Promoting Health Literacy with inmates #priesterhealth 2013

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Promoting Health Literacy with inmates #priesterhealth 2013

  1. 1. Promoting Health Literacy andSelf-Care Management withInmatesD. Young, C. Weinert, G. Kouame, J. Keery& I. FryeCollege of Nursing, Gallatin County DetentionCenter & National Network of Libraries ofMedicinedyoung@montana.edu
  2. 2. Bozeman, Montana
  3. 3. Gallatin County Detention Center
  4. 4. Definition of Health Literacy“The degree to which individuals have thecapacity to obtain, communicate, process, andunderstand basic health information andservices needed to make appropriate healthdecisions.”- Affordable Care Act (ACA)
  5. 5. What is the Greatest Predictor ofHealth Outcomes?• Age• Race• Income• Education• Employment• Health literacy
  6. 6. Why Promote Health Literacy?• Nearly 9 out of 10 adults have difficulty usingeveryday health information• Health literacy is the #1 predictor of healthoutcomes• Inmates have high incidence of chronic healthconditions (80-90% vs 50% for all US)• Chronic health conditions account for 75% ofall health care expenditures and 70% of alldeaths
  7. 7. Poor Health Literacy Leads to:• Lower use of preventive care services• Greater use of emergency care• Frequent hospitalizations• Poor self-care management• Unhealthy behaviors• Poor health outcomes & premature deaths• Higher health care costs (loss of $238billion/yr)
  8. 8. Why Inmates & Health Literacy?• Poor health literacy = poor health outcomes• Low literacy levels• High incidence of chronic health conditions• Poor self-care management• 9 out of 10 have no health insurance• Frequent users of high cost emergencyservices upon release
  9. 9. Why Inmates & Health Literacy?
  10. 10. Inmates Have High Incidence ofChronic Health Conditions• Asthma• Hypertension• Tuberculosis• Diabetes• Hepatitis• HIV/AIDS• Substance Abuse & Mental Health Issues
  11. 11. Inmates Have High Mortality RatesAfter Release• Drug overdose• Cardiovascular disease• Homicide• Suicide• Cancer• Liver disease• HIV
  12. 12. Goal of the ProjectTo improve the health literacy, self-caremanagement skills and personal health caredecision-making of inmates incarcerated inthe county jail
  13. 13. Objectives of the Project• To enhance the capacity of inmates in theirunderstanding of locating, evaluating andusing basic health information• To motivate inmates to take moreresponsibility for their own health care• To increase the inmate’s understanding of theimportance in seeking assistance from locallibrarians after release
  14. 14. Experimental Design• Target Population – adult men scheduled to behoused in the jail more than 21 days• Timetable – 10 weekly sessions, seven inmatesper session, involving a total of 70 inmates• Class Format –– Six handouts provided on day one– Instructed classes 2.5 hrs/day – M, W, F– Self study classes 2 hrs/day – T & Th
  15. 15. What was the Biggest Challenge?
  16. 16. Constructing a Health InformationInternet-in-a-Box Offline System• MedlinePlus• Understanding Medical Words: A Tutorialfrom the National Library of Medicine• USDA SuperTracker• Plain Language Medical Dictionary• 12 Power Point Presentation• 42 videos
  17. 17. Internet-in-a-Box Offline System
  18. 18. 12 PPT Presentations on the CD• Computer Basics• What is Health Literacy?• My Health Companion © & Other Resources• Advocacy and Self-Care• Prevention and Screening• Sexually Transmitted & Infectious Diseases
  19. 19. 12 PPT Presentations (con’t)• Tobacco Epidemic• Mental Illness• The Science of Addiction• Nutrition• Oral Health• Library Resources
  20. 20. Experimental Design• Project announced to inmates• Participating inmates selected• Informed Consent forms signed• Pre-Survey Questionnaires filled out
  21. 21. Experimental Design (con’t)• Six Handouts:– My Health Companion ©– Staying Healthy Student Resource Book– Coping with Stress Student Book– Talking with Your Doctor– Seeking Drug Abuse Treatment: Know What toAsk– the List – Community Resources for GallatinCounty
  22. 22. General Population Pod
  23. 23. Inmate Meeting Room
  24. 24. Results• 55 participants recruited• 39 completed all class session and pre-andpost-surveys• Age range – 19-69 (mean of 35.4 years)• Marital status– 13 % married– 41 % divorced– 39 % never married– 7 % other (2 % widowed; 5 % common law)
  25. 25. Results (con’t)• Likelihood to use handout materials:– “the List” – 49 %– Seeking Drug Abuse Treatment - 44 %– Coping with Stress – 44 %– Talking with your Doctor – 36 %– Staying Healthy – 33 %– My Health Companion © – 29 %• Strengths and Weaknesses• Other Comments
  26. 26. Results (con’t)• Unfortunately with the small number of 39,we cannot say anything definite about theoutcomes• There was a noted increase in confidence inseeking health care and understanding thehealth care system• There was a noted increase in knowledge ofusing My Health Companion © & StayingHealthy
  27. 27. Local Key Collaborators• Gallatin County Detention Center (County Jail)• Montana State University (Extension, Collegeof Nursing, & Library)• Gallatin City-County Health Department• Gallatin Mental Health Center• Bozeman Public Library• Healthy Roads Media
  28. 28. National Key Contributors• National Network of Libraries of Medicine,Pacific Northwest Region, Uof WA• National Library of Medicine, NIH, DHHS– MedlinePlus– Understanding Medical Words• United States Department of Agriculture– SuperTracker• Taubman Health Sciences Library, Universityof Michigan– Plain Language Medical Dictionary
  29. 29. The Future of ACA and Inmates
  30. 30. Who’s Eligible for ACA HealthInsurance Marketplaces?• The only requirements to get insurance throughthe Marketplace are:– You must live in the U.S.– You must be a U.S. citizen or national (or lawfullypresent)– You can’t be currently incarceratedhttp://www.healthcare.gov/marketplace/about/eligibility/
  31. 31. ACA Ten Essential Health Benefits• Ambulatory patient services• Emergency services• Hospitalization• Maternity and newborn care• Mental health and substance use disorder services• Prescription drugs• Rehabilitative and habilitative services and devices• Laboratory services• Preventive and wellness services and chronic diseasemanagement• Pediatric services, including oral and vision care
  32. 32. Q & A Time
  33. 33. Contact Information• David Young• Extension/College of Nursing• P.O. Box 172230• Bozeman, MT 59717-2230• E-mail: dyoung@montana.edu• Phone: (406) 994-5552

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