In It Together: National Health Literacy Project for Black MSM Training of Trainers Module 4: Strategies to Improve Face-to-Face Communication

WELCOME Trainer: Larry Carter Phone: This material was produced by John Snow Inc., under Contract #HHSH I with the Health Resources and Services Administration, U.S. Department of Health and Human Services.

RECAP OF MODULE 3 Health literate health care organizations:  Help people find, process, understand, and use health information and services  Remove health literacy barriers  Share 10 common attributes, which are supported by health literate activities  Set health literacy goals that are clearly defined and supported by actionable and measureable steps  Train and support staff so they are comfortable talking about sexual orientation and stigma 3

TAKE-AWAY ACTIVITY 1.Which 3 attributes of a health literate organization could your organization address? 2.Why did you select these 3 attributes? 4

TODAY’S TRAINING GOALS Trainers will recognize important moments in face-to-face communication, increase their awareness of barriers to effective communication, and learn strategies to improve their face-to- face communication skills 5

LEARNING OBJECTIVES By the end of the training, participants will be able to:  Identify at least 3 barriers to face-to-face communication  Implement at least 3 strategies to improve face-to-face communication  Describe a care partnership 6

INTRODUCTION TO EFFECTIVE COMMUNICATION Through communication, people come to know what is happening around them, both nearby and faraway and, by talking to others, make sense of it. Communication is the mechanism by which teachers teach and learners learn, by which marketers promote products and services, and consumers decide what to buy and to consume. It is the means by which communities build consensus and enforce norms, and the means by which conflicts arise, discrimination is expressed, and convergence can eventually emerge. It is the process by which policies are negotiated and publicized to set political and institutional agendas. Of course, it is a critical aspect of how health professionals provide care and patients seek and use it, and the process by which a person is persuaded to do something healthy or unhealthy. Storey, D., Seifert-Ahanda, K., Andaluz, A., Tsoi, B., Matsuki, J.M., & Cutler, B. (2014). What is health communication and how does it affect the HIV/AIDS continuum of care? a brief primer and case study from New York City. JAIDS Journal of Acquired Immune Deficiency Syndromes, 66, S241-S249. 7

WHY HIV CARE/TREATMENT INSTRUCTIONS ARE DIFFICULT  Constant stream of new science and information  Explanations are given using medical jargon  Information is complex 8

GOAL OF COMMUNICATION Goal: Receiver understands message without difficulty SENDER RECEIVER 9

COMMUNICATION CHALLENGES  Lack of clarity  Poor word choice  Distractions (“noise”) 10

MAIN FUNCTIONS OF COMMUNICATION  Giving or getting information  Persuading someone  Making a social connection 11

EFFECTIVE COMMUNICATION An information exchange between people that results in:  New or improved understanding  New or better awareness  Shared understanding of issues and solutions 12

IMPORTANT MOMENTS IN HIV COMMUNICATION  Explaining what to bring and what to expect from regular doctor and other provider visits  Explaining disease and symptoms  Communicating medication instructions  Describing medication side effects  Explaining what insurance is and how to use it 13

BARRIERS TO EFFECTIVE COMMUNICATION 1.Listening 2.Understanding 3.Spoken communication 14

BARRIERS TO EFFECTIVE COMMUNICATION: LISTENING 1.Focus on personal agenda 2.Experience of information overload 3.Focus on the messenger, rather than the message 4.Internal or external noise 5.Distractions from illness or pain 15

BARRIERS TO EFFECTIVE COMMUNICATION: UNDERSTANDING 1.Stereotyping and generalizing 2.Negative focus 3.Assuming similar interpretations 4.Experiencing contradictory cues 16

BARRIERS TO EFFECTIVE COMMUNICATION: UNDERSTANDING  Stereotyping and generalizing  Negative focus  Assuming similar interpretations  Experiencing contradictory cues 17

BARRIERS TO EFFECTIVE COMMUNICATION: UNDERSTANDING  Stereotyping and generalizing  Negative focus  Assuming similar interpretations  Experiencing contradictory cues 18

BARRIERS TO EFFECTIVE COMMUNICATION: SPEAKING  Lack of clarity 19

BARRIERS TO EFFECTIVE COMMUNICATION: SPEAKING  Lack of clarity  Using stereotypes and generalizations  Jumping to conclusions Rintamaki, L. S., Davis, T. C., Skripkauskas, S., Bennett, C. L., & Wolf, M. S. (2006). Social stigma concerns and HIV medication adherence. AIDS Patient Care & STDs, 20(5),

