Health Literacy

Health Literacy Coordination

• Department health literacy workgroup
• Agency health literacy workgroups
• HHS health literacy intranet site
• Quick Guide to Health Literacy for HHS employees
• Health literacy action plan

HEALTH LITERACY

Strategies for Improving Health Literacy

Four Strategies for Improving Health Literacy

1. Improve the usability of health information.
2. Improve the usability of health services.
3. Build knowledge to improve decisionmaking.
4. Advocate for health literacy improvement.

1. Improve the Usability of Health Information

• Is the information appropriate for the users?
• Is the information easy to use?
• Are you speaking clearly and listening carefully?

Identify the Intended Users of the Health Information and Services

• Know the intended users of the health information and services:
  • Demographics
  • Behavior
  • Culture
  • Attitude
  • Literacy skills
  • Language
  • Socioeconomic status
  • Access to services
• Decide which channel(s) and format are most appropriate.

Evaluation

Evaluate users' understanding before (formative), during (process), and after (outcome) the introduction of materials.

Test!     Test!     Test!

Acknowledge Cultural Differences and Practice Respect

• Accepted roles of men and women
• Value of traditional vs. Western medicine
• Favorite or forbidden foods
• Manner of dress
• Body language, especially touching or proximity

What Is Cultural Competency?

Cultural competency is the ability of health organizations and practitioners to recognize the following in diverse populations to produce a positive health outcome:

• Cultural beliefs
• Values
• Attitudes
• Traditions
• Language preferences
• Health practices

Use Plain Language

• Plain language is a strategy for making written and oral information easier to understand.
• Key elements of plain language include:
  • Using simple language and defining technical terms
  • Using the active voice
  • Breaking down complex information into understandable pieces
  • Organizing information so the most important points come first

Speak Clearly and Listen Carefully

• Use a medically trained interpreter if necessary:
  • For those who do not speak English well, plain English will not help.
  • Ensure that all language access services, including translation, are in plain language.
  • Refer to CLAS standards.
• Ask open-ended questions:
  • Elicit cultural beliefs and attitudes: "Tell me about the problem and what may have caused it."
• Check for understanding:
  • Use the "teach-back" method: Have the person restate the information in his or her own words.

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Improve the Usability of Health Information on the Internet

• Don't forget Refer to the Office of Management and Budget (OMB) Policies for Federal Public Websites for further guidance.

  People cannot find the information they seek on Web sites 60% of the time.
• Many elements that improve written and oral communication can be applied to information on the Web:
  • Plain language
  • Large font
  • White space
  • Simple graphics

Improve the Usability of Health Information on the Internet

Health literacy has implications for Web-based communication beyond written text. Consider the following strategies:

• Apply user-centered design principles and conduct usability tests.
• Include interactive features and personalized content.
• Organize information to minimize scrolling.
• Use uniform navigation.

2. Improve the Usability of Health Services

• Improve the usability of health forms and instructions.
• Improve the accessibility of the physical environment.
• Establish a patient navigator program.

Health Forms and Instructions

Healthcare and public health settings rely heavily on forms and printed instructions:

• Medical history forms
• Insurance forms
• Informed consent forms
• Child immunization records for school
• Test results
• Directions to the lab or pharmacy
• Hospital discharge and home care instructions
• Clinical research protocols and announcements

Improve the Usability of Health Forms and Instructions

• Revise forms to ensure clarity and simplicity.
• Test forms with intended users and revise as needed.
• Provide forms in multiple languages.
• Offer assistance with completing forms and scheduling followup care.

Improve the Physical Environment

Settings with lots of signs and postings have a high literacy demand:

• Include universal symbols and clear signage in multiple languages.
• Promote easy flow through healthcare facilities.
• Create a respectful and shame-free environment.

Establish a Patient Navigator Program

• Patient navigators are health professionals or community health workers who help patients:
  • Evaluate their treatment options.
  • Obtain referrals.
  • Find clinical trials.
  • Apply for financial assistance.
• Congress recently passed the Patient Navigator Outreach and Chronic Disease Prevention Act of 2005.

3. Build Knowledge to Improve Decisionmaking

• Improve access to accurate and appropriate health information.
• Facilitate healthy decisionmaking.
• Partner with educators to improve health curricula.

Improve Access to Accurate and Appropriate Health Information

• Create new mechanisms for sharing and distributing understandable health education materials:
  • Create audience or language-specific databases.
  • Partner with adult educators.
• Identify new methods for information dissemination:
  • Cell phones, palm pilots, personalized and interactive content, information kiosks, talking prescription bottles, etc.

Improve Access to Accurate and Appropriate Health Information

• Form partnerships with civic and faith-based organizations trusted in the community.
• Work with the media to increase awareness of health literacy issues.
• Work with providers to ensure that the health information they share is accurate, current, and reliable.