Health literacy implications of the Affordable Care Act – 2010 [US]
This paper, from the Center for Health Care Strategies, is written for organisations and advocacy groups with an interest in health literacy. This paper identifies the direct and indirect links to health literacy within the Affordable Care Act. These provisions fall into six health and healthcare domains including health care workforce training, patient information and quality improvements within the health care system. This paper discusses each link to health literacy in detail.
Let’s Ask 4: Questions for consumers and providers about health insurance – 2013 [US]
The world of health insurance will change on January 1, 2014, when all US residents will be required to have health insurance or pay a penalty. Easy to understand and easy to use tools are needed to provide clear information about how those changes affect consumers and providers. Two such tools are available: (1) slide sets that can be used to provide information for health care providers and students in health professions training and (2) a consumer guide. This Institute of Medicine Roundtable on Health Literacy paper, by Wu et al (2013) summarises key information from these tools that can be used to help start a conversation between providers and consumers about how to get and use health insurance under the Act.
Development and Evaluation of a Hypertension Knowledge Test for Korean Hypertensive Patients
Patients’ knowledge concerning high blood pressure (HBP) is a useful outcome measure in high blood pressure education programs. However, valid and easy-to-use HBP knowledge assessment tools are scarce. The purpose of the study was to validate the HBP Knowledge Test (HKT) in two independent samples of Korean Americans with HBP. Han et al (2011) concluded that the reliability and validity of the HKT was supported in this sample and was also sensitive in detecting differences among persons with and without adequate HBP control.
Comparison of a one-time educational intervention to a teach-to-goal educational intervention for self-management of heart failure: design of a randomized controlled trial
Heart failure (HF) is common, costly and associated with significant morbidity and poor quality of life, particularly for patients with low socioeconomic status. Self-management training has been shown to reduce HF related morbidity and hospitalisation rates, but there is uncertainty about how best to deliver such training and what patients benefit. This study by DeWalt et al (2009) compares a single session self-management HF training program against a multiple session training intervention and examines whether their effects differ by literacy level.
Relationship Between Literacy, Knowledge, Self-Care Behaviors, and Heart Failure-Related Quality of Life Among Patients With Heart Failure
Macabasco-O’Connell et al (2011) sought to examine the relationship between literacy and heart failure related quality of life (HFQOL), and to explore whether literacy related differences in knowledge, self-efficacy and/or self-care behavior explained the relationship. The authors found that low literacy was associated with worse HFQOL and lower heart failure related knowledge, self-efficacy, and self-care behaviors, but differences in knowledge, self-efficacy and self-care did not explain the relationship between low literacy and worse HFQOL.
Low-Literacy Interventions to Promote Discussion of Prostate Cancer: A Randomized Controlled Trial
Professional organisations recommend that physicians discuss prostate cancer with patients to make individual screening decisions. However, few studies have tested strategies to encourage such discussions, particularly among high-risk populations. Kripalani et al (2007) examined the effects of two low-literacy interventions on the frequency of prostate cancer discussion and screening. It was found that two simple low-literacy interventions significantly increased discussion of prostate cancer and prostate specific antigen test orders, but not performance of digital rectal examinations. Both interventions were effective in empowering low-literacy patients to initiate conversations about prostate cancer with their physician.
Active-Learning Strategies to Develop Health Literacy Knowledge and Skills
The objective of this study by Devraj et al (2010) is to implement active-learning exercises in a required pharmacy course and assess their impact on students' knowledge and confidence in identifying and communicating with patients with low health literacy. The authors conclude that the addition of active-learning activities was effective in teaching health literacy concepts to pharmacy students.
Strategies To Improve Communication Between Staff and Patients: Training Program for Pharmacy Staff
This training program from the AHRQ is intended for pharmacy staff members who regularly interact with patients and provide patients with health information. The training program: Introduces pharmacists, pharmacy technicians, and other pharmacy staff to the problem of low health literacy; Identifies implications of the problem; Explains techniques for pharmacy staff members to improve communication with patients who may have limited health literacy skills.
Clinical research in low-literacy populations: using teach-back to assess comprehension of informed consent and privacy information
In this article by Bengtzen et al (2008), the authors examined the independent effect of literacy on subject comprehension, determining whether subjects could correctly teach back eight key concepts on the first attempt. Approximately 40% were able to teach back the eight items initially; those with higher literacy levels did much better. Despite the use of simplified consent procedures, this study found that literacy remains an independent predictor of comprehension.
Ethnic Disparities in CPAP Adherence in New Zealand: Effects of Socioeconomic Status, Health Literacy and Self-Efficacy
This article by Bakker et al (2011) investigates the influence of ethnicity on adherence with continuous positive airway pressure (CPAP) in a sample of New Zealand patients. The authors conclude that there is a discrepancy and that this disparity in CPAP adherence demonstrated between Māori and non-Māori can be explained in part by lower education levels and socioeconomic status.