Enhancing Provider-Patient Communication in Healthcare

1. Health Communications Progress Review June 24, 2003 Focus Area 11

2. 11-1. Household internet access by race and ethnicity, 1998-2001 Percent 2010 target Asian/Pacific Islander White Total Hispanic Black Note: Asian/Pacific Islander, Black, and White are not Hispanic; Hispanic can be of any race. Source: U.S. Department of Commerce, Bureau of the Census, Computer and Internet Use Supplement to the Current Population Survey.

3. 11-1. Household internet access by gender, 1998-2001 Percent 2010 target Male Female Source: U.S. Department of Commerce, Bureau of the Census, Computer and Internet Use Supplement to the Current Population Survey.

4. 11-1. Household internet access by education level of head of household, 1998-2001 Percent 2010 target At least some college High school graduate Less than high school Source: U.S. Department of Commerce, Bureau of the Census, Computer and Internet Use Supplement to the Current Population Survey.

5. 11-1. Household internet access by geographic location, 1998-2001 Percent 2010 target Urban Rural Source: U.S. Department of Commerce, Bureau of the Census, Computer and Internet Use Supplement to the Current Population Survey.

6. 11-1. Household internet access, 2001 Percent 2010 target A/PI Urban Rural Black White Male Hispanic Female High school Less than high school At least some college Note: A/PI (Asian/Pacific Islander), Black, and White are not Hispanic; Hispanic can be of any race. Source: U.S. Department of Commerce, Bureau of the Census, Computer and Internet Use Supplement to the Current Population Survey.

7. 11-6 a-d. Provider-patient communication, 2000 2010 target Percent of patients who report providers always: Listen carefully Show respect Explain things clearly Spend enough time Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

8. Black White Hispanic 2010 target 11-6a-d. Provider-patient communication by race/ethnicity, 2000 Percent of patients who report providers always: Listen carefully Show respect Explain things clearly Spend enough time Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

9. Private Public No health insurance 2010 target 11-6a-d. Provider-patient communication by health insurance status, 2000 Percent of patients who report providers always: Listen carefully Show respect Explain things clearly Spend enough time Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

10. Age 18-24 Age 25-44 Age 45-64 Age 65+ 2010 target 11-6a-d. Provider-patient communication by age, 2000 Percent of patients who report providers always: Listen carefully Show respect Explain things clearly Spend enough time Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

11. 11-6a. Patients reporting that doctors or other health providers always listen to them by race/ethnicity and gender, 2000 Percent 2010 Target Total Not Hispanic Hispanic Female Male Black White Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

12. 11-6a. Patients reporting that doctors or other health providers always listen to them by education level, geographic location, and health insurance status, 2000 Percent 2010 Target Urban Rural Education <12 12 13+ Health insurance status Private Public None years years years Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

13. 11-6a. Patients reporting that doctors or other health providers always listen to them by disability status and age, 2000 Percent 2010 Target Disabilities With Without Age groups 18-24 25-44 45-64 65+ Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

14. 11-6b. Patients reporting that doctors or other health providers always explain things clearly by race/ethnicity and gender, 2000 Percent 2010 Target Total Not Hispanic Hispanic Female Male Black White Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

15. 11-6b. Patients reporting that doctors or other health providers always explain things clearly by education level, geographic location, and health insurance status, 2000 Percent 2010 Target Urban Rural Education <12 12 13+ years years years Health insurance status Private Public None Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

16. 11-6b. Patients reporting that doctors or other health providers always explain things clearly by disability status and age, 2000 Percent 2010 Target Disabilities With Without Age groups 18-24 25-44 45-64 65+ Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

17. 11-6c. Patients reporting that doctors or other health providers always show respect for what they have to say by race/ethnicity and gender, 2000 Percent 2010 Target Total Not Hispanic Hispanic Female Male Black White Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

18. 11-6c. Patients reporting that doctors or other health providers always show respect for what they have to say by education level, geographic location, and health insurance status, 2000 Percent 2010 Target Urban Rural Education <12 12 13+ years years years Health insurance status Private Public None Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

19. 11-6c. Patients reporting that doctors or other health providers always show respect for what they have to say by disability status and age, 2000 Percent 2010 Target Disabilities With Without Age groups 18-24 25-44 45-64 65+ Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

