Health Literacy

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Health Literacy

  1. 1. Literacy The Effects To Physical and Mental Health Presented by Caroline R. Colbert, M.Ed., CHES
  2. 2. National Surveys of Adult Literacy • NALS: National Adult Literacy Survey done in 1992 and 2003 • IALS: International Adult Literacy Survey 1992 NALS
  3. 3. International Adult Literacy Survey • American adults score at an average level of literacy performance when compared with adults in other industrialized countries Higher About the same Lower Finland Canada United Kingdom Norway Germany Ireland Sweden Australia Switzerland Netherlands Italy
  4. 4. 2003 Results Level % Millions Grade Level Below Basic 14 30 6th grade or lower Basic 29 63 8th grade Intermediate 44 95 High School Proficient 13 28 College but not graduate level • No real change in numbers or levels between 1992 and 2003 • 1992 study had 5 levels, 2003 study had only 4 levels
  5. 5. Literacy and Health • Report poorer overall health • Are less likely to make use of screenings • Present in later stages of disease • Are more likely to be hospitalized • Have poorer understanding of treatment • Have lower adherence to medical regimens
  6. 6. Education and Health • Mothers with more education are more likely to have received early prenatal care. • Mothers with fewer then 12 years education are 10 X more likely to smoke during pregnancy. • Death rates for chronic disease, communicable disease, and injuries are inversely related to education.
  7. 7. Health Literacy: Definition The ability of individuals to obtain, interpret and understand basic health information and services; AND Use such information and services in ways that enhance health.
  8. 8. So…. A health literate person is able to use health concepts and material including applying information to novel situations. A health literate person is able to participate in the ongoing public and private dialogues about health, medicine, scientific knowledge and cultural beliefs.
  9. 9. Mental Health Literacy is: • an individual’s knowledge and beliefs about mental illness, • poor mental health literacy often represents a powerful barrier to treatment – most members of the public cannot accurately label common mental disorders – inadequate knowledge is associated with delays in treatment seeking, decreased levels of treatment seeking, and utilization of non-optimal treatments – associated with the belief that one should be able to solve emotional problems alone or that such problems will disappear without treatment Addressing Patient Needs: The Role of Mental Health Literacy MEREDITH E. COLES, Ph.D., SHANNON COLEMAN, M.A. Binghamton, N.Y., and RICHARD G. HEIMBERG, Ph.D.
  10. 10. Cost of Low Health Literacy $73 Billion Annually Source Friedland, Georgetown University, 2003.
  11. 11. The Impact • Filling out forms at hospital or doctor’s office • Completing insurance paperwork • Reading & acting on prescription labels • Reading & understanding directions given by doctor • Accessing information • Recognizing cues to action • Accessing care & navigating institutions • Following health care regimes • Understanding health promotion/disease prevention materials
  12. 12. How patients hide illiteracy • “I forgot my glasses.” • “I don’t need to read this now; I’ll read it when I get home.” • “I’d like to discuss this with my family.” • “I have a headache now and can’t focus.” • “I’ll just take this with me and read it later.”
  13. 13. Video
  14. 14. So what is being done? • Writing material at a 6th or lower grade level. Federal government requires information for the Medicaid population be at a 5th grade. • Evaluating health material for literacy and cultural competency. • Training staff about health literacy. • Evaluate the materials that we are using and giving to: – Parents – Students
  15. 15. Effective Health Material • Use plain language and vocabulary • Acknowledge and honor the beliefs, values, and practices of the intended audience • Respect the emotional and personal needs of the reader • Is positive and accurate
  16. 16. Exercise • What does this say? • Can we say it easier?
  17. 17. Tools that help: • Testing Readability • Guidelines for evaluation
  18. 18. Two Readability Tests A B C D E Readability choice of number of words per syllables per grade level Formula text to measure words sentence 100 words calculation Three 100 word Count each Divide the # Count # of .4(C) + 12 (d) samples selected word. Number of sentences syllables per -- 16 = Flesch - from beginning, and symbols by the # of text selection grade level* Kincaid middle, and end are considered words of text words Three 100 word Divide the Sum of the Plot the answer samples selected total # of syllables in to C and D on Fry from beginning, sentences by all 3 passages; the Fry middle, and end 3 then divide by Readability of text 3 Graph** * alternative formula is Grade Level = .39(C) + 11.8 (D) -15.59 ** +0.865 added as an adjustment to the grade level factor Componets
