacifier or even their finger in honey for the infants to suck on. They think this will calm them down or cure colic. Honey can contain botulism spores, which can make an infant very sick. Even if you know someone who gave their child honey with no ill effects, you should NEVER give it to your infant. Health Literacy Friendly? A. Do not dip a pacifier or even your finger in honey for a child to suck on, even if you think it will help to calm them down. B. Babies less than 1 year old should never eat honey. Honey may have bacteria in it that can make your baby sick. www.wicworks.com (online learning) 9
Tips for Creating a Handout Need to know information Friendly terminology Text appeal Visually Appropriate Layout Logical Simple and short Health Literacy Friendly http://www.ahs.uwaterloo.ca/~kh346/images/hand2.jpg Readability Tools SMOG Readability Index Gunning FOG Readability Test Fry Readability Graph Flesch-Kincaid Formula Microsoft Word Corel s WordPerfect 10
Feedback Questions Can you tell me what you like/don t like about this? When it says what does it mean to you? Is something you would be likely to do? Why do you think it is important for people to know about? Would you show me how you will do? What, if anything did we leave out that should be included? Assessing Understanding Many clients have trouble reading these forms and answering the questions. What about this form is difficult for you to understand? Instead of, Do you have any questions? ask What are your questions? Some people have trouble understanding what is? What does it mean to you? Auditory Visual Kinesthetic Learner Types http://www.lbhf.gov.uk/images/healthy-meal_tcm21-38557.jpg 11
Teaching without Handouts Ask the client how they learn best Interactive Activities Use pictures and models Use dialogues (avoid monologue) Storytelling What can your clients do? Keep a health journal Ask Me 3 campaign What is my main problem? What do I need to do? Why is it important for me to do this? Understanding health information is everyone s right; improving clear health communication is everyone s responsibility. -Pfizer 12
Presenters Contact Information: Bindi Desai Lessing, MPH, RD, LDN Regional Nutritionist Consultant 312-793-1646 Bindi.Desai-Lessing@illinois.gov Ginny Belt, RD, LDN Regional Nutritionist Consultant 815-730-4212 Ginny.Belt@illinois.gov 13