1. Bonnie Braun, PhD Elizabeth Maring, PhD Linda Aldoory, PhD Mili Duggal, MPH School of Public Health Horowitz Center for Health Literacy University of Maryland Extension

2.  Evaluate use of clicker technology in focus groups  Distinguish core health message preferences among low-income, rural mothers  Determine how to apply findings

3. Understanding learners' preferences for both style of messages and delivery mechanisms could improve the ability of health professionals to attract learners’ attention and produce intended action … Improved Health Outcomes

4.  Health literacy principles suggest that health information must be User-focused Easy to understand and do Culturally appropriate Emotionally appealing Scientifically sound

5.  They and their families experience Poorer health outcomes Limited availability and access to health services Inadequate health insurance coverage Low levels of health literacy

6. What factors help or hinder rural mothers’:  Attention to health messages  Understanding of messages  Actions in response to messages  Preferred channels of receiving messages

7. Reduce health disparities and improve health and well-being Actively develop health messages Perceive control over one’s life Feel empowered to make good decisions Accomplish goals

8.  Ethnically diverse mothers (African American, Asian American, Hispanic, Native American, and White) living in rural communities in eight states  Primary caregivers of at least one child between the ages of 0 and 12  Income 185% or less than the federal poverty line

9.  Participants responded to questions about: Their own health and their health literacy Perceived sense of control Appeal of test health messages Preferences for receipt of health messages  Participants discussed what elements mattered most to them

10.  Tested initial health messages in the areas of: Physical health, dental health, and food security

11. Press Your Clicker--Yes Raise Your Hand — No

13. FINAL MESSAGE Hi, I’m Mary. I have two kids and I am always busy and pinched for money! I want my children to be healthy. I don’t want my kids to have cavities like I did. Our dentist told me that my kids might get cavities if they don’t drink water with fluoride and use toothpaste with fluoride. I’ve been buying bottled water and toothpaste with fluoride added to prevent cavities. Empathetic about their busy life “I am always busy and pinched for money” Tells a short story or includes simple steps that the mothers find easy to do Positive – what good can happen after you do the action In mother’s voice citing an authority figure “my dentist told me…” Medium amount of content

14. FINAL MESSAGE #1 Empathetic about their busy life Tells a short story or includes simple steps that the mothers find easy to do Positive – what good can happen after you do the action In mother’s voice citing an authority figure (e.g., “my dentist told me…” “My health educator told me…”) Medium amount of content

15. Understanding learners' preferences for both style of messages and delivery mechanisms could improve the ability of health professionals to attract learners’ attention and produce intended action… Improved Health Outcomes

16. Partners University of Massachusetts, Amherst, Washington State University, University of Maryland Extension, Rural Maryland Council, Maryland Rural Health Association, University of Maryland School of Public Health, Herschel S. Horowitz Center for Health Literacy And 14 Rural Families Speak state research teams. This study is funded by a USDA National Institute of Food and Agriculture Rural Health and Safety grant.

17. Contact Information: Bonnie Braun, PhD., Professor & Faculty Scholar Herschel S. Horowitz Center for Health Literacy University of Maryland-College Park School of Public Health 301-335-4335 bbraun@umd.edu