All Relevant Resources for Primary Health Organisations
Resource: An oral health literacy intervention for Indigenous adults in a rural setting in Australia
Indigenous Australians suffer substantially poorer oral health than their non-Indigenous counterparts and new approaches are needed to address these disparities. This article by Parker et al (2012) describes the implementation of an oral health literacy intervention.
Resource: Applicability of Internationally Available Health Literacy Measures in the Netherlands
This study by Fransen et al (2011) evaluated the cross-cultural applicability of the Rapid Estimate of Adult Literacy in Medicine (REALM), the Newest Vital Sign (NVS), the Set of Brief Screening Questions (SBSQ), and the measure of Functional Communicative and Critical Health Literacy (FCCHL). Each measure was translated into Dutch following standardized procedures. The authors assessed feasibility, internal consistency, and construct validity among patients with coronary artery disease and patients with diabetes type 2. Despite reasonable psychometric properties as demonstrated so far, these measures need to be further developed in order to increase applicability for assessing health literacy in clinical-epidemiological research in the Netherlands.
Resource: Ask, Understand, Remember: A Brief Measure of Patient Communication Self-Efficacy Within Clinical Encounters
This article by Clayman et al (2010) describes an effort to develop and validate a brief, reliable measure of patient communication self-efficacy within clinical encounters. The measure, referred to as the Ask, Understand, Remember Assesment, (AURA) was moderately correlated with the total score from an existing chronic disease management self-efficacy scale and disease knowledge. It was found that the AURA is brief, valid, has low reading demands, and is an appropriate tool for use among patients with chronic illness. It may also be useful in identifying and assisting patients who are at risk for errors or non-adherence with self-care behaviors.
This site, commissioned by the National Patient Safety Foundation in the U.S., is a patient education programme designed to promote better communication with our health professionals. It is a widely phrased concept, and is designed for both patient and health professionals.
Resource: Association of eHealth Literacy with Colorectal Cancer Knowledge and Screening Practice Among Internet Users in Japan [Jap]
In rapidly developing Internet-user societies, eHealth literacy has become important in promoting health and wellbeing. Previous studies have observed that poor health literacy is associated with less knowledge and screening practice of colorectal cancer (CRC). Little is known about whether eHealth literacy is associated with these variables. Mitsutake et al (2012) examined the associations between eHealth literacy, knowledge of CRC, and CRC screening practices. The researchers found that Internet users with high eHealth literacy are more likely to have knowledge and previous screening practice related to CRC compared to those with low eHealth literacy.
Resource: Associations Among Health Literacy Levels and Health Outcomes in Pregnant Women with Pregestational and Gestational Diabetes in an Urban Setting
Poor health literacy is a problem for over 45% of American adults and is associated with a variety of adverse health outcomes. Low health literacy has been associated with poor prenatal care utilization and a higher likelihood of poorer glycemic control. Poor glycemic control can lead to poor birth outcomes for both the mother and infant. Health literacy levels of pregnant women with diabetes can influence these outcomes and need to be known early in the pregnancy. Interventions can influence tighter glycemic control and lessen the impact of diabetes for the mother and infant. Therefore, the purpose of this study was to explore the associations among health literacy levels and health outcomes in pregnant women with pregestational and gestational diabetes.
Resource: Associations Between Older Adults’ Spoken Interactive Health Literacy and Selected Health Care and Health Communication Outcomes
Recent trends in the conceptualization of health literacy lead toward expansive notions of health literacy as social practice, rather than as a narrower cognitive capacity to understand health-related texts and materials. These expansive and complex constructions of health literacy demand tools for assessing individuals’ propensities to actively seek information in their interactions with health care professionals and other health information sources. This study proposes a measure of this information-exchange component of health literacy and examines its capacity to predict outcomes and processes such as satisfaction with health care and comprehension of spoken health messages (Rubin et al, 2011).
Resource: Attributes of a Health Literate Organization
This paper describes 10 attributes of a health literate organization, that is, an organization that makes it easier for people to navigate, understand, and use information and services to take care of their health.
Resource: Availability and Readability of Emergency Preparedness Materials for Deaf and Hard-of-Hearing and Older Adult Populations: Issues and Assessments [US]
This report looks at the findings of a literature review exploring the issues related to emergency preparedness materials (EPM) for hearing impaired and older adult populations. The primary focus of the review was to assess the availability and readability of materials for these populations and to recommend improvements. Neuhauser et al (2013) found no research about the readability of EPM aimed at this population. The authors collected EPM and interviewed staff from community based organisations serving heraing impaired and elderly adults. They found that all EPM tested above the recommended reading level for each group. Neuhauser et al (2013) recommended that more EPM for these populations should be made widely available, adhere to health literacy principles, and be accessible in alternative formats including American Sign Language. Developers should engage the intended users of EPM as co-designers and testers.
