This document outlines an Extension committee's presentation on increasing health literacy through Cooperative Extension programs. It discusses: - Extension's focus on improving population health literacy and addressing social determinants of health. - Definitions of health literacy and challenges like navigating healthcare. - Examples of Extension programs that integrate health literacy, like a program teaching kids about food marketing. - The committee's plans to identify best practices, engage partners, and evaluate programs to further increase health literacy nationwide. - An invitation for attendees to provide input and get involved in future activities and an action team.

1. EXTENSION COMMITTEE ON ORGANIZATION & POLICY
Cooperative Extension’s
National Focus on Health Literacy

2. Presenters
Dr. Sonja Koukel, Chair
New Mexico State University Extension
Dr. Fatemeh Malekian
Southern University
Ag Research & Extension Center, LA

3. Health Extension is an important movement
with the potential to change health
practices in America as we now know it

4. Presentation Outline
• Overview: Extension’s Framework for
Health & Wellness
• Health literacy – Definitions
• Health literacy – Addressing social
determinants of health
• Examples of integrated health literacy
• Be part of the process!
• Action team members

5. Overview
• Extension Committee on
Organization and Policy (ECOP)
– Established Task Force (2012)
– Extension Task Force Report 2014

6. 58%
23%
10%
9%
Chart Title
1st Qtr 2nd Qtr 3rd Qtr 4th Qtr
Based on the Na onal Preven on Strategy Ac on Plan, U.S.
Department of Health & Human Services

11. BAA (Board on Ag Assembly) –
BoHS (Board on Human Sciences)

12. BAA—BoHS Healthy Food Systems, Healthy People Steering Committee
Societies, Families & Individuals Focus Group
Co-chairs: Rick Klemme, University of Wisconsin, and
Celvia Stovall, Alabama A&M University
Action Teams will –
1. Identify research-based programs and curriculum.
2. Identify gaps in knowledge leading to new research questions.
3. Develop new research-based programs and curriculums.
4. Initiate system-wide impact evaluation.
5. Provide professional development on program implementation and
evaluation.
6. Identify and engage existing and new strategic partners.

13. Action Team Charge
Health Literacy Action Team will:
 Invite additional internal and external partners as
needed for maximum effectiveness
 Identify and develop systematic programs and
curriculum
 Engage colleagues in professional development
 Provide assistance with resource development
 Develop and launch system-wide program impact
evaluation

14. Health Literacy - Definitions
When you think of Health Literacy…
What comes to mind?
Please use the chat box
to share your thoughts

15. Literacy Vs Health Literacy
• Literacy and Health Literacy – not the same
• Literacy
– Person’s ability
to read and write
– Basic or fundamental
literacy

16. Literacy Vs Health Literacy
Health literacy represents
the cognitive and social skills
which determine the motivation and
ability of individuals to gain access to,
understand and use information in ways
which promote and maintain good health
~ World Health Organization, 1998

17. Health Literacy - Definitions
The degree to which an individual has
the capacity to obtain, communicate,
process and understand basic
health information and services
to make appropriate health decisions
~Patient Protection and Affordable Care Act of 2010

18. Health Literacy - Definitions
Health literacy goes beyond the individual
It also depends upon
the skills, preferences, and expectations
of health information and care providers:
The doctors, nurses, administrators,
home health workers, the media,
and many others

19. Health Literacy Framework

20. Social Determinates of Health
(SDH)
The social determinants of health (SDH)
are the conditions in which people are born,
grow, work, live, and age, and the wider set of
forces and systems shaping the conditions of daily life
~World Health Organization

21. Social Determinates of Health
(SDH)
POLL
Which of these do you think is the strongest predictor of health?
A. Age
B. Gender
C. Income
D. Literacy skills
E. Education level
F. Community
G. Racial or ethnic group
H. Health and Health care
I. Environment

22. Social Determinates of Health
(SDH)
A. Age
B. Gender
C. Income
D. Literacy skills
E. Education level
F. Community
G. Racial or ethnic group
H. Health and Health care
I. Environment

23. Equality vs Equity

24. At-Risk Audiences
• Older adults
• Racial and ethnic minorities
• Low income levels
• Less than a high school degree
• General Educational Development
(GED) Certifications
• English as a second language (ESL)

25. Health Literacy Challenges
• Public health policy shifts
• Health conditions
• Health disparities
• Economic situation

26. Health Literacy Challenges
• Population change
• Technology
• Inability to understand health information
• Difficulties in navigating the healthcare
environment
• Compromised quality of care when patients’
health literacy is inadequate

