“Keep it simple”: older African Americans’ preferences for a health literacy intervention in HIV management – 2015 [US]
This study explored the preferences of older African Americans with HIV for a health literacy intervention to promote HIV management. Using patient-centred participatory design methods, semi-structured individual interviews were conducted to determine patient preferences for intervention development and design. Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine - Revised (REALM-R). The researchers found that nearly half of the participants had limited health literacy. Four key themes emerged from the interviews. Patients expressed the need to keep health information simple, jargon free and to limit the amount of information given in one session. Patients preferred a team-based approach to health education. Previous research has shown that using medical experts and peer educators with "lived experience" of a condition can increase patient engagement and further improve overall outcomes. Patients expressed a desire to use technology to help self-manage their conditions. Interventions may need to account for digital and eHealth literacy needs. Tailoring teaching strategies to patients' individual needs was a frequent theme. To maximise patient health outcomes and ensure the long term success and sustainability of programs, the researchers recommend that culture, age, gender, mental health and health literacy levels need to be considered when designing educational interventions.
Conceptualising patient empowerment: a mixed methods study – 2015 [UK]
Interventions and health policy programmes have been established to promote patient empowerment, with a particular focus on patients affected by long-term conditions (LTC) in primary care. However, a clear definition of patient empowerment is lacking, making it difficult to assess effectiveness of interventions designed to promote it. The aim in this mixed methods study was to develop a conceptual map of patient empowerment, including components of patient empowerment and relationships with other constructs such as health literacy, self-management and shared decision-making. A literature review and qualitative interviews with stakeholders were used to inform the development of the concept map. The review identified three levels of principles underpinning patient empowerment: the patient level, healthcare provider level, and the healthcare system level. Each level has responsibilities to support patients with LTC to self-manage their condition by optimising healthcare services. Nutbeam's model of health literacy was included as one indicator of patient empowerment because patients need to be able to understand medical information in order to contribute to shared decision-making and manage their own LTC. The researchers suggest that training interventions for healthcare providers and patients may be effective tools for developing patient empowerment. Communication, motivation and counselling skills were recommended for health care providers. Training in finding and evaluating health information on the Internet were recommended for patients.
Relationship among patients’ perceived capacity for communication, health literacy, and diabetes self-care – 2014 [US]
The mechanisms underlying the relations among health literacy, perceived capacity for communication, diabetes knowledge, and diabetes self-care are unclear. This study, by Leung et al (2014), tested this relation using structural equation modeling with a sample of 137 Chinese patients 65 years of age or older with type 2 diabetes. The model showed that health literacy, knowledge, communication capacity, and diabetes self-care formed complex relations. The researchers concluded that to enhance self-care, interventions should be tailored to increase patient health literacy and perceived capacity for communication with health care providers. Training should be provided to patients to enhance their communication abilities.
A health literacy fable for tomorrow: help the world be healthy with health literacy. Discussion paper – 2014 [US]
This discussion paper (3 pages), by Andrew Pleasant, was written for the Institute of Medicine's Roundtable on Health Literacy. In this paper the author tells the story of an American town that lost health literacy and the health care system went from an emphasis on health care to sick care. The author argues that health literacy can create a path to a happy, healthy future in which good health is not only a human right but also well within everyone’s reach.
I Want to Walk with my Moko: Preventing Type 2 Diabetes – 2013 [NZ]
In New Zealand Type 2 diabetes is almost three times more common in Maori than non-Maori. Maori are diagnosed younger and are more likely to develop complications such as eye disease, kidney failure, stroke and heart disease. This documentary (23 minutes), from Alison Clark (University of Canterbury PhD candidate), focuses on some simple steps you can take to prevent Type 2 diabetes from affecting your whanau. It features real people making positive and realistic changes by eating good kai (food) and keeping active. This video resource is highly recommended for anyone teaching health and life skills in adult and youth education courses. The people featured discuss their real life experiences with diabetes and demonstrate cheap and easy strategies to improve health outcomes.
Health Literacy Action: Toolkit for Patient Educators – 2010 [US]
This toolkit, from the Cancer Patient Education Network, aims to help patient educators and health care providers promote understanding and awareness of health literacy within their organisations. The toolkit provides links to resources under the following topics: create awareness, provide health professional training, get patients involved, alternate document design, and committee member resource suggestions.
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.