By: Desiree M. Sebastian, RN BSN
O 1) To develop awareness of how low
literacy impacts health literacy
O 2) To develop awareness of how health
literacy affects health outcomes
O 3) Recognize those at risk for low health
O 4) Identify strategies to improve health
literacy in personal practice
IOM Health Literacy Video
Uploaded on Jun 29, 2007
This video provides an overview of the findings from
the 2003 IOM report on health literacy.
What is Literacy?
O Pre-Civil War: Read and write own name
O 1940‟s (WWII era): Read at 4th grade
O 1960‟s: Completed 8th grade
O National Adult Literacy Survey 2002:
... “The ability to use printed and written
information to function in society, to achieve
one‟s goals, and to develop one‟s
knowledge and potential.”
(Kirsh, Jungeblut, Jenkins, &
Kolstad, 2002, p. 2).
What is Health Literacy?
O IOM, The Agency for Healthcare Research
... “The degree to which individuals have the
capacity to obtain, process, and understand
basic health information and services
needed to make appropriate decisions
regarding their health.” AHRQ (2007).
How does Low Literacy Impact
O Most health materials are written at the
10th grade level or higher
O IOM---Health Literacy
Half of all adults in the US have difficulty
understanding and using health information
Populations at Risk
O Older adults
O Less than HS education/GED certification
O Racial or ethnic minorities
O Low income status
O People with compromised health status
O English as second language
Impact of Low Health Literacy
on Health Outcomes
O More likely to say they have poor health
O Less use of preventative services
O Higher incidence of chronic conditions
O Higher rate of ED visits and
O Higher healthcare costs
How Can You Assess for Low
O Literacy Assessment Tools
O REALM (Rapid Estimate of Adult Literacy
in Medicine) AHRQ (2009).
O TOFHLA (Test of Functional Health
Literacy in Adults) Peppercorn (2013).
How can HCP improve Health
O Be more aware of potential for low literacy
O Review „Social History‟ in chart
O Ask how they prefer to receive information
O Watch for “Red Flags”
O I forgot my glasses
O I’ll bring this home and discuss with family
O I don’t feel well
O I don’t have time today
More “Red Flags”
O Incomplete registration forms
O Frequently missed appointments
O Lack of follow through for tests or referrals
O DM related
O INR Levels
O Encourage questions
O SLOW DOWN
O Address patient concerns
O Use analogies
O “Arthritis is like a creaky hinge on a door”
O Use plain language
O “Pain killer” instead of “analgesic”
O Use teach-back techniques
AHRQ. (2007). Health Literacy: Program Brief. Agency for Healthcare
Research and Quality. Rockville, MD.
AHRQ. (2009). Health Literacy Measurement Tools: Fact Sheet. Agency for
Healthcare Research and Quality. Rockville, MD.
Kirsh, Debora (2013). Helping Your Patient‟s Understand. Power Point
Presentation. SUNY Upstate College of Nursing.
Kirsh, I. S., Jungeblut, A., Jenkins, L.,Kolstad, A. (2002). Adult Literacy in
America. A First Look at the Findings of the National Adult Literacy
Survey. (3rd ed.). Washington, D.C.: Department of Education.
Peppercorn. (2013). TOHFLA Teaching Version. Peppercorn Books.
O As you watch the video, pay attention to the
patient incidents presented.
O After video, we will break up into 4 groups.
O Each group will have 10 minutes to:
Discuss incident presented
O Identify problem in the system that allowed
incident to occur
O Develop plan to correct identified problem in
order to prevent future reoccurrence of incident.
O Each Group will present problem and possible
solution as determined by the group.