Do low-numeracy people avoid shared decision-making? 2011 [Ger]
Doctors have been increasingly encouraged to involve patients in decision making. Galesic and Garcia-Retamero (2011) investigate if low numeracy skills impact patient willingness to participate in shared decision making, are those preferences different in countries with different medical systems, and for different age groups. The authors found that patients with low numeracy preferred to be more passive, high-numeracy patients were happy to be active participants in decision making. On average, Americans were more active than Germans. Middle-aged participants preferred to be more active compared to both younger and older ones. The authors suggest that education efforts to increase numeracy, as well as using non-quantitative communication formats, may foster involvement of low-numeracy patients in decisions about their health.
Numeracy Skill And The Communication, Comprehension, and Use Of Risk-Benefit Information – 2007 [US]
Low numeracy skills, an element of poor health literacy, is associated with the comprehension and use of important health information. In this paper, Peters et al (2007), review the literature on numeracy as a concept, examine why numeric skill is important to health care decisions, what the best practices are for the presentation of numeric health information this literature and what strategies can be used to help less numerate people act more effectively and take charge of their health.
A Proposed ‘Health Literate Care Model’ Would Constitute A Systems Approach To Improving Patients’ Engagement In Care – 2013 [US]
Improving health outcomes relies on patients’ full engagement in prevention, decision-making, and self-management activities. Yet relatively few Americans are proficient in understanding and acting on available health information. Koh et al (2013) propose a Health Literate Care Model that would weave health literacy strategies into the widely adopted Care Model (formerly known as the Chronic Care Model). This model calls for first approaching all patients with the assumption that they are at risk of not understanding their health conditions or how to deal with them, and then subsequently confirming and ensuring patients’ understanding. For health care organisations adopting this model, health literacy would then become an organisational value infused into all aspects of planning and operations, including self-management support, delivery system design, shared decision-making support, clinical information systems to track and plan patient care, and helping patients access community resources. Koh et al also propose a measurement framework to track the impact of the new Health Literate Care Model on patient outcomes and quality of care.
Amplifying the Voice of the Underserved in the Implementation of the Affordable Care Act. Discussion paper – 2013 [US]
In this discussion paper, by Patel et al 2013, was written for the IOM Roundtable on Health Literacy. It addresses the listening to the needs of uninsured patients and the importance of health organisatiions communicating health care messages in ways that are meaningful to these communities. Patel et al stress that although the ACA makes some provisions for helping people choose an insurer, these provisions are not enough to reach those who need help understanding and accessing health insurance. Patel et al propose five strategies for reaching out to, engaging with and empowering underserved communities.
The Impact of Functional Health Literacy and Acculturation on the Oral Health Status of Somali Refugees Living in Massachusetts – 2013 [US]
Geltman et al (2013) assessed the impact of health literacy and acculturation on the oral health status of Somali refugees in Massachusetts. This is one of the few studies looking at the relationship between literacy and health outcomes in refugee populations in the United States. Previous research from Australia indicated that the more integrated a refugee is into the dominant culture, the higher the likelihood that they would become alienated from their traditional culture and adopt a Western diet (without adopting preventative aspects of Western oral health practices). In contrast refugees with a low level of acculturation had better oral health outcomes due to continuing beneficial traditional practices and avoiding a Western diet. In this study, Geltman et al found similar patterns. The oral health of Somalis with low health literacy was initially good but worsened over time in the US as they adopted Western dietary patterns, had less access to preventive care and less utilisation of beneficial oral hygiene practices.
Strategies to Address Low Health Literacy and Numeracy in Diabetes – 2010 [US]
Osborn et al (2010) provide an overview of how low health literacy and numeracy impact on the management of diabetes and patient self-care. Several examples of critical numeracy skills for diabetics are given. The authors highlight communication strategies that health professionals can use with patients to help address health literacy and numeracy limitations. These strategies include using plain printed language, using everyday oral language free of medical jargon, avoiding phrases with multiple interpretations, and asking open-ended questions. The use of the teach-back method in clinical settings is briefly described. Two US diabetes education resources are described. These are The Diabetes Literacy and Numeracy Education Toolkit (DLNET) and The American College of Physicians Foundation Living With Diabetes Guide.
Numeracy and Health: Helping Americans Do the Math – 2011 [US]
Dr. Valerie Reyna of the College of Human Development, Cornell University, shares insights and strategies that healthcare providers and policy makers can use to make it easier for consumers to interpret health-related numbers. Dr Reyna explains why numeracy matters in health care, why numerical information can be hard to understand, why adults have difficulty understanding ratios and fractions, and gives specific strategies for harnessing the power of 'gist' to make information easier to understand.
Perspective: The Role of Numeracy in Health Care – 2008 [US]
Numeracy, the “ability to understand and use numbers in daily life” is an important but understudied component of literacy. While literacy and numeracy are strongly correlated, Rothman et al (2008) found that many patients with adequate reading ability had poor numeracy skills. The authors examined the research on numeracy in health literacy and concluded that better tools were needed to measure numeracy and more studies were required to assess the unique contribution of numeracy in the management of health conditions.
The Safe Use Initiative and Health Literacy: Workshop Summary (2010)
Every year at least 1.5 million people suffer adverse effects from medication. These problems occur because people misunderstand labels, are unaware of drug interactions, or otherwise use medication improperly. The Food and Drug Administration's Safe Use Initiative seeks to identify preventable medication risks and develop solutions to them. The IOM held a workshop to discuss the FDA's Safe Use Initiative and other efforts to improve drug labeling and safety. This document summarises the discussion from this workshop.
Stardardizing Medication Labels: Confusing Patients Less. Workshop Summary – 2008 [US]
Medications are an important component of health care, but each year their misuse results in over one million adverse drug events that lead to emergency room visits, hospitalizations and, in some cases, death. Almost half of all patients misunderstand label instructions. As a patient's most tangible source of information on prescription drug use, the label on a medication container is a crucial line of defense against such medication safety problems. This report, by Lyla M. Hernandez from the Institute of Medicine’s Roundtable on Health Literacy, summarises a workshop aimed at examining what is known about how medication container labeling affects patient safety and discusses approaches to addressing identified problems.