Three simple steps to health literacy The Asthma Foundation: New Zealand Respiratory Conference 2013 Susan Reid 20 September 2013

Health literacy definitions Good health literacy means people: “have the capacity to obtain, process and understand basic health information and services in order to make informed and appropriate health decisions” Kōrero Mārama, 2010 Health literacy is an interaction between the skills of individuals and the demands of the health system 2 literacy-maori-feb2010

NZ health literacy statistics More than 56.2% of adult New Zealanders (1,626,000 adults) have low levels of health literacy Low levels are a result of unfamiliarity and complexity of health information Most people with low skills are Pākeha and employed and unaware they have low health literacy Particular issues for Māori, Pacific peoples, non English speakers, rural, younger, older & unemployed 3

Evolution of health literacy Patients Service delivery improvement (health professionals) System enhancement 4

You can’t tell by looking so use a Universal Precautions approach As a starting point treat everyone as if they might have low health literacy. Adjust your starting point depending on what the person knows. 5

Three steps to better health literacy 6

What we often observe 1. Assume 2. Tell 3. Assume 7

An example 8

Step 1: Find out what people know Schema Theory Everyone relates new knowledge to what they already know or have experienced 9

Step 2: Build health literacy skills and knowledge Link it to what the person already knows (schema) Give information in logical steps Give information in manageable chunks Ask questions Explain technical words Use actual equipment Use written materials Help consumers anticipate next steps Medicine reviews Reinforce and emphasise 10

Step 3: Check you were clear Use Teach-back where you, the health professional, take responsibility for checking you have been clear. Not a test for consumer, but about how well you communicated. Check understanding and, if necessary, re-explain using different language. 11

Teach-back: a suggested script “We have gone over a lot today so to make sure I have been clear please tell me how you are going to take this new medicine... and I will listen to make sure I have been clear.” 12

13 Teach-back: Cardiologist

Three steps to better health literacy 14

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