How to Use The Book What To Do When Your Child Gets Sick. A Train-the-Trainer Session

How to Use The Book What To Do When Your Child Gets Sick A Train-the-Trainer Session

Institute for Healthcare Advancement Health literacy experience Creation of the Easy-To-Read Health Book Series

Objectives Understand at least one health literacy tool to work effectively with low literacy adults. Practice how to use the book with families to care for their child and avoid unnecessary emergency rooms.

Health Literacy

Health Equity 1. Everyone has the opportunity to live a long and healthy life. 2. Health should not be compromised because of race, ethnicity, age, etc. 3. Increasing equity means creating fair opportunities for health and eliminating gaps. (2017, October 25).What is health equity?. Retrieved from http://www.bphc.org/whatwedo/health-equity-social-justice/what-is-health-equity/pages/what-is-healthequity.aspx

Which of the following is the strongest predictor of an individual s health status? A. Age B. Income C. Literacy skills D. Employment status E. Education level F. Racial or ethnic group

Which of the following is the strongest predictor of an individual s health status? A. Age B. Income C. Literacy skills D. Employment status E. Education level F. Racial or ethnic group Report on the Council of Scientific Affairs, Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association, JAMA, Feb 10, 1999

Health Literacy Literacy Health literacy Access Understand Apply Sorensen, K. et al (2012) Health literacy and public health: A systematic review and integration of definitions and models. BioMed Central Ltd. doi:10.1186/1471-2458-12-80

Health Literacy Myths People who can t read, can t learn Most people with low literacy are immigrants or minorities People who can t read will tell someone they need help reading written instructions You can tell how well someone can read by the number of years they attended school (2017, October 25). Health Literacy Myths, Misperceptions and Reality. Retrieved from http://www.idph.state.ia.us/fsbupdate/common/pdf/110804.pdf

Low health literacy means difficulty with Understanding written and verbal information Filling out health forms Finding a doctor or healthcare services Sharing medical history with doctors Palumbo,R. (2015)Discussing the Effects of Poor Health Literacy on Patients Facing HIV: A Narrative Literature Review

Low health literacy means difficulty with Taking the correct dosage of medication Treatment adherence Confidence in self-management of care Palumbo,R. (2015)Discussing the Effects of Poor Health Literacy on Patients Facing HIV: A Narrative Literature Review

Health literacy statistics 1 in 5 Americans can t read above a 5 th grade level 1 in 2 Americans can t read at an 8 th grade level or higher 2003 National Assessment of Adult Literacy

Health Literacy Communication Education Ethics Organizational Systems and Policy Public Health Language, Culture, and Identity Community Engagement

How can you help? L o o k o u t f o r r e d f l a g s

Look out for red flags Frequently missed appointments Incomplete registration forms Non-compliance with medication Unable to name medications, explain purpose or dosing AHRQ Universal Precautions Toolkit: Health literacy- Hidden Barriers and Practical Strategies

Look out for red flags Identifies pills by looking at them, not reading label Unable to give coherent, sequential history Ask fewer questions Lack of follow-through on tests or referrals AHRQ Universal Precautions Toolkit: Health literacy- Hidden Barriers and Practical Strategies

Focus on need to know and need to do Parents want to know: owhat is wrong (briefly) owhat they need to do and why oemphasize benefits AHRQ Universal Precautions Toolkit: Health literacy- Hidden Barriers and Practical Strategies

How can you help? M a k e s i m p l e c h a n g e s i n y o u r i n f o r m a t i o n t o p a r e n t s

Design strategies More is better White space is meant to be filled up Fancy type faces are cool and good Style should be formal Art provides effective communication AHRQ Universal Precautions Toolkit: Health literacy- Hidden Barriers and Practical Strategies

6 Design Strategies 1. Type 2. Paragraphs 3. Grouping 4. Graphics 5. White Space

1. Type Serif for body San serif for headings 12 to 14 point for body Avoid ALL CAPS Make use of high contrast

2. Paragraphs Use 1.2 to 1.5 spacing between lines Leave right margin jagged Block paragraphs with no indents are best One line return between paragraphs

3. Chunking Helps to organize Keep similar ideas together Use a bulleted list Stepwise process (1,2,3) Write things in a logical order Use clear headings

4. Graphics Use to help in understanding Need to be simple and clear, not abstract Provide captions when appropriate Table and charts should also be simple Avoid ghosting

5. White Space Makes handouts less intimidating Helps to give the eyes a rest Use white space around paragraphs, graphics, pictures, etc Check your documents: Is there a balance between text and white space?

How can you help? P r a c t i c e Te a c h - B a c k

Teach-back is A way to make sure you explained information clearly. It is not a test or quiz of customers. Asking your customer to explain in their own words what they need to know or do, in a caring way A way to check for understanding and, if needed, re-explain and check again

10 steps to effective teach back 1. Use a caring tone of voice and attitude. 2. Display comfortable body language, and make eye contact. 3. Use plain language. 4. Ask the patient to explain back, using their own words.

10 steps to effective teach back 5. Use non-shaming, open-ended questions. 6. Avoid asking questions that can be answered with a simple yes or no. 7. Emphasize that the responsibility to explain clearly is on you.

10 steps to effective teach back 8. If the consumer is not able to teach back correctly, explain again and re-check. 9. Use reader-friendly print materials to support learning. 10. Document use of teach-back and your customers response to the teach-back process when possible.

