Health Literacy

1. Health Literacy Specialists: Connie Arnold, PhD Associate Professor of Medicine Terry Davis, PhD Professor of Medicine and Pediatrics

2. Health Literacy : the Intersection of Patient skills and System Demands Health Literacy • IOM Report (2004) • 90 million adults have trouble understanding/acting on health information • Healthy People 2020 • Improve health communication (plain language materials) • Joint Commission (2007) • Patients must be given information they understand * US DHHS, May 27, 2010. (www.health.gov/communication/HLactionplan)

3. High school dropout rate in LA 29% 47% graduates go on to a 4 year college 43% need remedial classes Only 3 of 5 TOPS students graduate college in 6 years

4. Low Literacy is a National Problem(National Adult Literacy Survey) % Adults with Level 1 Literacy Skills 22% U.S. Adults are Level 1 Adults > 65 (49%), Chronic Illness (42%) African-American (41%) Hispanic (52%) National Institute for Literacy 1998; National Adult Literacy Survey 1993 Tables 1.1.A 1.1B 1.2 A1.2 B

5. Low Literacy Rates By Parish % Adults with Level 1 Literacy Skills 28% Louisiana Adults are Level 1 National Institute for Literacy 1998

6. Literacy Definition (Requirements) Expand With Increasing Demands Of Society Literacy “…at a level needed to function on the job and in society.” Read Write Problem Solving Internet Skills Math Skills Communicate National Literacy Act, 1991; S. White, Project Director NAALS 2016

7. Numeracy: A Hidden ProblemUnderstanding Food Labels You drink this whole bottle of soda. How many grams of total carbohydrates does it contain? 67.5 grams 32% answered correctly 200 primary care patients 73% private insurance 67% at least some college 78% read > 9th grade 37% math > 9th grade Rothman R, Am J Prev Med, 2006

8. Video Its easy to make a mistake

10. Health Information Needs To Be Improved – We can Help Oral Communication: • Not clear to patient • Too much medical jargon • Not focused on what patient needs to know and do Patient Education is often NOT: • Easy to read, understand, act on • Organized from patient’s perspective • Focused on behavior as well as knowledge Questionnaires are often: • Not clearly understood • Likert format can be confusing Consent and HIPAA Documents are: • Too long, too much information, too complex

11. 7 Steps to Improve Oral Communication • Slow down • Avoid medical jargon, use living room language • Limit information – write brief take home information • Focus on need to know and do. Patients also need to know the benefits of what they are doing. • Use pictures, teaching tools (pamphlets, brown bag medications) • Repeat and summarize information • Teach back/show back to confirm understanding

12. A Good Model for Patient Education • Patientnot disease • ‘Need to know and do’ Help patients change health behavior: • Increase knowledge and confidence managing disease • Help patients solve self-care problems • Over 5 million copies have been distributed by the American College of Physicians Foundation Guides focused on:

13. Pictures Can be Good Teaching Tools Patients may not understand or use measurements

14. Health Literacy Consultation We can help you: • Develop questionnaires that patients can understand. • Lower the reading level and simplify Consent and HIPAA Documents. • Develop patient education and health information that is understandable and actionable. • Enhance oral communication.