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    1. Plain Language: Tools and Techniques<br />Peggy Sissel-Phelan, Ed.D.<br />Best Practices Working Group<br />Health Literacy Section<br />Arkansas Public Health Association <br />Annual Conference <br />May 12, 2011<br />
    2. Outline <br />Introduction of Concepts<br /><ul><li>Health Literacy
    3. Best Practices
    4. Plain Language
    5. Rationale for Plain Language
    6. Skill Building Resources
    7. Resources</li></li></ul><li>Health Literacy<br />Definition ~<br /> Need ~<br /> Scope ~<br />
    8. Health Literacy<br />Definition ~ <br /> Health literacy is the use of a wide range of skills that improve the ability of people to act on information in order to live healthier lives. <br /> These skills include reading, writing, listening, speaking, numeracy, and critical analysis, as well as communication and interaction skills. <br /> Health literacy allows the public and personnel working in all health-related contexts to find, understand, evaluate, communicate, and use information.<br />(Calgary Charter on Health Literacy, 2008)<br />
    9. Health Literacy<br />Need ~<br />97 million adults in U.S. struggle with literacy<br />That’s one third of the U.S. population . . .<br />Half of all adults 16+<br />Cannot<br /><ul><li>Find which foods contain a specific vitamin
    10. Identify a specific location on a map
    11. Use fractions
    12. Interpret a growth chart or table</li></li></ul><li>Health Literacy<br />Need ~<br />Health Care Disparities<br />Race<br />Class<br />Ethnicity<br />Education<br />Isolation<br /><ul><li> Poverty
    13. Age
    14. Gender
    15. Cultural beliefs
    16. Language</li></li></ul><li>Health Literacy<br />Need ~<br />Health Care Complexity<br />Primary Care<br />Prevention<br />Access<br />Diagnosis<br />Treatment<br /><ul><li> Specialties
    17. Prognosis
    18. Insurance
    19. Medication
    20. Compliance</li></li></ul><li>Health Literacy<br />Need ~<br />NAAL results for Below Basic Group<br />37% have a HS or some college education<br />52% speak English as birth language<br />54% have no physical or mental disabilities<br />Kutner M et al, Nat Center for Educ Statistics 2005<br />
    21. Health Literacy<br />Definition ~<br /> Understanding + Actions = Outcomes<br /> Need ~<br />Widespread + Immediate<br /> Scope ~<br /> The Public + The personnel in all health-related areas<br />
    22. Best Practice<br /><ul><li> Practitioner’s role</li></ul> - give best possible care <br /> - communicate about the care<br /><ul><li> Practitioner’s goal</li></ul> - best possible outcome<br /> - patient understanding<br />
    23. Best Practice<br /><ul><li> Practitioner’s responsibility</li></ul> - culturally competent<br /> - assume that everyone may have difficulty understanding<br /> - have knowledge of barriers to care<br /> - create environment that helps<br /> all patients understand<br />
    24. Best Practice<br /><ul><li> Patients have the right to understand health-care information that is necessary for them to safely care for themselves, and to choose among available alternatives.
