The Health Information Literacy Curriculum
Sponsored by the Medical Library Association Funded by the National Library of Medicine
Contract Number HHSN276200663511/NO1-LM-6-3511
2008
Learning Objectives
Recognize the impact low health literacy has on patient care
Name five strategies and resources to improve health literacy
Describe the health literacy services offered by the library
What is Health 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.”
Healthy People 2010
What factors affect Health Literacy?
Health literacy is dependent on individual and system factors
Communication skills Information and knowledge Culture and language Demands of the system
Why is Health Literacy Important?
Low health literacy is linked to…
Under-utilization of services Increased medication errors Poor knowledge about health Increased hospitalizations Poor health outcomes Increased healthcare costs
Health Literacy and Cancer Screening
Women with low health literacy are less likely to have had a mammogram or Pap test than women with higher health literacy skills
Source: Davis, et al (1996). Caner. Lindau, et al (2002). Am J Obstet Gynecol.
Health Literacy and Diabetes Management
0 20 40 60 80 100
Percent of patients with diabetes correctly answering questions according to literacy level (low, moderate, high)
Need to Know: symptoms of low blood sugar (hypoglycemia)
Need to Do: correct action for hypoglycemic symptoms
Low
ModerateHigh
LowModerat
e High
Source: Williams, et al (1998). Arch Int Med.
Health Literacy and Healthcare Costs
$0
$2,000
$4,000
$6,000
$8,000
$10,000
$12,000
Low-literacy Better literacy
$2,891
$10,688
Annual Healthcare Costs of Medicaid Enrollees
Source: Weiss, et al (2004). J Am Board Fam Pract.
(<3rd-grade reading level) (>4th-grade reading level)
How is Information Critical to Health Literacy?
Health information is key to:
Patient and provider communication Shared health care decision making Understanding and following directions Recognizing when to seek care Learning and adopting healthy behaviors
What are the Challenges?
Health literacy in the U.S.
Readability of health materials
Health information and the Internet
Health Literacy in the U.S. Health Literacy in the U.S.
Intermediate
Basic
Below Basic
Proficient
13%
12%
53%
22%
77 million adults have basic or below health literacy skills
Source:Source: The Health Literacy of American Adults. Results from the 2003 National Assessment of Adult Literacy. The Health Literacy of American Adults. Results from the 2003 National Assessment of Adult Literacy. National National
Center for Education Statistics (2006).Center for Education Statistics (2006). http://nces.ed.gov/naal/health.asp
Readability of Health Information
Over 300 studies show health-related materials far exceed the reading ability of U.S. adults
Increasing number of studies show similar results when looking at the readability of online health information
Source: NLM Bibliography—Understanding Health Literacy and Its Barriers (2004). www.nlm.nih.gov/pubs/cbm/healthliteracybarriers.html
Health Information and the Internet
80% of Internet users search for health information
75% rarely or never check the source and date
72% express trust in most or all information found online
Source:Source: Fox, S. Vital Decisions (2003). Online Health Search (2006). Washington, DC: Fox, S. Vital Decisions (2003). Online Health Search (2006). Washington, DC: Pew Internet & Pew Internet & American Life Project. American Life Project. www.pewinternet.org/PPF/c/5/topics.asp
Health Literacy From the Patient’s Perspective
Source: Source: Help Your Patients UnderstandHelp Your Patients Understand. AMA Foundation Health Literacy. . AMA Foundation Health Literacy. www.ama-assn.org/ama/pub/ category/9913.html
Mrs. CordellMr. Bell
Strategies to Improve Health Literacy
Use “living room” language
Limit information (3-5 key points)
Use easy-to-read print materials
Practice teach-back
Use Information Rx
Address culture and language needs
“Living Room” Language
Name common terms for…
Hypertension Insomnia Benign Hazardous
Disorder Option Poultry Routinely
Ask Me 3 – National Patient Safety Foundation
www.npsf.org/askme3
Teach-Back Method
Source: Source: Help Your Patients UnderstandHelp Your Patients Understand. AMA Foundation Health Literacy. . AMA Foundation Health Literacy. www.ama-assn.org/ama/pub/category/9913.html
Information Rx
www.MedlinePlus.govwww.MedlinePlus.gov
Interactive Health TutorialsInteractive Health Tutorials
www.NIHSeniorHealth.govwww.NIHSeniorHealth.gov
www.library.tufts.edu/hsl/spiral/
“Top 10” Most Useful Consumer Health Websites
Cancer.gov * CDC.gov * Familydoctor.org * Healthfinder.gov * HIVInsite.ucsf.edu *
**Available in SpanishAvailable in Spanish
KidsHealth.org * Mayoclinic.com Medem.com MedlinePlus.gov * Noah-health.org *
Source: Medical Library Association. www.mlanet.org Source: Medical Library Association. www.mlanet.org
How Can Librarians Help?