Let s practice teach-back in a role play

Teach-back practice Scenario: Carol is speaking with Paul about what to do when his 4 year old has a fever. The father wants to know when he should call the doctor or nurse. Carol wants to make sure he understands so he know what to do when his child gets sick. Who will volunteer to be Carol?

Teach-back practice Carol: Here is a book called What To Do When Your Child Gets Sick. It will tell you all about what to do when you child has a fever.

Teach-back practice Carol: Turn to page 15. At the bottom of the page you will see When do I call the doctor or nurse?

Teach-back practice Carol: This is a list of things you should look out for but I want to point out a couple that are important for you.

Teach-back practice Carol: Call you doctor is he has a fever of 103 degrees and higher. You should also call the doctor if they are hard to wake up or if he has a hard time breathing

Teach-back practice Carol: This is a long list but I just went over a few that are important for you. Its important to me that you know when to call to doctor. Can you tell me the important tips I gave you?

Teach-back practice Paul: Sure! You told me that I should call a doctor when my son s temperature is 103 degrees or higher. You also said that I need to call the doctor if he is hard to wake up or has a hard time breathing.

Teach-back practice Practice with a buddy! 1. Pick a partner 2. Turn to page 75 in the book 3. Assign who will be the educator and who will be the parent

Teach-back practice 4. Educators try to explain to the parent what they can do at home to help their child with a cold or flu. 5. Make sure to check for understanding. 6. Switch roles!

Tips for training parents

Brainstorming Question How is educating parents different than educating children?

8.Adults want to know why they need to learn Explain the importance of the information Tell them how it will help them in a practical setting

7.Adults want to be involved in the learning process Encourage discussion 2-way instructing

6.Adults need affirmation that they are indeed learning Ask for feedback Use Teach-back

5.Adults want to know what is expected of them and what they can expect Describe what is coming up. Describe what they need to do.

4.Adults need to be able to understand the instructor Speak loudly, slowly, and clearly Use plain language

3.Adults want to learn practical things that they can apply immediately How does this information apply to their work or home?

2.Adults may need to be coached during practice activities Everyone fears failure Help to reduce some of the fear of new challenges

1. Adults just want to have fun!

Training tips Be familiar with the book What To Do When Your Child Gets Sick Practice giving the class Speak slower than normal in a one-to-one conversation

What To Do When Your Child Is Sick Study of 256 caregivers showed 90% of parents use the book multiple times and avoided medical intervention for a common problem. 4 year study from UCLA showed: Decrease in school days missed Decrease in work days missed My son had a fever and I panicked a little bit, but then I remembered the training and I said, Wait a minute, I don t have to run to the ER. I know what to do Head Start Parent Mayer GG, et al. (2001) Results of utilizing a low-literacy self-help book in Hispanic child health center/

Let s Get Started! You ll be playing the part of the parents You ll see what it s like to be parent so you will know how to deliver the training Feel free to ask questions throughout

Let s see what s in the book Open up the book Take a kook at the first 2 pages Put important phone numbers and your child s information here

When to call the doctor or clinic Turn two pages This section tells you when you should call the doctor right away These are important urgent situations to remember Sometimes you should call 911

What s in this book Turn the page This is a visual table of contents that s shows you what in the book This is a tool to help you look things up in the book First locate the body part with the problem and then go to that page

What s in this book Turn the page This is a more traditional table of contents It shows what is in each chapter of the book

Practice finding topics Let s practice using this traditional table of contents On what page can we find information on stomach pain?

Practice finding topics Now, let s practice using the visual table of contents Turn back a page On what page can we find information on teething?

What s in this book from A - Z Turn to page 175 in the back This section of the book is called an index You can also use this section of the book to find specific topics

Let s look at a chapter Turn to page 85 Each chapter in the book starts with a notes page Use this page to write down things you want to ask your doctor or want to remember

Let s look at a health problem Now turn to page 103 Each section is put together the same way All sections answer the same 5 questions

5 step format 1 What is it? 2 What do I see? 3 What can I do at home? 4 When do I call a doctor or nurse? 5 What else should I know?

What is it? How does it happen? When does it happen? What does it mean?

What do I see? What are the symptoms? How do I know that my child has this problem? What does my child look like when this happens? What will my child act like when this happens?

What can I do at home? Things you can do Things you need to keep track of Understand what you need to have at home Tips on how can your help your child feel better

When do I call a doctor or nurse? What does the doctor need to know? When should you call? Who do you call? What is an emergency?

What else should I know? What is causing it? What is typical? What else should I look for? What are potential complications?

Word List Turn to page 169 This is where you can look up words used in the book that you may not know It s important to know what these words mean to care for your child in urgent situations

Hands on practice Scenario: Your child is coughing What page can you find out about coughs? What is a cough? When do you worry?

Use this book at home How will you use this book when you get home? Where will you put it? What is your favorite part of the book? What will you tell a friend about this book?

Practice Pick a buddy and practice coaching Don t forget to cover: What s in this book Notes section of each chapter 5 sections of every chapter Word list Index Hands on practice

Everyone Benefits!

Thank you! Contact me about the training (714) 447-3460 ext 204 dgonzalez@iha4health.org Contact IHA about the book (800) 434-4633 books@iha4health.org Visit: www.iha4health.org