BARRIERS TO EFFECTIVE COMMUNICATION: SPEAKING  Lack of clarity  Using stereotypes and generalizations  Jumping to conclusions  “Non-responsive” responses 21

BARRIERS THAT PREVENT CLIENTS FROM ACTING ON HEALTH INFORMATION  Use of technical or medical terminology  Focusing on information rather than actions  Limited awareness of cultural differences 22

STRATEGIES TO HELP HEALTH PROFESSIONALS LISTEN EFFECTIVELY  Focus on client  Pay attention to non-verbal messages 23

STRATEGIES TO HELP HEALTH PROFESSIONALS LISTEN EFFECTIVELY  Focus on client  Pay attention to non-verbal messages  Listen to seek an overall understanding 24

STRATEGIES TO HELP HEALTH PROFESSIONALS LISTEN EFFECTIVELY  Focus on client  Pay attention to non-verbal messages  Listen to seek an overall understanding.  Be empathetic  Ask questions 25

STRATEGIES FOR ACCURATE PERCEPTION 26

 Be self-aware  Acknowledge personal limitations  Sit down with patient  Slow down your speech  Portray approachable body language  Make patient feel valued STRATEGIES TO IMPROVE PATIENT PERCEPTIONS OF HEALTH PROFESSIONALS 27

STRATEGIES TO IMPROVE SPOKEN COMMUNICATION  Use plain, non-medical language  Limit content to 2-3 main points  Repeat key points multiple times  Incorporate words/expressions used by client  Give instructions specific and appropriate to client’s life  Encourage client to ask questions 28

STRATEGIES TO IMPROVE SPOKEN COMMUNICATION  Use plain, non-medical language  Limit content to 2-3 main points  Repeat key points multiple times  Incorporate words/expressions used by client  Give instructions specific and appropriate to client’s life  Encourage client to ask questions  Consider client’s cultural context  Forge a care partnership 29

PRACTICE ACTIVITY  Use plain, non-medical language  Limit content to 2-3 main points  Repeat key points multiple times  Incorporate words/expressions used by client  Give instructions specific and appropriate to client’s life  Encourage client to ask questions  Consider client’s cultural context  Forge a care partnership Ahmed 34-year-old male Diagnosed with HIV 4 months ago Currently on ART Lives in a neighborhood with a large Muslim community. 30

HOW HEALTH PROFESSIONALS CAN FOSTER A CARE PARTNERSHIP 1.Provide HIV information to client in a way he can understand 2.Listen to client and answer his questions 3.Treat client with respect, honesty, and compassion 31

HOW HEALTH PROFESSIONALS CAN FOSTER A CARE PARTNERSHIP 4.Respect client’s privacy and privacy of his medical information 5.Communicate openly about benefits and risks associated with any of client’s treatments 6.Provide client with information to help client make informed decisions about his care and treatment options 32

HOW HEALTH PROFESSIONALS CAN FOSTER A CARE PARTNERSHIP 7.Include client as a member of the care team 8.Work with client, and any other partners who treat or support him, in coordination of his care 9.Commit to the highest quality and safety standards 10.Help client to set goals for his health care and treatment plans 33

WHAT CAN WE ENCOURAGE A CLIENT TO PROMISE IN A CARE PARTNERSHIP? 1.Ask questions when he does not understand and keep asking until he does understand 2.Be a responsible and active member of his health care team 3.Participate in decisions about his HIV care 4.Communicate concerns about his care plan 34

WHAT CAN WE ENCOURAGE A CLIENT TO PROMISE? 5.Treat us with respect, honesty, and consideration 6.Give us the information that we need to treat him 7.Learn all that he can about HIV 8.Understand his care plan to the best of his ability 9.Tell us if he has trouble reading the information or understanding our guidance 35

RECAP Identify at least 3 barriers to effective face-to-face communication Recognize at least 3 strategies to improve face-to-face communication Explain a care partnership 36

NEXT STEPS In Module 5, we will explore how print material can be used to promote health literacy. We will also learn how to identify or create health literate print material, and how to make prescription instructions easier to understand. 37

TAKE AWAY ACTIVITY Apply one strategy that you learned today to improve one of the following: Your listening skills Your client’s understanding Your spoken communication Be prepared to discuss what you tried and how it worked when we meet next. 38

THANK YOU! Trainer: Larry Carter Phone: This material was produced by John Snow Inc., under Contract #HHSH I with the Health Resources and Services Administration, U.S. Department of Health and Human Services. 39