All Relevant Resources for Primary Health Organisations
Resource: Advances in Patient Safety: New Directions and Alternative Approaches
This website from the Agency for Healthcare Research and Quality includes lots of articles on reporting systems, patient safety tools and practices, medication safety and numerous other areas relating to improving patient safety.
Resource: Age Differences in Genetic Knowledge, Health Literacy and Causal Beliefs for Health Conditions
This study by Ashida et al (2011) examines the levels of genetic knowledge, health literacy and beliefs about causation of health conditions among individuals in different age groups. The researchers find that adding extra information may help older people understand genetic knowledge more easily, and that increase levels of genetic knowledge about complex diseases may help people to maintain healthy lifestyles.
Resource: Alcohol and prescription drug safety in older adults [US]
This study, by Zanjani et al (2013), investigated older adults' knowledge of prescription drug safety and interactions with alcohol, and pharmacists' willingness to disseminate prescription drug safety information. The authors found that the majority of patient participants had literacy issues and required help reading written materials from their doctor or pharmacy. In terms of health literacy one third of older adults did not read prescription warning labels. Zanjani et al (2013) found that low literacy contributes to inadequate understanding of drug and alcohol interaction. The study also showed that pharmacists can play a key role in improving patient drug safety outcomes by administering brief interventions to patients. Such interventions would likely lead to fewer alcohol / drug interactions, fewer medical visits and lower medical costs. Zanjani et al (2013) recommend that future research should focus on designing interventions aimed at increasing awareness of drug safety and alcohol use in older adults.
Resource: Amplifying Diffusion of Health Information in Low-Literate Populations Through Adult Education Health Literacy Classes
This article by Freedman et al (2011) draws on classroom observations and qualitative interviews with 21 students and 3 teachers in an adult education health literacy class to explore the efficacy of using adult education courses to teach functional health literacy skills to low-literate populations. Ultimately, this study suggests that the adult education system is in a prime position to impart functional health literacy skills to low-literate populations in the classroom. Significantly, this study demonstrates that adult education students themselves may be a powerful vehicle for health communication beyond the walls of the classroom.
Resource: 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.
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: Archive of Webinar: Why do we give patients numbers? Making health data make sense – 2013 [US]
This is an archived copy of a webinar run by Surround Health (October 15, 2013) on the topic of patients and health numeracy. Every day patients face numbers - reading electronic health records (EHRs), risk information, nutrition labels, navigating through the health insurance marketplace, and more. But, can they derive meaning from the numbers to manage their health? This webinar explores how to communicate quantitative information to patients for decision making. Topics covered include: Why information evaluability is what really matters, how best to communicate risk, how to convey numbers in a format and context that matches patients’ specific need. Presenter: Brian J. Zikmund- Fisher (University of Michigan, School of Public Health). Duration: 1 hour.
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: Bridging the Digital Divide in Diabetes: Family Support and Implications for Health Literacy [US]
This study, by Mayberry et al (2013), explored the relationships between health literacy, numeracy, and computer literacy and the usage of a patient web portal and health information technology. Patient web portals offer patients remote access to their medical record and communication with providers. Adults with health literacy limitations are less likely to access and use health information technology. In diabetes, patient web portal use has been associated with patient satisfaction, patient–provider communication, and glycemic control. Mayberry et al (2013) found that computer literacy was positively associated with health literacy and numeracy, but health literacy was not associated with numeracy. The authors also found that family members played a key role in helping patients access and use the health information technology, taught them usage skills, and acted as online delegates. Mayberry et al (2013) suggest that family members may bridge the health information digital divide in diabetes by helping patients access patient web portals and health information technology for diabetes management.
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.