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Health Literacy What’s Done and What’s Left to Do

Health Literacy What’s Done and What’s Left to Do. Paul D. Smith, MD, Associate Professor UW Department of Family Medicine Paul.Smith@fammed.wisc.edu. Please complete evaluation. Orange form in packet Drop off at registration desk. Topics today. Literacy VS health literacy

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Health Literacy What’s Done and What’s Left to Do

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  1. Health LiteracyWhat’s Done andWhat’s Left to Do Paul D. Smith, MD, Associate Professor UW Department of Family Medicine Paul.Smith@fammed.wisc.edu

  2. Please complete evaluation • Orange form in packet • Drop off at registration desk

  3. Topics today • Literacy VS health literacy • History of health literacy • What’s new • Where are we now? • What’s next

  4. What is Literacy? • Literacy is a combination of skills: • Verbal • Listening • Writing • Reading

  5. What is Health Literacy? The Institute of Medicine 2004 “The degree to which individuals have the capacity to obtain, process, and understand basic information and services needed to make appropriate decisions regarding their health.”

  6. Literacy VS Health Literacy • Almost everyone will have difficulty with health literacy at some point. • Much harder for those that do not: • Read very well. • Speak English as their primary language.

  7. Two Sides to the Equation • It’s all about effective communication • Verbal • Written • Multi-media • It has to be presented in a way that is understandable to most people.

  8. History - 1974 • Health literacy first use in publication • Health Education as Social Policy Simonds SK. Health education as social policy. Health Educ Monogr 1974;2:1-25.

  9. History - 1990 • Health literacy appears in medical literature • Start to see reports of correlation between literacy and health outcomes

  10. History - 1993 • National Adult Literacy Survey (NALS) • First nationwide assessment of adult literacy

  11. History - 1993 • Rapid Estimate of Adult Literacy in Medicine • REALM • First tool for assessing health literacy Davis T, Long S, Jackson R, Mayeaux E, George R, Murphy P, Crouch M. Rapid Estimate of Adult Literacy in Medicine: A Shortened Screening Instrument. Fam Med 1993; 25:391-5.

  12. History - 1996 • National Institute for Literacy • Health and Literacy listserv starts http://www.nifl.gov/mailman/listinfo/Healthliteracy

  13. History - 1999 • American Medical Association • Ad Hoc Committee on Health Literacy Report American Medical Association, Council on Scientific Affairs, Ad Hoc Committee on Health Literacy. Health literacy: report of the Council on Scientific Affairs. JAMA 1999 Feb 10;281(6):552-7.

  14. History - 2000 Department of Health and Human Services • Healthy People 2010 • Health literacy definition that is commonly used U.S. Department of Health and Human Services. (2000). Healthy People 2010 (2nd ed.) [with Understanding and Improving Health (vol. 1) and Objectives for Improving Health (vol. 2)]. Washington, DC: U.S. Government Printing Office.

  15. History - 2003 • Paul Smith stumbles on issue • 1st attempt at a health literacy grant • 1st of many failures

  16. History - 2003 • National Assessment of Adult Literacy • 2nd adult literacy assessment • National representative sample • Measured health literacy • 12% of adults are proficient in health literacy http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006470 http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483

  17. History - January 2004 • Agency for Healthcare Research and Quality • Literacy and Health Outcomes • Comprehensive review of the literature http://www.ahrq.gov/downloads/pub/evidence/pdf/literacy/literacy.pdf

  18. History - April 2004 • Institute of Medicine • A Prescription to End Confusion • Comprehensive evaluation and recommendations http://www.nap.edu/catalog/10883.html

  19. History - July 2004 • First Wisconsin Health Literacy Summit • David Kindig, PhD • ~50 attendees • Paul Smith’s first health literacy presentation.

