Putting Information Into Health Literacy
The Health Information Literacy Curriculum
Originally sponsored by the Medical Library Association Originally funded by the National Library of Medicine
Contract Number HHSN276200663511/NO1-LM-6-3511Updated by the NN/LM MCR September 2012
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?
A set of skills that people need to function effectively in the health care environment
Source: Berkman et al (2011). Health literacy interventions and outcomes: an updated systematic review, pg. ES1.
Why is this Important?
Estimated over 300 languages spoken in the United States
More than 90 million Americans have low health literacy
Source: The Joint Commission (2011). Facts About Patient-Centered Communications, p1.
Role of Health Communication and Health Information Technology
Effective use of communication and technology can increase health literacy;
Support shared decision-making; Provide new opportunities to connect with
culturally diverse and hard-to-reach populations
Source: Healthy People 2020: Health Communication and Health Information Technology Objectives.
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
Economic Impact
Limited literacy costs the U.S. health care system between $50 and $73 billion per year
Source: American Medical Association Foundation (2009). Health literacy and patient safety: manual for clinicians, pg. 7.
Health Literacy and Healthcare Costs
Annual Healthcare Costs of Medicaid Enrollees
Source: Weiss, et al (2004). J Am Board Fam Pract.
(<3rd-grade reading level) (>4th-grade reading level)
Health Literacy and Child Health
Most written child health information remains too complex for most US adults to understand
Adults with low health literacy are between 1.2 and 4 times more likely to exhibit negative parenting or child preventive care behaviors– including maternal depression, errors in dosing
child medication, and decreased use of preventive-care services
Source: Sanders et al (2009), Archives of Pediatrics & Adolescent Medicine. Literacy and Child Health: A Systematic Review, pg. 7.
Health Literacy and Cancer Screening
Men with lower health literacy are 1.5 times less likely to know about colorectal cancer screening test, and 3.5 times more like to have never heard about it
Women with limited health literacy were significantly less likely to ever have had a cervical cancer screening, with the majority of prevention materials written at a level of grade 12
Source: Dolan et al (2004), J Clin Oncol.,Garbers et al (2004), Prev Chronic Dis.
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: Bennett et al (2009) , Cho et all (2008), White et al (2008).
Health Literacy and Asthma
Limited literacy had a significant impact on quality of life, risk of ER visit or hospitalization, or worse disease control for African Americans and Latino adults – more so than socioeconomic factors
Source: Curtis et all (2012). Journal of Asthma.
Health Literacy and Diabetes Education
Patients with low literacy had significantly lower increase in knowledge regarding diabetes-related concepts than those with higher literacy in a before and after multimedia educational intervention
Source: Kandula et al (2009) Patient Education and Counseling.
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.
77 million adults have basic or below health literacy skills
Source: The Health Literacy of American Adults. Results from the 2003 National Assessment of Adult Literacy. National Center for Education Statistics (2006).
Intermediate
Proficient
Below Basic
Basic
53%
22%
13%
12%
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
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: Fox, S. Vital Decisions (2003). Online Health Search (2006). Washington, DC: Pew Internet & American Life Project.
Health Literacy From the Patient’s Perspective
Mr. BellMrs. Cordell
Source: Help Your Patients Understand. AMA Foundation Health Literacy.
Strategies to Improve Health Literacy
Use plain language
Limit information (3-5 key points)
Use easy-to-read print materials
Practice teach-back
Use Information Rx
MedicalHypertensionInsomniaBenignHazardousDisorderOptionRoutinelyAdverse
Plain LanguageHigh blood pressureCan’t sleepNOT cancerDangerousProblemChoiceOftenBad
Plain Language
Teach-Back Method
Source: Help Your Patients Understand. AMA Foundation Health Literacy.
Easy-to-Read Materials
Deciphering Medspeak BrochuresHIVCancerDiabetesOther
Source: www.mlanet.org/resources/medspeak/.
Information Rx
www.MedlinePlus.govwww.MedlinePlus.gov
Interactive Health Tutorials
www.NIHSeniorHealth.gov
“Top 10” Most Useful Consumer Health Websites
Cancer.gov* CDC.gov* Familydoctor.org* Healthfinder.gov* HIVInsite.ucsf.edu*
*Available in Spanish
KidsHealth.org* Mayoclinic.com* MedlinePlus.gov* Noah-health.org* NIHSeniorHealth.gov
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 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?
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