27. Health Literacy Assessment
Basic
Below
Basic
Proficient
14%
12%
53%
22%
National Assessment of Adult Literacy (NAAL): National Center for Educational Statistics, U.S. Dept. of Education, 2003.
Intermediate
Average Medicare
n=19,000 U.S. Adults

28. U.S. Adults Proficient
in Health Literacy
12 %

29. Importance
of Health Literacy
Those with limited literacy skills:
• Report poorer overall health
• Less likely to make use of screenings
• Report poorer understanding of how to manage their chronic
diseases
• Have poorer health outcomes
Adapted from: Michael Villaire, MSLM 2010

30. Importance
of Health Literacy
Those with limited literacy skills:
• Less likely to understand their diagnosis
• Less likely to have screening / preventive care
• Less likely to understand the medication labels
• More likely to present in later stages of disease
• More likely to be hospitalized / re-hospitalized
Adapted from: Michael Villaire, MSLM 2010

31. Skills Needed to
Increase Health Literacy
Individuals need knowledge in:
• Accessing health care services
• Reading and understanding information given to them
• Analyzing relative risks and benefits
• Calculating prescription dosages
Adapted from: National Network of Libraries of Medicine

32. Skills Needed to
Increase Health Literacy
Individuals need knowledge in:
• Interpreting and understanding medication labels
• Communicating with health care providers
• Evaluating information for credibility and quality
• Interpreting test results
Adapted from: National Network of Libraries of Medicine

33. What is Known
Low
Health Literacy Skills Contribute To
Higher
Utilization of Health Care Services

34. What is Known
Improving
Health Literacy
can save lives

35. Improving Health Literacy
• Adult educators
• Cooperative Extension Educators
• Community members
• Family & Consumer Sciences Educators
• Healthcare consumers
• Healthcare professionals
• Healthcare / Public Health systems
• Individuals
• Patients / Caregivers
• Pharmaceutical companies
• Public health professionals

36. Examples of
Integrated Health Literacy
• Extension program
– Kid Quest, South Dakota State University
• Targets 5th and 6th grade students
• Classroom or after school settings
• Comprised of eight 30 minute modules
• Selected Module 8: Media Messages
Participants learn about food product advertising and how to
determine fact from fiction while teaming up to “sell” a healthy
product to their age group
Website: www.igrow.org

37. Examples of
Integrated Health Literacy
• Stanford University Chronic Disease Self-
Management Program
– Created to build participants 'confidence in their
ability to mange their health and maintain active
and fulfilling lives
– Subject matter includes appropriate use of
medications
– Offered by Extension, public health, senior
centers, others
http://patienteducation.stanford.edu/programs/cdsmp.html

38. Your Input
Use the chat box to share any resources, programs or curriculum

39. Action Team Activities
• Logic model
• Database
• Gap analysis
• Webinars
• Oral/poster presentations
• Possible publications in peer-reviewed
journals

40. Upcoming Activities
2016 National Health Outreach Conference
Roanoke, VA
April 6-8, 2016
Pre-Conference
A Picture of Health: Assembling the Pieces that Fit
Wednesday April 6, 2016
12:30 to 5:00 PM (CST)
http://www.cpe.vt.edu/2016nhoc/pre-conference.html

41. Upcoming Activities
Concurrent Session
Focus on Health Literacy:
Impacts on Individual and Public Health
Thursday April 7, 2016
2:40 to 3:40 PM (CST)
2016 National Health Outreach Conference
Roanoke, VA
April 6-8, 2016
http://www.cpe.vt.edu/2016nhoc/

42. Be Part of the Process
• Integrate Health Literacy into
existing programs
• Revise existing programs to include
Health Literacy
• Provide resources, programs, curricula
to the Health Literacy Action Team
for use in the national gap analysis
Help Develop the Health Literacy Database

43. We want to hear from you!
~ Thank You ~

44. Action Team Members
Sonja Koukel, Chair, New Mexico State University
sdkoukel@nmsu.edu
Lisa Barlage, Ohio State University
barlage.7@osu.edu
Sarah Bercaw, University of Delaware
sbercau@udel.edu
Nancy Crevier, University of Wisconsin
nancy.crevier@ces.uwex.edu
Jatunn Gibson, Auburn University
jtg0006@auburn.edu
Belinda Letto, University of Tennessee
briddle@utk.edu
Fatemeh Malekian, Southern University Agricultural Research and Extension Center
fatemeh_malekian@suagcenter.com
Cathy Newkirk, Michigan State University
newkirk@anr.msu.edu
Linda Quade, South Dakota State University
Linda.Quade@sdstate.edu