Free access to the Internet Information Rx Program Patient information packets Consumer health collection Native language resources Teaching and training Virtual chat / email assistance Health literacy workgroup
Why Now? Why Hospitals?
“The safety of patients cannot be assured without mitigating the negative effects of low health literacy and ineffective communication on patient care.”
The Joint Commission
Source: “What did the Doctor Say?:” Improving Health Literacy To Protect Patient Safety. The Source: “What did the Doctor Say?:” Improving Health Literacy To Protect Patient Safety. The Joint Commission (2007). Joint Commission (2007). www.jointcommission.org/PublicPolicy/health_literacy.htm
Take Home Points
Accurate and reliable health information is critical to health literacy
Use Information Rx to refer patients to reliable health information and to the library for help
Librarians are available to address the health literacy needs of patients and providers
Thank You!
Questions? Comments?
References AHRQ Report—Literacy and Health Outcomes (2004)
www.ahrq.gov/clinic/epcsums/litsum.htm
AMA Foundation Health LiteracyAMA Foundation Health Literacy www.ama-assn.org/ama/pub/about-ama/our-people/affiliated-www.ama-assn.org/ama/pub/about-ama/our-people/affiliated-groups/ama-foundation/our-programs/public-health/health-groups/ama-foundation/our-programs/public-health/health-literacy-program.shtmlliteracy-program.shtml
Fox, S. & Fallows, D. (2003) Internet Health Resources. Fox, S. & Fallows, D. (2003) Internet Health Resources. Washington, DC:Washington, DC: Pew Internet & American Life Project Pew Internet & American Life Project www.pewinternet.org/Reports/2003/Internet-Health-Resources.aspx
Healthy People 2010, Health Communication, Objective 11-2 www.healthypeople.gov/Document/HTML/Volume1/11HealthCom.htm
IOM Report—Health Literacy: A Prescription To End Confusion (2004) www.iom.edu/CMS/3775/3827/19723.aspx
References NLM Bibliography—Understanding Health Literacy
and Its Barriers (2004) www.nlm.nih.gov/pubs/cbm/healthliteracybarriers.html
The Health Literacy of America’s Adults: Results The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult from the 2003 National Assessment of Adult Literacy (2007)Literacy (2007) http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483
The Joint Commission Report: “What did the The Joint Commission Report: “What did the Doctor Say?:” Improving Health Literacy To Protect Doctor Say?:” Improving Health Literacy To Protect Patient Safety (2007)Patient Safety (2007) www.jointcommission.org/PublicPolicy/health_literacy.htm
Medical Library Association “Top 10” Most Useful Medical Library Association “Top 10” Most Useful Consumer Health WebsitesConsumer Health Websites www.mlanet.org/resources/medspeak/topten.html
Pilot Site Librarians Martha Prescott, Berkshire Medical Center Health
Sciences Library Tori Koch and Kim Hart, Billings Clinic Medical Library Andrea Harrow, Good Samaritan Hospital Health
Sciences Library Holly Kimborowicz, Lake Hospital System Medical Library Jeff Mason and Mary Chipanshi, Regina General Hospital
Health Sciences Library Julie Smith, St. Joseph Hospital Burlew Library Denise Rumschlag and Carolyn Martin, St. Vincent
Hospital Library Lenora Kinzie, Stormont-Vail Healthcare Stauffer Health
Sciences Library, and Scarlett Fisher-Herreman, Topeka & Shawnee County Public Library
Geneva Bush Staggs and Beverly Rossini, University of South Alabama Biomedical Library
Acknowledgements
Project Advisors Elliot Siegel, Robert Logan, Angela Ruffin,
Lisa Boyd, Susan Barns, Cindy Olney, Kathy Schilling, Marge Kars, Terry Jankowski, Barbara Bibel, and Cathy Boss
Health Information Literacy Research Project Sabrina Kurtz-Rossi, Project Coordinator Jean P. Shipman, Co-Principal Investigator Carla J. Funk, Co-Principal Investigator
Acknowledgements