Health and Literacy Sigma Theta Tau International Nursing Honor Society: Omicron Alpha Chapter October 2, 2008

1. Health and LiteracySigma Theta Tau International Nursing Honor Society: Omicron Alpha ChapterOctober 2, 2008 Marsha L. Tait, National Coalition for Literacy Donna Valerino, Literacy Volunteers of Greater Syracuse

2. Presentation Highlights • The Scope of Adult Literacy Globally and in the US • The 2003 National Assessment of Adult Literacy • The NAAL Health Literacy Report • Tips and Techniques for Health Care Providers • Resources

3. Why Should You Care? Poor Health Outcomes: • Poor Health Knowledge • Less Frequent Screening and Preventive Care • Increased Use of Emergency Rooms • Increased Hospitalization • Higher Rates of Disease and Mortality Baker et al, 1997

4. Global Adult Literacy • The UN defines illiteracy as having no reading and writing skills at all • UNESCO estimates more than 770 million adults are illiterate • Two-thirds of illiterate adults are women • UN Decade of Literacy: Cut illiteracy in half by 2015

5. The 2003 National Assessment of Adult Literacy (NAAL) was the first examination of the literacy skills of America’s adults in more than a decade • A nationally representative household survey of more than 19,000 adults, including adults in prison

6. Patient Interviews

7. NAAL: What is Adult Literacy in the US? Definition: using printed and written information to function in society, to achieve goals, and to develop knowledge and potential.

8. 2003 NAAL Key Findings • 11 million adults are Non-literate in English • 30 million adults have Below Basic Literacy skills • 63 million adults have Basic Literacy skills

9. Special NAAL Report: Health Literacy Definition: The degree to which individuals have the capacity to obtain, process, and understandbasic health literacy information and services needed to make appropriate health decisions. ?

10. AMA Definition of Health Literacy Definition: the ability to read and comprehend prescription bottles, appointment slips and other essential health-related materials required to successfullyfunction as a patient.

11. Health Literacy Skills

12. Health Literacy by Gender • More men (16%) than women (12%) had Below Basic or Basic Literacy Skills • Less men (51%) than women (55%) had Intermediate literacy skills • Men had lower average health literacy scores (242) than women (248)

13. Health Literacy Skills of Older Americans • Adults aged 65+ had the lowest average health literacy scores • More Americans aged 65+ had Below Basic or Basic Skills than any other age group (29 + 30%) • Adults with Medicare and Medicaid or no health insurance had the lowest average health literacy scores

14. Health Condition Self-Assessment

15. Characteristics of Population with Low Health Literacy

16. Source of Health Information A higher percent of adults with Below Basic or Basic literacy skills cited radio and television as their primary source of health information.

17. Information from Professionals

18. Information From People

19. Information From Print

20. Information From The Net

21. Information From The Airwaves

22. Factors Affecting Patient Provider Communication Additional factors that may hinder understanding: • Intimidation, fear, vulnerability • Shock upon hearing a diagnosis • Extenuating stress within the patient's family • Multiple health conditions to understand and treat

23. Make Effective Communications an Organizational Priority • Address Patients’ Communication Needs Across the Continuum of Care • Pursue Policy Changes that Promote Improved Provider-Patient Communications

24. What Can You Do? Train your staff to: • Create a safe environment where patients feel comfortable talking openly with you • Use plain language instead of technical language or medical jargon • Sit down (instead of standing) to achieve eye level with your patient • Use visual models to illustrate a procedure or condition • Ask patients to "teach back" the care instructions you give to them From “Askme3.org

25. 3 3 3 • What is my main problem? • What do I need to do? • Why is it important for me to do this?

26. Signage

27. Simplify, Simplify, Simplify! Refer to helpful and appropriate sources of information: “A widely used analgesic, antipyretic, and anti-inflammatory agent; also used as an antiplatelet agent...” www.webmd.com

28. Avoid Jargon • “Hypertension” vs “High Blood Pressure” • “Fatigued” vs “Tired” • “Acetaminophen” vs “Tylenol” • “Febrile” vs “Feverish” • “Myopathy” vs “Muscle Aches”

29. Become An Advocate! Americans spend more money on premium label ice cream each year than on adult basic education and literacy programs!

30. Partner with:

31. Health Literacy Resources • www.askme3.org • www.cdc.gov/az/a.html • www.healthliteracy.worlded.org/index • www.hsph.harvard.edu/healthliteracy/ • www.jointcommission.org • www.lvgs.org • www.national-coalition-literacy.org • www.proliteracy.org • www.rwjf.org

32. New! • Medicare officials unveiled a new tool kit last week that can help adult educators teach the nearly 88,000 participants in adult education programs who are 60 or older about the benefits of Medicare. The tool kit includes materials describing Medicare as well as material for caregivers for persons eligible for Medicare. The materials, developed with input from OVAE, are available online at Medicare’s new Web site by clicking on Ask Medicare. Information in Spanish also is available on the site. www.medicare.gov

33. Clear Communication “What is clear to you is clear to you. Every patient should be a full partner in his or her medical decisions. This requires crystal-clear communication that is done with compassion and mutual respect.” ~~ Toni Cordell, former adult literacy student and health literacy advocate

34. And Remember…

35. Thank You! mltait@maxwell.syr.edu dvalerino@lvgs.org