advancing clear health communication to positively impact health outcomes

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Advancing Clear Health Communication to Positively Impact Health Outcomes. The Problem: Low Health Literacy – Scope and Impact Finding a Solution The Partnership for Clear Health Communication Ask Me 3 How to Become Involved: Solutions into Action. Presentation Sections. - PowerPoint PPT Presentation

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  • Advancing Clear Health Communication to Positively Impact Health Outcomes

  • Presentation SectionsThe Problem: Low Health Literacy Scope and ImpactFinding a SolutionThe Partnership for Clear Health CommunicationAsk Me 3How to Become Involved: Solutions into Action

  • The Problem:Low Health LiteracyScope and Impact

  • Do You Know Which Critical Public Health IssueImpacts nearly one in every three people living in the United StatesCan hit any population segment, regardless of age, race, education or incomeCosts the healthcare system as much as $58 billion a yearCant be diagnosed by any new medical technology and is not visible to the eye

  • The Issue: Low Health LiteracyWhat is health literacy? The ability to read, understand and act on health information

  • How Big Is the Problem?Approximately 40 to 44 Million Adults in the US Are Functionally Illiterate1Approximately 50 Million Are Marginally Illiterate1Average Reading Skills of Adults in the US Are Between the 8th and 9th Grade Levels2More Than 90 Million People in the US Have Difficulty ReadingSources:1 Kirsch et al., A First Look at the Results of the National Adult Literacy Survey Natl Center for Education Statistics, 19932 Stedman L, Kaestle C. Literacy and Reading Performance in the US From 1880 to Present. In: Kaestle C, Editor. Literacy in the US: Readers and Reading Since 1880. New Haven (CT): Yale University Press; 1991. P. 75128

  • Reading Levels & Skills0-56-910-16+

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    Reading Grade Level

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    % of US Population

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    Reading Grade Level

    % of US Population

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    Levels

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    % of US Population

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  • How Does Low Health Literacy Affect Your Practice?

    Chances are high that some of your patients are among the 90 million who have low health literacy

    You may not know that patients with poor health literacy skills are in your care:They use well-practiced coping mechanisms that effectively mask their problemThey are often ashamed to admit they have difficulty understanding information and instructions

  • Defining the Problem ScopeCoping Mechanisms for Patients With Low Literacy 98%Bring Someone Who Can ReadWatch and Copy Others ActionsAsk for Help From Medical StaffAsk Other Patients90%80%88%Source: Parikh et al., 1996

  • Who Is at Risk for Low Health Literacy?Anyone in the US regardless of age, race, education, income or social class can be at risk for low health literacy Ethnic minority groups are disproportionately affected by low health literacyThe majority of people with low literacy skills in the US are white, native-born AmericansOlder patients, recent immigrants, people with chronic diseases and those with low socioeconomic status are especially vulnerable to low health literacy

  • Low Health Literacy Impacts a Patients Ability to Fully Engage in the Healthcare SystemThe Largest Study Conducted to Date on Health Literacy Found ThatSource: Williams MV, Parker RM, Baker DW, et al. Inadequate Functional Health Literacy Among Patients at Two Public Hospitals. JAMA 1995 Dec 6; 274(21):1,6778233%Were unable to read basic health care materials42%Could not comprehend directions for taking medication on an empty stomach26%Were unable to understand information on an appointment slip43%Did not understand the rights and responsibilities section of a Medicaid application60%Did not understand a standard informed consent

  • Low Health Literacy Negatively Impacts Health Outcomes Adults with low health literacy:Are often less likely to comply with prescribed treatment and self-care regimens1Make more medication or treatment errors1Fail to seek preventive care1Are at a higher risk for hospitalization than people with adequate literacy skills2Remain in hospital nearly 2 days longer3Lack the skills needed to negotiate the health care system1People with low health literacy AND diabetes: Were found to be less likely to have effective glycemic control4Were more likely to report vision problems caused by their diabetes41 Weiss, BD. 20 Common Problems in Primary Care. McGraw Hill. December 19992 Baker DW, Parker RM, Williams MV, Clark WS. Health Literacy and the Risk of Hospital Admission. Journal of General Internal Medicine. 1998; (13): 791-798.3 Kirsch IS, Jugebut A, Jenkins L, Kolstad A. Adult Literacy in America: A First Look at the Results of the National Adult Literacy Survey. Washington, DC: Department of Education 1993. 4 Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, Palacios J, Sullivan GD, Bindman AB. Association of Health Literacy With Diabetes Outcomes. JAMA. July 24/31 2002 (288) No 4.

