1. Introduction to Health Information Literacy Developed by the Medical Library Association working with the National Library of Medicine under contract HHSN276200663511/NO1-LM-6-3511 April 2008

2. Learning Objectives Describe the impact low health literacy has on quality patient care Define health information literacy and the challenges patients face Identify health information literacy resources and tools available to you and your patients

3. What is 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. Healthy People 2010

4. What factor affect Health Literacy? Health literacy is dependent on the individual and system factors: Communication skills Information and knowledge Culture and language Demands of the system

5. Health Literacy From the Patients Perspective? Source: Help Your Patients Understand. AMA Foundation Health Literacy. www/.a-ssn.org/ama/pub/ category/8115.html www/.a-ssn.org/ama/pub/ category/8115.htmlwww/.a-ssn.org/ama/pub/ category/8115.html Mrs. Cordell Mr. Bell

6. Why is Health Literacy Important? Health literacy is linked to: Under utilization of services Increased medication error Poor knowledge about health Poor health outcomes Increased hospitalization Increased health care costs

7. Why Now? Healthy People 2010 (DHHS 2000) Health Literacy: A Prescription to End Confusion (IOM 2004) Evidence Report/Literacy and Health (AHRQ 2004) 17th Surgeon General of the United States - Dr. Richard Carmona (2006)

8. Why Hospitals? The safety of patients cannot be assured without mitigating the negative effects of low health literacy and ineffective communication on patient care. The Joint Commission Source: What did the Doctor Say?: Improving Health Literacy To Protect Patient Safety. The Joint Commission (2007). www.jointcommission.org/PublicPolicy/health_literacy.htm www.jointcommission.org/PublicPolicy/health_literacy.htm

9. How is Information Critical to Health Literacy? Health information is key to: Patient and provider communication Shared health care decision making Understanding and following a treatment plan Recognizing when to seek care Learning about and adopting healthy behaviors

10. What is Health Information Literacy? The abilities needed to: Recognize a health information need Identify relevant sources of information Assess the quality of the information Understand and use the information to make informed health care decisions

11. What are the Health Information Literacy Challenges? Health Literacy Levels Readability of Health Materials Health Information and the Internet

12. Health Literacy in the U.S. Over 75 million adults have Basic and Below Basic health literacy Over 75 million adults have Basic and Below Basic health literacy Only 1 in 9 adults have proficient health literacy skills Only 1 in 9 adults have proficient health literacy skills Number & Percentage of Adults in Each Health Literacy Level Source: The Health Literacy of American Adults. Results from the 2003 National Assessment of Adult Literacy. National Center for Education Statistics (2006).http://nces.ed.gov/Pubsearch/pubsinfo.asp?pubid=2006483 Source: The Health Literacy of American Adults. Results from the 2003 National Assessment of Adult Literacy. National Center for Education Statistics (2006). http://nces.ed.gov/Pubsearch/pubsinfo.asp?pubid=2006483http://nces.ed.gov/Pubsearch/pubsinfo.asp?pubid=2006483

13. Readability of Health Information Numerous studies document health materials written at reading levels far exceeding patient skills More recent studies find similar results looking at the readability and usability of online health resources Source: NLM BibliographyUnderstanding Health Literacy and Its Barriers (2004): http://www.nlm.nih.gov/pubs/cbm/healthliteracybarriers.html http://www.nlm.nih.gov/pubs/cbm/healthliteracybarriers.html

14. Computers and the Internet 80% of Internet users search for health information 86% do not seek advice about which websites to use 72% express trust in most or all information found online 75% said they rarely or never check for source and date Source: Fox, S. Vital Decisions (2003). Online Health Search (2006). Washington, DC:Pew Internet & American Life Project. Source: Fox, S. Vital Decisions (2003). Online Health Search (2006). Washington, DC: Pew Internet & American Life Project. http://www.pewinternet.org/PPF/c/5/topics.asphttp://www.pewinternet.org/PPF/c/5/topics.asp

15. MLA Top 10 Most Useful Consumer Health Websites Cancer.gov * CDC.gov * Familydoctor.org * Healthfinder.gov * Kidshealth.org * AidsInfo.nih.gov Mayoclinic.com Medlineplus.gov * Medem.com Noah-health.org * *Available in Spanish and/or other languages

