One Health Literacy: Concepts
and Measurement
Shana Gillette
Assistant Professor in Risk Communication
Dept. of Clinical S...
“The degree to which individuals have
the capacity to obtain, process, and
understand basic health information and
service...
More than one third of adults in the
United States have difficulty with
common health tasks, such as following
directions ...
Low or limited health literacy is linked
with adverse health outcomes such as
poorer self-management, less healthy
behavio...
Health
Outcomes

Health
Literacy

Healthy
Lifestyles &
Environments;
more effective
Health Services
Instruments used to assess health
literacy:
• NAAL (National Assessment of Adult Literacy)
• REALM (Rapid Estimate of Adul...
A Broader Measurement of Health
Literacy—beyond reading and writing
what literacy enables us to do:
(Freebody and Luke 199...
Functional Literacy:
– Reading and writing linked to
everyday tasks
– Most current tools measure some
form of basic/functi...
Interactive Literacy:
• Use social skills to complete interactive
tasks such as:
– Listen to treatment options
– Describe ...
Critical Literacy:
• Reconcile information from different
sources, expert and non-expert
• Reflect on the options availabl...
Expansion of Health Literacy Definition
from:
“The degree to which individuals have
the capacity to obtain, process, and
u...
Expansion of Health Literacy Definition
to:
“Health literacy represents the cognitive
and social skills which determine th...
Causal Pathways: Health Literacy & Outcomes

Paasche-Orlow and Wolf, 2007
American Journal of Health Behavior
Conceptual Framework for Individual Health Literacy
McCormack, 2009 in NAS, 2009
Conceptual Framework for Individual Health Literacy
McCormack, 2009, in NAS 2009
Health
Literacy
Skills

Stimulus

Capabil...
Conceptual Framework for Individual Health Literacy
McCormack, 2009, in NAS 2009
Health
Literacy
Skills

Stimulus

Capabil...
Measuring One Health Literacy:
Measure Progression of Functioning
– From inability to optimal
– Measures of Literacy and S...
Measuring One Health Literacy:
Map Literacy to Identify High Risk Areas
Literacy, quality of care, health outcomes
– When ...
Measuring One Health Literacy:
Incorporate Emerging Media
– Increase immediacy of measurement
– Analyze social dynamics of...
One Health Literacy is at the core of
the health literacy framework

QUESTIONS?
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One Health Literacy: Concepts and Measurement

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GRF 2nd One Health Summit 2013: Presentation by Shana Gililette, Colorado State University

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One Health Literacy: Concepts and Measurement

  1. 1. One Health Literacy: Concepts and Measurement Shana Gillette Assistant Professor in Risk Communication Dept. of Clinical Sciences
  2. 2. “The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” (Ratzan and Parker, 2000)
  3. 3. More than one third of adults in the United States have difficulty with common health tasks, such as following directions on a prescription drug label. (U.S. Department of Health and Human Services 2009)
  4. 4. Low or limited health literacy is linked with adverse health outcomes such as poorer self-management, less healthy behaviors, higher mortality, and overall poorer health. (Piette, Wang, Osmond, Daher, Palacios, Sullivan, & Bindman, 2002; Baker, Gazmararian, Williams, Scott, Parker,Green Wren, & Peel 2004; Baker, Wolf, Fineglass, Thompson, Gazmarian, & Huang 2007)
  5. 5. Health Outcomes Health Literacy Healthy Lifestyles & Environments; more effective Health Services
  6. 6. Instruments used to assess health literacy: • NAAL (National Assessment of Adult Literacy) • REALM (Rapid Estimate of Adult Literacy in Medicine) • TOFHLA (Test of Functional Health Literacy in Adults)
  7. 7. A Broader Measurement of Health Literacy—beyond reading and writing what literacy enables us to do: (Freebody and Luke 1990) – Basic/Functional Literacy – Communicative/Interactive Literacy – Critical Literacy
  8. 8. Functional Literacy: – Reading and writing linked to everyday tasks – Most current tools measure some form of basic/functional literacy
  9. 9. Interactive Literacy: • Use social skills to complete interactive tasks such as: – Listen to treatment options – Describe symptoms – Make an appointment
  10. 10. Critical Literacy: • Reconcile information from different sources, expert and non-expert • Reflect on the options available • Take action on a decision based on critical reflection
  11. 11. Expansion of Health Literacy Definition from: “The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” (Ratzan and Parker, 2000)
  12. 12. Expansion of Health Literacy Definition to: “Health literacy represents the cognitive and social skills which determine the motivation and ability of people to gain access to, understand, and use information in ways that promote and maintain good health and are critical to health empowerment.” (Nutbeam on WHO, 1998)
  13. 13. Causal Pathways: Health Literacy & Outcomes Paasche-Orlow and Wolf, 2007 American Journal of Health Behavior
  14. 14. Conceptual Framework for Individual Health Literacy McCormack, 2009 in NAS, 2009
  15. 15. Conceptual Framework for Individual Health Literacy McCormack, 2009, in NAS 2009 Health Literacy Skills Stimulus Capabilities
  16. 16. Conceptual Framework for Individual Health Literacy McCormack, 2009, in NAS 2009 Health Literacy Skills Stimulus Capabilities Shared Health
  17. 17. Measuring One Health Literacy: Measure Progression of Functioning – From inability to optimal – Measures of Literacy and SelfCare • Reduce risk of low literacy increase functioning directly • Apply to a life course model
  18. 18. Measuring One Health Literacy: Map Literacy to Identify High Risk Areas Literacy, quality of care, health outcomes – When is there a negative effect? – Can there be a protective effect? – How do they interact?
  19. 19. Measuring One Health Literacy: Incorporate Emerging Media – Increase immediacy of measurement – Analyze social dynamics of literacy – Analyze cultural dynamics of literacy
  20. 20. One Health Literacy is at the core of the health literacy framework QUESTIONS?

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