Integrating Health Literacy with Basic Skills & Family Literacy Practice

1. Integrating Health Literacy with Basic Skills & Family Literacy Practice J. Kimbrough, PhD & J. Gore, MSW

2. What is health literacy? Health literacy is the ability to obtain, understand and use health information. Health literacy is an essential life skill for individuals. It helps people seek and use information to take control over their health. Health literacy is a public health imperative. Building health literacy improves overall population health Health literacy is an essential part of social capital. Low health literacy is a strong contributor to health inequities. Health literacy is a critical economic issue. A recent US study estimated that low health literacy costs the economy $73 billion per year.

3. Who Is at Risk for Low Health Literacy? • Anyone in the US – regardless of age, race, education, income or social class – can be at risk for low health literacy • Ethnic minority groups are disproportionately affected by low health literacy • The majority of people with low literacy skills in the US are white, native-born Americans • Older patients, recent immigrants, people with chronic diseases and those with low socioeconomic status are especially vulnerable to low health literacy

4. Why does it matter??? • Adults with low healthliteracy: • Are often less likely to comply with prescribed treatment and self-care regimens • Make more medication or treatment errors • Fail to seek preventive care • Are at a higher risk for hospitalization than people with adequate literacy skills • Remain in hospital nearly 2 days longer • Lack the skills needed to negotiate the health care system • People with low health literacyANDdiabetes: • Were found to be less likely to have effective glycemiccontrol • Were more likely to report vision problems caused by their diabetes

5. The Largest Study Conducted to Date on Health Literacy Found That… 33%Were unable to read basic health care materials 42%Could not comprehend directionsfor taking medication on an empty stomach 26%Were unable to understand informationon an appointment slip 43%Did not understand the rights and responsibilitiessection of a Medicaid application 60%Did not understand a standard informed consent

6. Health Literacy Status US clinical research efforts to identify best practices increased prioritization of health literacy issue; evidenced by policy & national health goals national conferences to share findings leadership from NCSALL NC • 2005 state conference • clinical research at UNC • localized projects • health department emphasis on readability • 2007 NC Institute of Medicine report & emphasis

7. Making an Impact… • Provider awareness & teaching skills • Consumer awareness & self-advocacy skills • General public awareness & demand for high quality healthcare for all

8. Consumer Awareness • One-on-one teaching in a healthcare setting • Health education materials at appropriate literacy levels • Group teaching in an adult education classroom or community-based setting

9. Teaching Health Literacy Content vs. skills Critical thinking Shared learning

10. Shared Goals… Different Roles Content vs. Skills Medical Professionals • Make health care services & resources available • Offer & explain appropriate screening procedures • Diagnose illnesses & develop a plan for patient care • Prescribe medicines & explain their purposes & side effects • Teach patients how to use medical tools • Suggest measures to protect individual & family health Adult Educators • Enhance students’ ability to complete forms, make inquiries & navigate new environments • Teach students to ask questions about tests, procedures & results • Develop students’ capacity to participate in planning by seeking clarification & offering suggestions • Teach students how to read medicine labels, calculate amounts & timing of dosages • Strengthen students’ ability to read charts and interpret ranges • Help students learn to locate information to guide their health-related decisions

11. Health Literacy Skills Basic Skills • Vocabulary • Navigation/reading maps/using health systems • Charts & graphs • Communicating with health professionals • Empowered decision-making Higher Skills • Researching health information – quality vs quackery • Risk & probability • Deconstructing media messages • Advocacy

12. Teaching Health Literacy Skills

13. Teaching Health Literacy Skills

14. Teaching Health Literacy Skills

15. Teaching Health Literacy Skills

16. Teaching Health Literacy Skills

18. What does this medicine treat?

19. Anthony • 12 years old and weighs 93 lbs. • Soccer goalie. • Championship game today. • Anthony has allergies: stuffy, runny nose and sneezing; watery eyes. • Should he take this medicine? If so, how much? How often? What side effects should he look for?

20. Drug Facts Label Active Ingredients And what they do

21. Becoming an Advocate for Health Literacy Health literacy education Ask Me 3 Coalition Building

22. Promotes three simple, but essential, questions and answers for every healthcare interaction: What Is My Main Problem? • Why Is It Important for Me to Do This? What Do I Need to Do? Diagnosis Treatment Context What Is Ask Me 3

23. Resources UNCG ESOL lesson plans: http://www.uncg.edu/csr/pubhealthinitiatives.htm Resources on creating additional lesson plans: http://healthliteracy.worlded.org/docs/comp/Materials/curricula.html Picture Stories for Adult ESL Health Literacy: http://www.cal.org/caela/esl_resources/Health/healthindex.html Vocabulary Games http://iteslj.org/Techniques.Koprowski-RecyclyingVocabulary.html Practice Health Forms www.fda.gov/usemedicinesafely/my_medicine_record.htm

24. Take Action! Find out more about how you can help improve health literacy in your community. Contact the North Carolina Council on Health Literacy for more information and to join our state’s collaborative health literacy effort.