16. www.medlineplus.gov

17. Interactive Health Tutorials http://www.nlm.nih.gov/medlineplus/tutorial.html

18. NIHSeniorHealth.gov

19. www.aidsinfo.nih.gov

20. www.kidshealth.org

21. www.informationrx.org

22. Deciphering Medspeak Medical Library Associations Consumer Health Brochures HIV Cancer Diabetes Asthma Others www.mlanet.org/resources/medspeak/index.html

23. Strategies to Improve Communication Limit information (3-5 key points) Use easy-to-read information Be specific and concrete, demonstrate Check for understanding, use a Teach Back or Show Me approach Recognize culture difference and language needs

24. How Can Librarians Help? Fill Information Rxs with accurate and reliable information Free access to the Internet Help patients find information they can use and understand Patient information packets

25. How Can Librarians Help? Patient/Consumer trainings Search skills Search skills Assessment skills Assessment skills Provider trainings Search skills Health literacy training Community outreach

26. Take Home Points Accurate and reliable information is critical to health literacy and essential to providing quality care Info Rxs is a valuable tool for referring patients to reliable health information and to the hospital library for support

27. Thank You! Questions Comments

28. References AHRQ ReportLiteracy and Health Outcomes (2004): http://www.ahrq.gov/clinic/epcsums/litsum.htm http://www.ahrq.gov/clinic/epcsums/litsum.htm AMA Foundation Health Literacy: www.ama- assn.org/ama/pub/category/8115.html AMA Foundation Health Literacy: www.ama- assn.org/ama/pub/category/8115.htmlwww.ama- assn.org/ama/pub/category/8115.htmlwww.ama- assn.org/ama/pub/category/8115.html Carmona, R.H. (2006) Health Literacy: A National Priority Journal of General Internal Medicine 21(8). Carmona, R.H. (2006) Health Literacy: A National Priority Journal of General Internal Medicine 21(8). www.blackwell- synergy.com/doi/full/10.1111/j.1525-1497.2006.00569.xwww.blackwell- synergy.com/doi/full/10.1111/j.1525-1497.2006.00569.x Fox, S. & Fallows, D. Internet Health Resources. Washington, DC:Pew Internet & American Life Project (2003). http://www.pewinternet.org/PPF/c/5/topics.asp Fox, S. & Fallows, D. Internet Health Resources. Washington, DC: Pew Internet & American Life Project (2003). http://www.pewinternet.org/PPF/c/5/topics.asp http://www.pewinternet.org/PPF/c/5/topics.asp Healthy People 2010 (2000): http://www.healthypeople.govhttp://www.healthypeople.gov Healthy People 2010 Health Literacy Action Plan Communicating Health: Priorities and Strategies for Progress (2003): http://odphp.osophs.dhhs.gov/projects/healthcomm/objective2.htm http://odphp.osophs.dhhs.gov/projects/healthcomm/objective2.htm

29. References IOM ReportHealth Literacy: A Prescription To End Confusion (2004): http://www.iom.edu/report.asp?id=19723 http://www.iom.edu/report.asp?id=19723 NIH/AHRQ program announcementsUnderstanding and Promoting Health Literacy: http://grants.nih.gov/grants/guide/pa- files/PAR-04-116.html; http://grants.nih.gov/grants/guide/pa-files/PAR-04- 117.html http://grants.nih.gov/grants/guide/pa- files/PAR-04-116.htmlhttp://grants.nih.gov/grants/guide/pa-files/PAR-04- 117.html NLM BibliographyUnderstanding Health Literacy and Its Barriers (2004): http://www.nlm.nih.gov/pubs/cbm/healthliteracybarriers.html http://www.nlm.nih.gov/pubs/cbm/healthliteracybarriers.html The Health Literacy of Americas Adults: Results from the 2003 National Assessment of Adult Literacy http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483 The Health Literacy of Americas Adults: Results from the 2003 National Assessment of Adult Literacy http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483 http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483 The Joint Commission Report: What did the Doctor Say?: Improving Health Literacy To Protect Patient Safety (2007): www.jointcommission.org/PublicPolicy/health_literacy.htm The Joint Commission Report: What did the Doctor Say?: Improving Health Literacy To Protect Patient Safety (2007): www.jointcommission.org/PublicPolicy/health_literacy.htm www.jointcommission.org/PublicPolicy/health_literacy.htm Medical Library Association, Top 10 Most Useful Consumer Health Websites www.mlanet.org/resources/medspeak/topten.html Medical Library Association, Top 10 Most Useful Consumer Health Websites www.mlanet.org/resources/medspeak/topten.html www.mlanet.org/resources/medspeak/topten.html