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Which of the following is the strongest predictor of an individual’s health status?
C) Literacy skills
D) Education level
E) Racial or ethnic group
F) Average Beer Intake at Metro
True or False?
Most people with limited literacy have low IQs.
People will tell you if they have trouble reading.
The number of years of schooling is a good general guide to determine literacy level
Most people with low literacy skills are poor, immigrants or minorities.
Goals of the Presentation
Discuss the Literacy & Health Project background
Define Health Literacy
Recognize the scope and implications of health literacy issues.
Examine & discuss the Health Binder
Literacy & Health Phase 1
Light bulb reaction
Trillium Foundation grant
Interviewed health care providers and low literacy learners
Few health care providers had an accurate awareness
Learners wanted more time and less jargon
Neither health care providers or literacy learners knew that the Literacy Council would work with health information
Train tutor trainers to include health literacy in training sessions
Develop a trainer workshop
Develop health information for low literacy learners
Share resources through the internet
Health literacy is the degree to which people are able to access, understand, appraise and communicate information to engage with the demands of different health contexts in order to promote and maintain good health across the life-course.
Compute and solve problems at levels of proficiency necessary to function in society
Ability to read, write and speak in English
Ability to achieve one’s goals and develop one’s knowledge and potential
Psychological / Mental Health
Ethnic interpretation of illness
Spiritual and religious beliefs
Majority of the lowest level readers are white and native born
Computational – Health Numeracy
The degree to which individuals have the capacity to access, process, interpret, communicate, and act on numerical, quantitative, graphical, biostatistical, and probabilistic health information needed to make effective health decisions
This involves the ability to make sense of information, as well as higher functions like inference, estimation, proprtions, percentages, frequencies, and equivalent situations. Information may be from multiple sources, and an example would be deterimining whether an analytical result was within the normal range, or understanding graphs
An understanding of basic biostatistics involving probability statements, skills to compare different scales (Probability, proportion, percent), to critically analyse quantitative information like life expectancy or risk, and understanding concepts like randomisation and blinding. An example would be making choices between treatments based on standard outcomes of relative or absolute risk
Scope of the Problem
LBS (Literacy Basic Skills)- Level 1
22% of adult Canadians are so limited that they are unable to determine the correct dosage from reading the medicine label.
LBS (Literacy Basic Skills)- Level 2
A further 26% can read provided that the materials are simple and presented in a familiar context.
LBS- Level 1
Indicates very low literacy skills where the individual may, for example have difficulty identifying the correct amount of medicine to give a child from the information found on the package. These individuals are generally aware they have a problem
LBS Level 2
Respondents can deal with material that is simple, clearly laid out and in which the tasks involved are not too complex. This is significant because it identifies people who may have adapted to everyday life, but would have difficulty learning new health related material and making informed decisions. These individuals often do not recognize their own limitations.
Navigating from one clinic to another
Following medication instructions
Interactions with providers
Coping strategies in general
Limited general knowledge (Health promotion & prevention)
Do not ask for clarification
Focus on details, hard to get them to prioritize
Don’t understand Likert scales, math
Deal in literal/concrete concepts, not abstract
Essential vocabulary only
Check answers without understanding
Not keeping appointments—26%
Unable to find clinic/office
Failure to take meds correctly—42% did not understand “empty stomach”
Overuse of emergency room
Lack of informed consent
Diagnosis made at later stages
Fewer years of schooling, poorer—fixed incomes
> 50% do not take meds as directed
68% cannot interpret blood sugar value
76% cannot follow Upper GI instructions
2 billion dollars spent per year on hospital admission for medication errors
Always assume and ask in sensitive way—”How do you like to get your information?” or “What things do you like to read?” or “How satisfied are you with how you read?” Treat all the same.
Have the student repeat the information
Use the “teach back” method
Never ask “Do you understand?”
Use models, sketches, pictures, symbols demonstrations
Know what languages and cultures you will encounter in your community-know what resources you will need
Check the reading level of materials you give to students
Develop partnerships between the health and literacy sectors
Work with your schools to get health education into the K—12 curriculum
Use pictures, photos, videos and other visuals—including med charts
Monosyllabic and simple language
Read over the instructions—highlight important parts with color
Lots of white space
Review materials for literacy level—rewrite as necessary, ask students for help
Writing style should be clear, concise, organized,
Assessing level of literature
Most pamphlets at 10-12th grade level
Informed consents at 14.3—16 th grade level
Internet health resources at similar grade levels
Request and respect student’s prior knowledge, opinion and experience
Speaking plainly is as important as writing plainly
Use everyday examples to explain technical or medical terms
Teach in an organized manner
Use the “interactive communication loop”
It is all of these things that have made them what they are and these are the things that you cannot come to know by hearsay; you can only know them if you have lived them.” Somerset Maughan, The Razor’s Edge (Introduction), 1944.
“ …follow the counsel of Aristotle, to speak as the common people do, to think as wise men do; and so should every man understand him, and the judgment of wise men follow him.”— Roger Ascham (1515-1568)