Resource: Back to Basics: Why Basic Research Is Needed to Create Effective Health Literacy Interventions
This paper by Johnson et al (2011) is United States policy centric). Limited health literacy is increasingly recognized as a public health problem. Growing recognition of the problem—and the need for solutions—creates an imperative for the field of health literacy research to identify effective interventions. The National Action Plan to Improve Health Literacy (U.S. DHHS, 2010) recommends increased basic research in health literacy. This paper elaborates on this call by explicating what is meant by basic research and describing several of the ways in which basic research will benefit the field of health literacy research and, particularly, progress toward designing successful interventions.
Resource: Baseline medication adherence and response to an electronically delivered health literacy intervention targeting adherence [US]
Medication adherence in persons treated for HIV continues to be an important focus for intervention. While high levels of adherence are required for good clinical outcomes, research shows many patients do not achieve these levels.Using the Information–Motivation–Behavioral Skills model as a conceptual framework for understanding patients’ information needs, Ownby et al (2013) developed a computer-delivered intervention, assessed its usability and acceptability, and evaluated the medication adherence of 118 patients for 1 month before and after they completed the intervention. Ownby et al (2013) found that individuals with adherence less than 95% showed significant increases in adherence over time using the electronic health literacy intervention. Participants’ self-reported knowledge and behavioral skills increased over the course of the study. The authors conclude that a computer-delivered intervention targeting HIV-related health literacy may be a useful strategy for improving patient adherence.
Resource: Brief Questions to Identify Patients With Inadequate Health Literacy
The objective of this study by Wallace et al (2006) was to evaluate 3 candidate questions to determine their accuracy in identifying patients with limited or marginal health literacy skills. The authors tested 305 English-speaking adults ising REALM, concluding that a singluar screening question may be sufficient for detecting limited and marginal health literacy skills in clinic populations.
Resource: Brief Report: Parent’s Health Literacy among High-Risk Adolescents with Insulin Dependent Diabetes
The objective of this study by Janisse et al (2010) was to describe the health literacy of parents of high-risk adolescents with insulin dependent diabetes and to examine the relation of parent's health literacy with treatment adherence. The authors found that parents with low health literacy may struggle to help their children adhere to the increasingly complex diabetes regimens being used at present.
Resource: CAHPS Item Set for Addressing Health Literacy
The Item Set for Addressing Health Literacy focuses on assessing providers' activities to foster and improve the health literacy of patients. The primary goal of these supplemental items for the Clinician & Group Surveys is to measure, from the patients' perspective, how well health information is communicated to them by health care professionals. It is part of a larger effort by the Agency for Healthcare Research and Quality to encourage a greater emphasis in the provider community on patient-centered care.
Resource: Can Cultural Competency Reduce Racial and Ethnic Health Disparities? A Review and Conceptual Model
This article from Cindy Brach and Irene Fraser describes tailoring health promotion and information to minorities to create beneficial outcomes. The authors stress the importance of cultural competency within the health system.
Resource: Cancer Risk Communication with Low Health Literacy Patients: A Continuing Medical Education Program
The objective of this paper by Price-Haywood et al (2010) describe a continuing medical education program to teach primary care physicians cancer risk communication and shared decision-making with low health literacy patients and baseline skills assessment. The baseline skills assessment suggests a need for physician training in cancer risk communication and shared decision making for patients with low health literacy.
Resource: Caring for Patients with Limited Health Literacy [US]
Health literacy is the degree to which individuals have the capacity to obtain, process, and understand health information, skills, and services needed to make informed health decisions and take informed actions. Narratives from Mr J, a 76-year-old man with multiple medical problems and limited health literacy, and his physician exhibit some of the difficulties experienced by patients with limited health literacy. Clinicians can help patients with limited health literacy by removing unneeded complexity in their treatment regimens and in the health care system and by using teach-back methods to assess and improve understanding. Rather than a selective screening approach for limited health literacy, a patient-based universal precaution approach for confirming patient comprehension of critical self-care activities helps ensure that all patients have their health literacy needs identified.
Resource: Caring for Patients with Limited Health Literacy. October 2011 Author in the Room Teleconference [US]
In this teleconference Michael Paasche-Orlow (2011) discusses some of the findings of his research article on improving the care of patients with limited health literacy. These findings include the need to remove unneeded complexity in treatment regimens and in the health care system and using teach-back methods to assess and improve patient understanding. Michael Paasche-Orlow (2011) concludes that a patient-based universal precaution approach for confirming patient comprehension of critical self-care activities can help ensure that all patients have their health literacy needs identified. This teleconference is part of the Institute for Health Care Improvement’s Author in the Room series.
Resource: Case Study: Iowa’s Health Literacy Collaborative Is Transforming Patient-Provider Communication
This case study provided by the Commonwealth Fund and Nowotny and McCarthy shows how Iowa’s largest integrated health care system converted health literacy research into practice. The report explains how this was achieved and the numerous beneficial outcomes.
Resource: CDC Online Health Literacy Training of Public Health Professionals
This free online health literacy training tool provided by the U.S. Centers for Disease Control and Prevention, introduces participants to health literacy fundamentals and demonstrates the significance of its impact in public health.