1. Health Literacy in British Columbia Dr. James Frankish, Senior Scholar Director, Institute of Health Promotion Research Associate Professor, Health Care & Epidemiology & College for Interdisciplinary Studies "You teach a child to read, and he or her will be able to pass a literacy test.‘ George W. Bush, Feb. 21, 2001 Partners in Community Heath Research-Training Program IHPR Institute of Health Promotion Research

2. Current Projects Research Training Program in Community Partnership Research Homelessness & Poverty-Related Research Health Literacy, & Literacy & Health Research Health-System Reform & Marginalized Groups Measuring the Health of Communities

3. Helps us know if it is a problem Helps us know where the problem is located Helps us know what to do about it Existing measures are inadequate Why Measure Health Literacy?

4. From Idea(s) to Measures The ‘idea’ of “health literacy” Our ‘idea’ of “health literacy” The ‘ingredients’ of health literacy Measuring ‘how much’ of the ingredients of health literacy are present Deciding how to define ‘success’ in measuring health literacy

5. To develop a measure of health literacy appropriate to the Canadian context To test the application of this measure with specific population groups To further develop a conceptual framework for better understanding health literacy and its role in Canadian society To develop the foundation for a descriptive and predictive model of the role of health literacy in relation to use of health services, determinants of health and quality of life Objectives of Research

6. What is a Construct? Abstract, hypothetical variables (our whole field) Mental states that can’t be directly observed Operational Definitions It must be representative of your construct of interest. Defined & influenced by how you measure Construct Validity Defined - the conceptual basis (construct) underlying the effect the degree to which the study measures and manipulates the construct Construct/Convergent Validity

7. The ability to access, understand, appraise, and communicate information to engage with the demands of health contexts to promote health across the life-course. (Health Literacy Research Team, Nov. 30, 2004) Operational Definition of Health Literacy

8. Data Analysis: Some Questions What health information are seniors looking for? Where do seniors go to get health information? What are some difficulties seniors experience in trying to find and understand health information?

9. Seniors & Health Literacy Seniors in our sample tended to be fairly educated and exposed to Canadian culture, and perceived their health to be fairly good Respondents rated themselves to be fairly health literate on the self-perceived measures of health literacy Types of information sought by the respondents varied broadly Multiple sources of information were often used to find information on a specific topic, most commonly from GPs, specialists, books (non-library) and the Internet Self-perceived measures of health literacy were reported to be influenced by a broad range of variables (context)

10. Seniors & Health Literacy Respondents did fairly well on most of the task-oriented measures of health literacy (REALM, reading passages) Measures of self-perceived health literacy had good internal consistency (Cronbach's alpha=0.852), and therefore a sum scale of these measures was created Self-perceived measures correlated with each other & the task-oriented measures with each other, but there was little relation between self-perceived & task-oriented measures Self-perceived measures of health literacy, REALM score, self-rated health, and demographic characteristics did not predict task-oriented measures of health literacy

11. At-Risk Youth & Health Literacy Youth saw health as inclusive of physical & mental health. Youth identified smoking, drugs, alcohol, sexual health, mental health, nutrition, fitness and injuries. They were aware of harm of smoking but said negative comments by teachers and peers deterred quitting. Youth saw mental health as central. Friendships were seen as contributors to health. Theys described a lack of information for youth about mental health.

12. At-Risk Youth & Health Literacy Access to information depended on hours of service, transportation, availability of services, and the quality of the relationship between the youth and care providers. Youth were more likely to confide in doctors & nurses & trust information if they perceived that the professionals took the time understand their health issues. The majority said they trust and utilize family doctors for their health concerns, with the exception of sexual health.

13. At-Risk Youth & Health Literacy They endorsed youth health clinics, because of caring, knowledgeable staff, but were critical of restrictive hours. Youth looked at written materials in schools, youth centres and doctor’s offices when there was a sense of urgency about an issue or when directed by a trusted source.

14. Contact Information Jim Frankish Institute of Health Promotion Research frankish@interchange.ubc.ca jimfrankish.com www.pchr.net