20. 11-6d. Patients reporting that doctors or other health providers always spend enough time with them by race/ethnicity and gender, 2000 Percent 2010 Target Total Not Hispanic Hispanic Female Male Black White Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

21. 11-6d. Patients reporting that doctors or other health providers always spend enough time with them by education level, geographic location, and health insurance status, 2000 Percent 2010 Target Urban Rural Education <12 12 13+ years years years Health insurance status Private Public None Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

22. 11-6d. Patients reporting that doctors or other health providers always spend enough time with them by disability status and age, 2000 Percent 2010 Target Disabilities With Without Age groups 18-24 25-44 45-64 65+ Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

23. Developmental Objectives 11-2: Improve the health literacy among persons with inadequate or marginal literacy skills 11-3: Increase the proportion of health communication activities that include research and evaluation 11-4: Increase the proportion of health-related World Wide Web sites that disclose information that can be used to assess the quality of the site. 11-5: Increase the number of centers for excellence that seek to advance the research and practice of health communication (now has baseline)

24. 11-2. Health literacy The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

25. Scope and nature of literacy problem About 50% of U.S. adults are in the two lowest levels of five levels of functional literacy skills • Lowest level: Simple, routine tasks involving brief and uncomplicated texts and documents, e.g., can locate time and place of a meeting on a form or identify a specific piece of information in an article • About 25% of Level 1 individuals are non-native speakers of English; about 66% didn’t finish high school; about 33% are 65+; and about 25% have disabilities • Second lowest level: More varied than Level 1 but still limited; can make simple inferences, integrate easily identifiable information, and perform simple numerical calculations

26. 11-2. Nature of health literacy problem • Health literacy requires written as well as other communication skills to understand and act on health information and services • Selected research findings on health literacy: • Low literacy diabetic patients are less likely to know symptoms and disease management • Low literacy asthma patients have less effective management • Low literacy is associated with poorer self-reported health status and greater risk of hospitalization

27. 11-2. Baseline data source • Health Literacy Component, 2003 National Assessment of Adult Literacy, National Center for Education Statistics, U.S. Dept. of Education • Three clusters of health literacy: • Clinical (e.g., filling out a patient information form) • Prevention (e.g., deciding to get a cancer screening) • Navigation of the health care system (e.g., understanding co-pays and deductibles in health insurance plans) • Expected results in 2004: Health literacy index scores on the ability of U.S. population groups to understand health-related information

28. 11-3. Research and evaluation of health communication activities • Most likely focus for measurement: Federal health communication campaigns • Campaigns are typically assessed against internal goals, not external criteria related to campaign design • Need for consensus-building on criteria for objective research and evaluation components in campaign designs

29. 11-3. What needs to be assessed • The universe of health communication activities that should have research and evaluation components (the denominator) • The actual number of health communication activities that do have research and evaluation components (the numerator). • Short-term goal: the measurement of research and evaluation within federally-funded or HHS communication activities. • Long-term goal: to identify and target for improvement any health communication programs not typically expected to include research and evaluation.

30. 11-4. Quality of internet health information • Number of health-related Web sites is constantly changing, which makes measurement difficult • Model of disclosure of quality criteria is still evolving • Government role in assessing quality of Web sites is unclear

31. 11-4. Information that should be disclosed to users of health Web sites ·Identity and contact information of the developers and sponsors of the site and information about any potential conflicts of interest or biases ·Explicit purpose of the site, including any commercial purposes and advertising ·Original sources of content on the site ·How the privacy and confidentiality of any personal information collected from users is protected ·How the site is evaluated ·How the content is updated

32. 11-5. Centers for excellence in health communication criteria • A focus on health communication research and practice • An operational emphasis on multi/interdisciplinary research teams • Solid institutional support • Translation of research into practice • Training of health communication professionals and integration of health communication training into other disciplines

33. 11-5. Centers for excellence in health communication baseline • Four centers have been identified by NCI (baseline) in 2003 • These centers are focused on cancer communication • A target-setting method has been proposed Source: National Institutes of Health, National Cancer Institute.

34. Data and slides for Healthy People 2010 progress reviews are available at: http://www.cdc.gov/nchs/ hphome.htm