The Challenge: Oral Health Literacy

1. The Challenge: Oral Health Literacy Anita LaTourette, RDH GDHA Hot Topics/Annual Session 10/13/2012

2. Have you ever… • Had a misunderstanding with a patient about a procedure? • Had a patient call to clarify care instructions after an appointment? • Had a patient whom from your perspective ignored your recommendations for her oral health or her child’s?

3. Oral health is a product of: • Appropriate self care or care giver assistance • Clinical care • Community initiatives To navigate the system, patients must: a. understand preventive measures and that dental services exist b. understand how to access the service c. understand how to use the service d. be persistent and ask questions

4. Our Role • Patient who encounter the dental team (dentist, dental hygienist, office staff) have the opportunity to receive guidance and learn skills for their personal self-care and those of their children. • The communication skills of the dental team contribute to the patient’s health literacy that contributes to improved health outcomes.

5. Health Literacy • Is essential to oral health • Literacy-Defined: The ability to read, write, speak, and compute and solve problems at levels of proficiency necessary to function on the job and in society, to achieve one’s goals and develop one’s knowledge and potential. National Literacy Act 1991

6. Health Literacy Defined • “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, IOM Report, 2004 • The Institute of Medicine Report, Health Literacy: A Prescription to End Confusion (2004), gave visibility to how literacy could affect outcomes.

7. Health Literacy is Dependent on Individual and Systemic Factors: • Communication skills of consumers and providers • Knowledge of consumers and providers of health topics • Culture and societal impact • Demands of the healthcare system • Demands of the situation

8. Scope of Health Literacy • Functional skills include reading, writing, speaking, listening, basic math skills • Knowledge of health topics—information about them and services available • Knowledge must be related to decision making • Understanding

9. People with Limited Health Literacy Skills Have: • Lower use of preventive services (fluoride toothpaste, flu shots, screening for children) • Higher use of treatments services which result in higher healthcare costs • Often feel a sense of shame about their skill level and/or develop strategies to compensate

10. Literacy Measured by: • People’s ability to apply reading skills to everyday tasks involving: a. prose literacy: skills needed to search, comprehend, and use continuous tests such as news stories and brochures. b. document literacy: skills needed to search, comprehend, and use noncontinuous texts such as job applications forms, maps and food labels. c. quantitative literacy: skills needed to identify and perform computations using numbers embedded in printed materials, such as numbers used in balancing a checkbook or completing an order form National Assessment of Adult Literacy (NAAL), 2003; released 2006

11. National Assessment of Adult Literacy 2003 Findings • Below basic: 30 million adults • Basic: 63 million adults • Intermediate: 95 million adults • Proficient: 28 million • Most adults scoring in Below Basic would not be able to read the dosage chart on a package of over the counter pediatric cold medicine. • Adults scoring in Basic would find the dosage chart difficult. • Report documents a mismatch between a large U.S. population and the demands of the healthcare system and providers. 95 million adults at basic or below.

12. Highest Population at Risk? • Limited health literacy is greatest among: -older adults -those who are poor -people with limited education -minority populations -persons with limited English proficiency

13. What Can We Do To Improve Communication with Patients? • Conduct a needs assessment of your setting • Improve the usability of all print and other information • Use plain language, no jargon • Present important points first • Use an active voice • Big words should be explained • Test your messages • Ensure information is science-based & consistent

14. What Can We Do to Improve Communication with Patients? • Create a user friendly physical environment • Have real people answer the phone • Provide clear directions to the location • Urge patients to bring a list of any questions they might have regarding the appointment • Use clearly written words for signs and directions • Provide help in completing all forms

15. What Can We Do to Improve Communication with Patients? • Assess patients’ level of Health Literacy • Use four simple questions -Did you have any questions when filling out medical forms? -Can you follow written instructions for medicine? - Do you read printed materials about health? -Do you have difficulty understanding written material? • Be alert to patient’s needs….if they do not read well, they may something like “I’ll take this home. I forgot my glasses.”

16. What Can We Do to Improve Communication with Patients? • Increase Our Skills Individually • Listen carefully to what patient has to say • Slow down, use short statements • Use visual aids when appropriate • Use the teach back method (you teach me) • Never ask a question that has a yes or no answer… instead “tell me about…”

17. Our Opportunities: • Educate people until they understand oral health is related to total health • Make oral health education presentations in your community • Go back to the basics…how to brush, floss, talk about prevention. • Promote/partner with schools to improve literacy. • Take communication classes.

18. Each of us must recognize that at any time our own health literacy might be challenged..whether it is for ourselves, family members or friends.

19. Low health literacy in the United States cost in excess of 100 billion dollars annually. Source: University of Connecticut School of Business 10/10/07 Taking our responsibility to improve health literacy will help decrease disparities and improve the quality of each individual life…….