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Sarah Kuklishon 10 October 2013
Transcript of Health Literacy
What is Health Literacy?
"Health literacy is 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
Approximately 89 million Americans have "basic" or "below basic" health literacy
One study found 60% of adult inpatients had "inadequate" or "marginal" health literacy
How do we identify these patients?
How do we help patients with limited health literacy?
Adjust our spoken communication
Teach the way the patient learns best
Review written materials frequently given to patients
Sarah Kuklish, SPT
University of Indianapolis
Why does this matter?
Stronger predictor of health status than income, employment status, education level, or racial/ethnic group
Increased mortality in persons over 65 years
More hospitalizations, more ED visits, lower use of preventative care, incorrect use of medications, and inability to understand labels and instructions.
Legal implications--Informed Consent
Who is at risk?
People over age 65
Racial/ethnic group other than white
Less than high school diploma/GED
Income at or below poverty level
Vanderburgh County Statistics
14.4% 65 years or older
13.8% race/ethnicity other than white
12.1% over age 25 <HS diploma/GED
15.5% at or below poverty line
Incomplete or incorrect forms
Frequently missed appointment times
Lack of follow-through for referrals
Lack of follow-through with HEP or illness management strategies
Making excuses when given written information
Difficulty taking or explaining purpose of medications
Following Up on Red Flags
"How happy are you with your reading?"
"What is the best way for you to learn new things?"
Outcome measures--"The Newest Vital Sign"
How do patients feel about being tested?
Strategies for Improving Communication
Simple sentence structure, plain language, no medical jargon
Minimize anatomy & physiology explanations
Introduce no more than 4 main messages per session
Speak in the language the patient is most comfortable with
Employ the "teach back" method
Create an environment for asking questions
The "Ask Me 3" Program
What is my main problem?
What do I need to do?
Why is it important for me to do this?
Berkman N, Sheridan S, Donahue K, Halpern D, Crotty, K. Low health literacy and health outcomes: An updated systematic review. Ann Intern Med. 2011;155:97-107.
Ennis K, Hawthorne K, Frownfelter D. How physical therapists can strategically effect health outcomes for older adults with limited health literacy. J Geriatr Phys Ther. 2012;35(3):148-154.
Heinrich C. Health literacy: The sixth vital sign. J Am Acad Nurse Pract. 2012;24:218-223.
Morris N, Grant S, Repp A, MacLean C, Littenberg B. Prevalence of limited health literacy and compensatory strategies used by hospitalized patients. Nurs Res. 2011;60(5):361-366.
Vangeest J, Welch V, Weiner S. Patients' perceptions of screening for health literacy: Reactions to the Newest Vital Sign. J Health Commun. 2010;15:402-412.
Weiss B. Health literacy and patient safety: Help patients understand.2nd ed. American Medical Association Foundation. 2007.
National Patient Safety Foundation
US Department of Health and Human Resources
Write it Right
Most health care information is written at a 10th grade level or above
Plain language, uni- or bisyllabic words, large font, lots of white space
Focus on desired behaviors rather than medical information
Flesch-Kincaid grade level
Fry Readability Formula, Simple Measure of Gobbledygook (SMOG)
Henderson County Statistics
14% 65 years or older
10.4% race/ethnicity other than white
15.3% over age 25 <HS diploma/GED
15% at or below poverty line