Cynthia Baur, Ph.D. Senior Advisor, Health Literacy
August 23, 2011
The National Action Plan
to Improve Health Literacy
Office of the Director
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Key Messages
Government agencies, foundations, and research universities should prioritize funding for qualitative and quantitative studies related to health literacy improvement.
Goal 6, National Action Plan
Funders play a critical role in the dissemination and use of research findings.
Goal 7, National Action Plan
What is the Gap?
Health Literacy: Hearing the voices of people on the receiving end of our communication
What is a 2 times greater risk for pneumonia if I don’t get a flu shot?
Greater than what?
What do these survival rates mean for me?
80% 8 of 10 women?
80 of 100? .8?
Is one better than the other?
What is Health Literacy? Obtain Process Understand Decide
Sources: National Library of Medicine, Healthy People
Health Information and Services
How is Health Literacy Different
from General Literacy?
Builds on literacy skills BUT ALSO
Cultural and contextual factors
Beliefs, experience and preferencesTopic area and conceptual knowledge,
such as knowledge of the body and how it works terms for specific health conditions scientific results and risk
Institute of Medicine Report
on Health Literacy• Limited health literacy is a major public
health issue• Interaction of individual skills and social
complexity creates health literacy problems• Professionals need health literacy training
Health Literacy Dynamic
Literacy in AmericaNational Assessment of Adult Literacy
(NAAL)
National sample survey conducted in 1992 and 2003
Performed by U.S. Department of Education,National Center for Health Statistics
In-person interviews with Americans age 16 and older (N~19,000) Tested in English or alternate short test in Spanish
Over sampling of Blacks and Hispanics
http://nces.ed.gov/naal/
NAAL Domains Emphasized the use of printed everyday
materials (newspapers, prescriptions, bills) needed to function
153 items that assessed prose, document, or quantitative literacy
Most items required searching text for specific information, short written responses
http://nces.ed.gov/naal/
Prose Document Quantitative
Categories and Sample Health Tasks
Proficient Proficient – Calculate employee’s share of health insurance costs for a year
IntermediateIntermediate – Determine healthy weight range; medication timing
BasicBasic – Explain why it is difficult to know if they have a specific chronic condition
Below BasicBelow Basic – Identify what is permissible to drink before a medical test
http://nces.ed.gov/naal/
Results from the NAAL
Kutner et al. National Assessment of Adult Literacy, 2006
Intermediate
Basic
Below Basic
Proficient
13%
12%
53%
22%
77 Million Adults have Basic or Below Basic Health Literacy
Health Literacy by Age
Kutner et al. National Assessment of Adult Literacy, 2006
59%
Health Literacy by Race/Ethnicity
Kutner et al. National Assessment of Adult Literacy, 2006
28%
66%
58%
Health Literacy by Education
Kutner et al. National Assessment of Adult Literacy, 2006
76%
44%
13%
11%
Outcomes Associated with Limited Health Literacy
Health outcomes Taking medications appropriately Interpreting labels and health messages Seniors’ health status and quality of life Mortality
Health services Hospitalization Emergency care visit Flu immunization
Knowledge and comprehension
Berkman et al 2011 Health Literacy Interventions and Outcomes :An Updated Systematic Review
Why A National Action Plan?
What is the Plan?
Seven Goal Areas
Health information creation and dissemination
Healthcare services
Early childhood-university education
Community-based services
Partnership and collaboration
Research and evaluation
Dissemination of evidence-based practice
HHS Health Literacy Research
NIH/AHRQ Understanding and Promoting Health Literacy Program Announcement (PAR-10-133) R01, R03 and R21 NIH: 85 grants totaling $67 million (2004-2011) http://obssr.od.nih.gov/scientific_areas/
social_culture_factors_in_health/health_literacy/index.aspx Additional research under other Funding
Opportunity Announcements and contracts NIH/AHRQ support of annual research
conference http://www.bumc.bu.edu/healthliteracyconference/
Ideas for research and intervention topics
NIH/AHRQ Program Announcement National Action Plan Goals Research presented at annual conference AHRQ systematic review
http://www.ahrq.gov/clinic/tp/lituptp.htm Evaluation of tools
Organizational audits Universal precautions in clear communication Clear communication training Standards
Call to Action
The National Action Plan to Improve Health
Literacy challenges individuals, organizations
and communities to fulfill their responsibility
to make
health information and services
ACCURATE, ACCESSIBLE AND ACTIONABLE
A Challenge Is your foundation using its resources to
improve health literacy OR perpetuate and create health literacy
barriers?
For more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: [email protected] Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
What questions do you have?
www.cdc.gov/healthliteracyhttp://blogs.cdc.gov/healthliteracy/
Office of the Director
Office of the Associate Director for Communication