  • Low Health Literacy Impacts Resource Utilization Adults with low literacy:Averaged 6% more hospital visits1*Stayed in the hospital nearly 2 days longer than adults with higher literacy skills1*Had fewer doctor visits, but used significantly more hospital resources2Had annual health care costs 4 times higher than those with higher health literacy3Among adults who stayed overnight in a hospital1Kirsch IS, Jugebut A, Jenkins L, Kolstad A. Adult Literacy in America: A First Look at the Results of the National Adult Literacy Survey. Washington, DC: Department of Education 1993. 2Baker DW, Parker RM, Williams MV, Clark WS. Health Literacy and the Risk of Hospital Admission. Journal of General Internal Medicine. 1998; (13): 791-798.3Weiss, BD. 20 Common Problems in Primary Care. McGraw Hill. December 1999.

  • Implications of Low Health LiteracyPoor Health OutcomesUnder-utilization of preventive servicesOver-utilization of health servicesUnnecessary health care expendituresLimited effectiveness of treatmentNeedless patient sufferingHigher patient dissatisfactionHigher provider frustration

  • You Cant Tell By Looking

  • Finding a Solution

  • Solutions: Focus on Care Providers and MaterialsDifferences between good and poor readersand how you can manage problems

    SKILLED READERSPOOR READERSMANAGING THE PROBLEMSInterpret meaningRead with fluencyGet help for uncommon wordsGrasp the contextPersistent readerTake words literallyRead slowly, miss meaningSkip over the wordMiss the contextTire quicklyExplain the meaningUse common words, examplesUse examples, reviewTell context first, use visualsShort segments, easy layout

  • The Patient-Provider Relationship70% of physicians say they provide patients with additional resources to help them understand their medications75% of physicians report patients have trouble understanding Rx informationThere Is a Disconnect Between Patient and Provider: Bridging the Information Gap Will Help Improve Health LiteracySource: Health Literacy & The Prescription Drug Experience: The Front Line Perspective From Patients, Physicians and Pharmacists, Roper ASW, May 2002

  • Why is this?Short-term memory has very limited capacity and short storage timeMost people can store 7 or fewer independent items at one timeThis memory lasts less than 1 minuteShort-term memoryLong-term memoryLong-term memory lasts for days and yearsLong-term memory has no practical capacity limitsTo move into long-term memory, use association and interaction

  • Getting Into Long-term MemoryGain the patients attentionPresent no more than seven items at a timeGet to the pointShort-term memoryLong-term memoryAssociate new information with what patient already knowsInvolve the patient in interaction with the informationRepeat or review

  • Written Communication87% report reading Rx informationYet only 34% believe others read this same informationWhat Do We Do?Develop Written Materials at 6th Grade or Below, Where 160MM Can Understand and ActWrittenMaking Health Information UnderstandableSource: Health Literacy & The Prescription Drug Experience: The Front Line Perspective From Patients, Physicians and Pharmacists, Roper ASW, May 200250% of adults read at below 8th grade reading levels20% of adults read at below 5th grade reading levels40% of seniors read at below 5th grade reading levelsConsumer healthcare materials written at 10th grade or above, where only 50MM can understand and act

  • What You Need to Know About Low Blood SugarTreat low blood sugar quickly. If you have signs of low blood sugar, eat or drink something that has sugar in it. Some things you can eat are hard candy, sugar-sweetened soda, orange juice, or a glass of milk. Special tablets or gel made of glucose (a form of sugar) can be used to treat low blood sugar. You can buy these in a drug store. Always have some of these items handy at home or with you when you go out in case your blood sugar drops too low. After treating a low blood sugar reaction, eat a small snack like half a sandwich, a glass of milk, or some crackers if your next meal is more than 30 minutes away. Source: The National Institute of Diabetes and Digestive and Kidney DiseasesExample of Health Communication That May Not Reach a Broad Consumer Audience70150Blood Sugar Is Too Low if It Is Under 70Blood Sugar Is Too High if It Is Over 240Good RangeToo HighToo Low9th Grade Reading Level

  • Example of Clear Health Commun

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