    25. Healthcare providers have a duty to provide information in simple, clear, and plain language and to check that patients have understood the information before ending the conversation. </li></ul>The 2005 White House Conference on Aging; <br />Mini-Conference on Health Literacy and Health Disparities. <br />
    26. Plain Language <br /><ul><li> is clear and simple
    27. the goal - patients are better able to: </li></ul>- Locate <br />- Form Questions <br />- Understand <br />- Act<br />
    28. Plain Language <br /><ul><li> Plain language guidelines have common set of principles
    29. Provider should: </li></ul> - identify the audience<br /> - adapt to their needs and abilities <br /> - have clear communication objective.<br />Shohet & Renaud<br />Critical Analysis on Best Practices in Health Literacy<br />CANADIAN JOURNAL OF PUBLIC HEALTH<br />Volume 97 (S2) pp. S10 - 13 2006<br />
    30. Plain Language <br />PLAIN<br />Active sentences<br />Short paragraphs<br />Mono or bi-syllable<br />Colloquial language<br />Present tense<br />2nd or 1st person (you, I)<br />COMPLEX<br />Passive sentences <br />Long paragraphs <br />Poly-syllable words <br />Clinical language <br />Past/mixed tense <br />3rd person (they, s/he)<br />
    31. Plain Language <br />Health language/ Word Choice <br />- No jargon and technical language<br />- Use lay terms about health concepts<br />- Terms clearly defined and explained<br />- No abbreviations, acronyms and statistics<br />
    32. Plain Language <br />It’ s Not Just Medical Terms . . .<br />We are disseminating information about….<br /> We are giving outinformation about…<br />How do you administer the medication?<br /> How do you give the medicine?<br />This product has an extensive list of symptoms that it treats…<br /> This medicine can help with many thingslike <br />fever, or pain, etc….<br />
    33. Plain Language <br />Signage<br />Intake forms<br />Medications<br />Treatment plan<br />Self care directives<br /><ul><li>Written
    34. Oral
    35. Visual</li></ul>Communication style<br />Adequate time<br />Feedback loop<br />Pictures<br />Sequence<br />Demonstrations<br />Video<br />
    36. Plain Language<br />Plain Writing Act of 2010(Public Law No: 111-274)<br /><ul><li>Federal agencies must use “plain writing”
    37. All “covered documents” issued to public</li></ul> ~ Letters, publications, forms, notices, instructions<br /> ~ Anything relevant to federal benefits or requirements<br />
    38. Plain Language Skills <br />Alternative Words Using<br />Plain Language<br />Based on: Plain Language Alternatives for Patient Information and Consent Materials Copyright © Sharon Nancekivell 2002-2007. All rights reserved. Electronic or print redistribution of this work for nonprofit purposes is permitted, provided this notice is attached in its entirety. All unauthorized, for-profit redistribution is prohibited. <br /> <br />Abdomen<br />Stomach /area around stomach<br />Abscess<br />Swollen area filled with a thick yellow or green liquid called pus<br />
    39. Plain Language Skills <br />Accompany<br />Go with<br />Spray<br />Aerosol<br />Biopsy <br />Taking a small bit of tissue to test<br />Clump of blood<br />Blood clot<br />By mouth<br />Swallow it<br />
    40. Resources<br />1. Universal Precautions Tool Kit <br />http://www.ahrq.gov/qual/literacy/healthliteracytoolkit.pdf<br />2. National Action Plan to Improve Health Literacy http://www.health.gov/communication/hlactionplan/pdf/Health_Literacy_Action_Plan.pdf<br />
    41. Universal Precautions Tool Kit<br />
    42. Resources<br />3. Plain Language Alternatives for Patient Information and Consent Materials Copyright © Sharon Nancekivell 2002-2007. http://healthcare.partners.org/phsirb/consfrm_files/Plain_Language_Alternatives_for_Patient_Information_and_Consent_Materials.pdf<br />4. Pfizer Clear Health Communication Initiative http://www.pfizerhealthliteracy.com<br />5. NYU Patient and Family Resource Centerhttp://www.nyupatientlibrary.org/medcenter/build-skills<br />
    43. Resources<br />6. Center for Health Care Strategies Health Literacy Fact Sheets<br /> http://www.chcs.org/publications3960/publications_show.htm?doc_id=291711<br />7. Institute for Healthcare Advancement<br />www.iha4health.org<br />Michael Villaire, MSLM<br />Director, Programs and Operations<br />mvillaire@iha4health.org<br />(800) 434-4633 x202 <br />8.American Medical Association<br /> Health Literacy Program and Kit<br />www. ama-assn.org<br />
    44. Resources<br />9.Help Your Patients Understand.” <br />Video Available from AMA Foundation <br />http://www.ama-assn.org/ama/pub/category/8035.html<br />10. <br />http://www. plainlanguage.gov<br />

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