Health and Literacy Crouse Nurse Practice Council Marsha L. Tait, National Coalition for Literacy Donna Valerino, Literacy Volunteers of Greater Syracuse.
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Health and LiteracyHealth and LiteracyCrouse Nurse Practice Crouse Nurse Practice
CouncilCouncilMarsha L. Tait, National Coalition for Marsha L. Tait, National Coalition for
LiteracyLiteracyDonna Valerino, Literacy Volunteers of Donna Valerino, Literacy Volunteers of
Greater SyracuseGreater Syracuse
PresentationPresentation HighlightsHighlights
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
Global Adult Global Adult LiteracyLiteracy
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
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
NAAL: What is Adult NAAL: What is Adult Literacy in the US? Literacy in the US?
Definition: using printed and written information to function in society, to achieve goals, and to develop knowledge and potential.
2003 NAAL Key 2003 NAAL Key FindingsFindings
11 million adults are Non-literate in English
30 million adults have Below Basic Literacy skills
63 million adults have Basic Literacy skills
Why Should You Why Should You Care?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
Patient InterviewsPatient Interviews
Special NAAL Report: Special NAAL Report: Health LiteracyHealth Literacy
Definition: The degree to which individuals have the capacity to obtain, process, and understand basic health literacy information and services needed to make appropriate health decisions.
?
AMA Definition of AMA Definition of Health LiteracyHealth Literacy
Definition: the ability to read and comprehend prescription bottles, appointment slips and other essential health-related materials required to successfully function as a patient.
NAAL Estimate ofNAAL Estimate ofHealth Literacy Health Literacy
SkillsSkills
Who needs help Who needs help with health with health
literacy?literacy?"We are your family-members; "We are your family-members;
we are your neighbors; we are we are your neighbors; we are your co-workers. We are small-your co-workers. We are small-business owners; we are first-business owners; we are first-responders. We are among the responders. We are among the working poor; we are working poor; we are millionaires. Few ever know our millionaires. Few ever know our truth. Because of shame and truth. Because of shame and stigma, we keep it hidden."stigma, we keep it hidden."
Characteristics of Characteristics of Population Population
with Low Health with Low Health LiteracyLiteracy
GenderGender 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)
Older AmericansOlder 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
Health Condition Self-Health Condition Self-AssessmentAssessment
Sources of Health Sources of Health InformationInformation
Information from Information from ProfessionalsProfessionals
36
29
17
18
37
33
19
11
34
37
21
8
30
39
23
8
0%
20%
40%
60%
80%
100%
BelowBasic
Intermediate
Health Care Professionals
None
A little
Some
A lot
Information From Other Information From Other PeoplePeople
Information From PrintInformation From Print
12
29
22
37
15
35
27
24
14
36
31
19
10
32
38
20
0%
20%
40%
60%
80%
100%
BelowBasic
Intermediate
Newspapers
None
A little
Some
A lot
Information From The Information From The InternetInternet
775
80
14
16
12
58
21
27
19
33
26
37
22
15
0%
20%
40%
60%
80%
100%
BelowBasic
Intermediate
Internet
None
A little
Some
A lot
Where are they Where are they getting it?getting it?
A higher percent of adults with Below Basic or Basic literacy skills cited radio and television as their primary source of health information.
Factors Affecting Factors Affecting Patient Provider Patient Provider CommunicationCommunication
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
Make Effective Communications an Organizational Priority
Address Patients’ Communication Needs Across the Continuum of Care
Pursue Policy Changes that Promote Improved Provider-Patient Communications
SignageSignage
1. What is my main problem? 2. What do I need to do? 3. Why is it important for me to do this?
What Can You Do?What Can You Do?
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
Avoid JargonAvoid Jargon “Hypertension” vs “High Blood
Pressure”
“Fatigued” vs “Tired”
“Acetaminophen” vs “Tylenol”
“Febrile” vs “Feverish”
“Myopathy” vs “Muscle Aches”
NYS Patients’ NYS Patients’ RightsRights
““Advance directives are verbal or written Advance directives are verbal or written instructions made by you before an instructions made by you before an incapacitating illness or injury… incapacitating illness or injury… Advance directives communicate that Advance directives communicate that your wishes about your treatment be your wishes about your treatment be followed if you are too sick or unable to followed if you are too sick or unable to make decisions about your care. make decisions about your care. Advance directives include but are not Advance directives include but are not limited to a health care proxy, a consent limited to a health care proxy, a consent to a do-not-resuscitate (DNR) order to a do-not-resuscitate (DNR) order recorded in your medical record, and a recorded in your medical record, and a living will.”living will.”
Simplify, Simplify, Simplify, Simplify, Simplify!Simplify!
Wikipedia
Colonoscopy is the endoscopic Colonoscopy is the endoscopic examination of the large colon and examination of the large colon and the distal part of the small bowel the distal part of the small bowel with a CCD camera or a fiber optic with a CCD camera or a fiber optic camera on a flexible tube passed camera on a flexible tube passed through the anus. It may provide a through the anus. It may provide a visual diagnosis (e.g. ulceration, visual diagnosis (e.g. ulceration, polyps) and grants the opportunity polyps) and grants the opportunity for biopsy or removal of suspected for biopsy or removal of suspected lesions.lesions.
Is Consent Is Consent Informed?Informed?
AdvocacyAdvocacy
Americans Americans are are
anticipated anticipated to spend to spend
$45.5 Billion $45.5 Billion
on their on their pets in pets in 2009!2009!
American Pet Products Association
Health Literacy Health Literacy ResourcesResources
www.askme3.org
www.cdc.gov/az/a.html
www.healthliteracy.worlded.org/index
www.hsph.harvard.edu/healthliteracy/
www.lvgs.org
www.jointcommission.org
www.national-coalition-literacy.org
www.proliteracy.org
www.rwjf.org
Clear Clear CommunicationCommunication
“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
And Remember…And Remember…
Marsha L. Tait mtait@twcny.rr.coDonna Valerino dvalerino@lvgs.org
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