1. Elisha Brownfield 7/23/15

2. Health Literacy The degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions

3. Health Literacy Nearly 9 out of 10 adults have difficulty using the everyday health information that is routinely available in our healthcare facilities, retail outlets, media and communities.

4. Health Literacy Without clear information and an understanding of the information's importance, people are more likely to: skip necessary medical tests, end up in the emergency room more often, and have a harder time managing chronic diseases like diabetes or high blood pressure. 2

6. How is Health Literacy Measured? TOFHLA (S-TOFHLA) – A modified Cloze method to assess reading and numerical comprehension REALM – Brief word recognition test Newest Vital Sign – A 3 minute screening tool for use in clinical settings

7. Effects of low Health Literacy Difficulty taking medications appropriately and interpreting labels and health messages Higher rates of hospitalization, emergency care visits and lower rates of flu immunizations Less health knowledge and comprehension of health information Are more likely to report their health as poor In particular, seniors' limited health literacy is associated with worse health status and quality of life and early mortality

8. Approximately 45% of high school graduates have limited health literacy

9. Factors associated with Low Health Literacy

10. How do we cause problems? Use of technical or medical terminology. pandemic, immunize, transmit, influenza, and prevalence Reliance on print communication – written instructions as a single source of communication. Focusing on information rather than actions. Limited awareness of cultural differences.

11. What Can I Do? Use plain language and slow down. Make sure you are understood (Teach Back) Use a caring tone of voice and attitude. Break it down into short statements. Focus on the 2 or 3 most important concepts Give instructions that are participatory and user-centered. Consider the current literacy level of the patient population

12. Teach Back ● Asking patients to repeat in their own words what they need to know or do, in a non-shaming way. ● NOT a test of the patient, but of how well you explained a concept. ● A chance to check for understanding and, if necessary, re-teach the information.

13. Teach Back Ask patients to demonstrate understanding “What will you tell your spouse about your condition?” “I want to be sure I explained everything clearly, so can you please explain it back to me so I can be sure I did.” “Show me what you would do.” Chunk and check Summarize and check for understanding throughout, don’t wait until the end. Do NOT ask... “ Do you understand?”

14. What Can I Do? Pictures Orally delivered health information Studies find narratives can lead to cancer-relevant belief and behavior change (Green, M.C., 2006) and to be more effective than statistical evidence on some patient outcomes (Mazor et al., 2007).Green, M.C., 2006Mazor et al., 2007 Grouping information into meaningful “chunks” of reasonable size Practical, science-based advice on explaining risks using numbers rather than words alone (10 out of 100) Every risk communication is processed both cognitively and emotionally….Success in a risk communication must be measured not only by what recipients know but by how they feel.

15. Resources Cdc.gov Kutner, M., Greenberg, E., Jin, Y., & Paulsen, C. ( 2006 ). The health literacy of America's adults: Results from the 2003 National Assessment of Adult Literacy (NCES 2006-483). Rudd, R. E., Anderson, J. E., Oppenheimer, S., & Nath, C. (2007). Health literacy: An update of public health and medical literature. In J. P. Comi ngs, B. Garner, & C. Smith. (E ds.), Review of adult learning and literacy (vol. 7) (pp 175–204). Mahwa h, NJ: Lawrence Erlbaum Associates.