  19. 19. Fry Readability Formula - extended* A. Choose three 100 word passages B. Count the total number of sentences in the passages ______ C. Find the average number of sentences per passage (B/3) _____ D. Count the total number of syllables in passages ______ E. Find the average number of syllables per passage ______ F. Plot the average on the graph * Reproduction Permitted - No Copyright. Zalaku, B. & Sammuels, S. (1988) Readability, its past, present & future. Newark, DL: International Reading Association
  20. 20. Readability on your computer • Microsoft Word has the ability to do a quick check of readability each time you do a document • Here is how it is done: – Open a word document – Tools – Options – Spelling & Grammar √ Show Readability Statistics
  21. 21. Printed Material • Spacing • Color and Fonts • Pictures • Watermarks
  22. 22. Use Illustrations/ Graphs Appropriately* • Use illustrations to help explain your text • Use simple line drawings • Illustrate the correct way to do things, not the wrong way • Avoid non-human cartoon figures • Show as much of the human body as you can • Avoid abstract graphs or charts *Szudy, E. & Arroyo, M. (1994) The right to understand: Linking literacy to health and safety training. Berkeley, CA: University of California, Berkeley.
  23. 23. Use Simple Line Drawings Colbert, C. (1996) Readability Study of Bloodborne Pathogens Material. University Park, PA: Penn State University
  24. 24. Show as much of the body as you can *Szudy, E. & Arroyo, M. (1994) The right to understand: Linking literacy to health and safety training. Berkeley, CA: University of California, Berkeley.
  25. 25. Use of fonts and spacing Literacy is an important and well-known correlate of health status and health-promoting behaviors in nonindust r ial ized nat ions. Despit e t his, research on the relationship between l it er a cy a n d h ea l t h in in d u st r ia l ized c o u n t r ies h as been l i m i t ed by difficulties in disentangling complex factors that covary with literacy. These factors include education level, socialeconomic and other demographic factors, self-efficacy, and cultural background. Several recent studies, however, indicate that even after adjusting for these convariables, literacy is related to multiple aspects of health status, and use of health services. For example, a study in general medical clinics at 2 public hospitals evaluated 402 patients with hypertension and 114 with diabetes mellitus and found patients’ functional health literacy strongly correlated with knowledge of their illness.' Note: Sometimes we use different fonts to make things “exciting” for the reader and to give a different look – the problem is that they may be difficult to people with visual or disabilities to read. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association (1999). “Health Literacy Report of the Council on Scientific Affairs. JAMA (281) 6. NOTE: Sometimes we use different fonts to make things “exciting” for the reader and to give a different look—the problem is that they may be difficult to people with visual or disabilities to read. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association (1999). “Health Literacy Report of the Council on Scientific Affairs. JAMA (281)6.
  26. 26. Literacy in the United States has been defined as “an individual’s ability to read, write, and speak in English, and compute and solve problems at levels of proficiency necessary to function on the job and in society, to achieve one’s goals, and develop one’s knowledge and potential.” The 1992 National Adult Literacy Survey, the most accurate portrait of English-language literacy in the United States, found that 40 to 44 million Americans, or approximately one quarter of the US population, are functionally illiterate, and another 50 million have marginal literacy skills. This means that almost half of our adult population has deficiencies in reading or computational skills.....' NOTE: It is difficult for some to read information that is over a watermark or picture – they wonder which is more important. Use of watermarks or pictures behind words
  27. 27. Another Exercise • Evaluate a brochure
  28. 28. So what can we do at ViaQuest? • Brainstorming Time – For our students – For our parents – For ourselves

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