  20. History - 2005 • Wisconsin Literacy, Inc. • First meeting of Health Literacy Committee

  21. History - 2006 • Wisconsin Hospital Association • Webcast presentations • Focus group project funded • American Academy of Family Physicians • Emotional response: stress, shame, fear

  22. History - 2007 • Health Literacy Summit 2 • 220 attendees • 3 national speakers • Webcast presentations • Regional Health Literacy Committees created

  23. History - 2008 • Regional Initiatives • Needs analysis • Surveys • Brochures, PowerPoint • Wingspread Conference

  24. History - 2009 • Health Literacy Summit 3 • 238 attendees • Andrew Pleasant and other national speakers • Pre-conference meeting of state representatives

  25. History - 2009 • Projects • Nursing health literacy curriculum • Improving Hospital Health Literacy Environment • Ask Me 3 • What to do When Your Child is Sick project

  26. History - 2009 • Wisconsin Literacy Projects • Incorporate health literacy into tutor training • Reach parent learners with “What to Do..” book • Develop learner resources for medication safety

  27. History - 2009 • Joint Commission new regulations • Effective communication • Cultural Competence • Family-Centered care Approved Requirements to Advance Effective Communication, Cultural Competence, and Patient- and Family-Centered Care Hospital Accreditation Program, The Joint Commission, November, 2009.

  28. www.healthliteracywisconsin.org Health literacy resources and links Activities of Regional Health Literacy Committees Health Literacy curricula Health care providers Adult literacy students What’s new?

  29. www.healthliteracymissouri.org Health literacy materials library Searchable database Easy to read patient education materials Published articles Health literacy tools What’s new?

  30. Consumer Assessment of Healthcare Providers and Systems Questions (CAHPS) Health literacy supplement www.cahps.ahrq.gov Agency for Healthcare Research and Quality

  31. Health Literacy Universal Precautions Toolkit http://www.ahrq.gov/qual/literacy/ Universal precautions VS testing for health literacy Agency for Healthcare Research and Quality

  32. Informed Consent and Authorization Toolkit for Minimal Risk Research http://www.ahrq.gov/fund/informedconsent/ Agency for Healthcare Research and Quality

  33. Department of Health and Human Services Action Plan to Improve Health Literacy Released May 27, 2010 What’s new? http://www.health.gov/communication/HLActionPlan/

  34. HHS Action Plan to Improve Health Literacy • Seven goals • Develop and disseminate health and safety information that is accurate, accessible, and actionable.

  35. HHS Action Plan to Improve Health Literacy • Promote changes in the health care system that improve health information, communication, informed decision making, and access to health services.

  36. HHS Action Plan to Improve Health Literacy • Incorporate accurate, standards-based, and developmentally appropriate health and science information and curricula in child care and education through the university level.

  37. HHS Action Plan to Improve Health Literacy • Support and expand local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community.

  38. HHS Action Plan to Improve Health Literacy • Build partnerships, develop guidance, and change policies. • Increase basic research and the development, implementation, and evaluation of practices and interventions to improve health literacy.

  39. HHS Action Plan to Improve Health Literacy • Increase the dissemination and use of evidence-based health literacy practices and interventions.

  40. The Joint Commission Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care – A Roadmap for Hospitals What’s New? http://www.jointcommission.org/PatientSafety/HLC/HLC_Develop_Culturally_Competent_Pt_Centered_Stds.htm

  41. Medline Plus website redesign http://www.nlm.nih.gov/medlineplus/ Easy to read materials Interactive videos What’s New?

  42. Higher level of awareness in WI and nationally Many projects started around the state More research being done Not many definitive answers Where are we now?

  43. Discussions of: Health literacy definition Health literacy measurement Health professional curricula National health literacy advocacy organization Where are we now?

  44. 82nd health literacy presentation Where are we now?

  45. More research and dissemination of results AHRQ document rating system More health literacy regional conferences What’s Next?

  46. Become part of the healthcare reform? Response to Action Plan? What’s Next?

  47. Publication of research results Collaboration Guide for hospitals and literacy organizations Easy-to-Understand Writing Guide County specific literacy information? What’s Next In Wisconsin?

  48. Health Literacy Summit IV April 12 – 13, 2011 Conference grant application Health materials development workshop Wingspread Conference follow up What’s Next In Wisconsin?

  49. Learn more Continue to raise awareness Start small Integrate health literacy into current efforts Connect with collaborators What Can You Do?

  50. Paul.smith@fammed.wisc.edu Health literacy resources document Want a copy?

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