Health Literacy CMST October 2014

HL Defined Term first used in 1974 in an article that described how health information impacts the educational system, health care system, and mass communication. Challenge: health literacy skills are required to function in health care systems that are increasingly characterized by technologic sophistication and complexity.

Definition, continued. The American Medical Association (AMA) defines health literacy as “a constellation of skills, including the ability to perform basic reading and numerical tasks required to function in the health care environment.” Healthy People 2010 defines health literacy as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”

Visualize HL The challenges of health literacy are somewhat akin to those a driver faces when lost in an unfamiliar area. We need 1.To find a source of accurate directions; 2.To correctly understand the language and meaning of necessary information; 3.And to follow the directions properly from beginning to end.

Lost in Health Literacyville Written information (street signs and printed maps) can be helpful—but may be hard to find and difficult to read/understand. Calling someone for help is an option—if we have access to a phone and can reach the person who knows the way and can communicate the directions accurately and effectively. Onboard navigational systems would help, but info may not be updated enough. And, most people don’t have this option and/or might be intimidated/unfamiliar with the technology. Stopping to ask for directions—IF we aren’t so embarrassed or ashamed to admit we are lost. The person giving directions must use language and landmarks that we can understand.

HL Attributes: PROSE LITERACY Prose literacy: the ability to locate requested information within written text documents (e.g., editorials, news stories, poems, and fiction), to integrate disparate information presented in the texts, and to write new information based on the texts.

HL Attributes: DOCUMENT LITERACY Document Literacy: the ability to locate selected information on a short form or graphical display of everyday information (e.g., job applications, transportation schedules, and maps), to apply selected information presented in documents, and to use writing to complete documents and survey forms that require filling in information.

HL Attributes: QUANTITATIVE LITERACY Quantitative Literacy (Numeracy): the ability to locate numbers within graphs, charts, prose texts, and documents; to integrate quantitative information from texts; and to perform appropriate arithmetic operations on text-based quantitative data (e.g., using a bank’s ATM, understanding a bar graph, and completing a FAFSA or Tax Return form.)

But there’s more…. Processing health information received through communication channels such as video, interactive multimedia, or interpersonal communication also requires skills such as speaking and listening. The ability to engage in conversations by speaking and listening (known as 2-way communication), is essential for accessing, understanding, and applying health information received from a physician or other interpersonal source.

And more… – Being able to clearly and accurately express physical, mental, and emotional states to health care providers. – To hear, process, and understand spoken information expressed by another person; – And to confidently interrupt and ask questions despite the power differential between patient and provide or patient and insurance administrator.

And more… Intercultural Literacy: Differences between the two communicators’ spoken language, cultural heritage, perceived power, education level, and other factors can make the positive exchange of health information in interpersonal interactions difficult or impossible. Media Literacy (the ability to develop an informal and critical understanding of the nature of mass media, the techniques used by them, and the impact of these techniques) required.

And more…. Computer Literacy: an understanding of the concepts, terminology and operations that relate to general computer use…AND the essential knowledge needed to function independently to avoid problems, adapt to new situations, keep information organized and communicate effectively with other computer literate people.

And more… Motivation to Receive and Process Information: related to people’s beliefs about the health information they receive. Lack of motivation to receive or to act on health information can be as much a barrier to functional health literacy as is the lack of cognitive abilities and skills. One predictor of an individual’s motivation is his or her perceived personal relevance of the information being presented.

For Wednesday: Health Literacy and the Communication…

HL & The Communication Matrix Functional health literacy is determined by the strength of the match between an individual’s health literacy abilities and the types of abilities required for processing specific types of health messages. These important intersections are depicted in the health literacy and communication matrix. The matrix reveals that functional health literacy is NOT exclusively a function of an individual’s abilities—BUT ALSO A FUNCTION OF THE CHARACTERISTICS AND QUALITIES OF THE COMMUNICATION MESSAGES THAT THE INDIVIDUAL RECEIVES.

COMMUNICATION MATRIX Individual health literacy attributes HEALTH MESSAGE CHANNELSHealth Message Content PRINTINTERPER- SONAL AUDIO/ VIDEO INTER-ACTIVE MULTI-MEDIA Quantitative Literacy Prose/ Document Literacy xxxxxx 2way Communication xxxxxx Media Literacy xxxxxx Computer Literacy xxxxxx Motivation (culture & relevance) xxxxxxx Physical/ mental impairments External assistance XXXXXX Cells represent the MOST IMPORTANT INTERSECTIONS between format and content of health messages and the health literacy attributes needed to access, understand, and apply these messages.