The Health Information Literacy Curriculum

Sponsored by the Medical Library Association Funded by the National Library of Medicine

Contract Number HHSN276200663511/NO1-LM-6-3511

2008

Learning Objectives

Recognize the impact low health literacy has on patient care

Name five strategies and resources to improve health literacy

Describe the health literacy services offered by the library

What is Health Literacy?

“The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”

Healthy People 2010

What factors affect Health Literacy?

Health literacy is dependent on individual and system factors

Communication skills Information and knowledge Culture and language Demands of the system

Why is Health Literacy Important?

Low health literacy is linked to…

Under-utilization of services Increased medication errors Poor knowledge about health Increased hospitalizations Poor health outcomes Increased healthcare costs

Health Literacy and Cancer Screening

Women with low health literacy are less likely to have had a mammogram or Pap test than women with higher health literacy skills

Source: Davis, et al (1996). Caner. Lindau, et al (2002). Am J Obstet Gynecol.

Health Literacy and Diabetes Management

0 20 40 60 80 100

Percent of patients with diabetes correctly answering questions according to literacy level (low, moderate, high)

Need to Know: symptoms of low blood sugar (hypoglycemia)

Need to Do: correct action for hypoglycemic symptoms

Low

ModerateHigh

LowModerat

e High

Source: Williams, et al (1998). Arch Int Med.

Health Literacy and Healthcare Costs

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

Low-literacy Better literacy

$2,891

$10,688

Annual Healthcare Costs of Medicaid Enrollees

Source: Weiss, et al (2004). J Am Board Fam Pract.

(<3rd-grade reading level) (>4th-grade reading level)

How is Information Critical to Health Literacy?

Health information is key to:

Patient and provider communication Shared health care decision making Understanding and following directions Recognizing when to seek care Learning and adopting healthy behaviors

What are the Challenges?

Health literacy in the U.S.

Readability of health materials

Health information and the Internet

Health Literacy in the U.S. Health Literacy in the U.S.

Intermediate

Basic

Below Basic

Proficient

13%

12%

53%

22%

77 million adults have basic or below health literacy skills

Source:Source: The Health Literacy of American Adults. Results from the 2003 National Assessment of Adult Literacy. The Health Literacy of American Adults. Results from the 2003 National Assessment of Adult Literacy. National National

Center for Education Statistics (2006).Center for Education Statistics (2006). http://nces.ed.gov/naal/health.asp

Readability of Health Information

Over 300 studies show health-related materials far exceed the reading ability of U.S. adults

Increasing number of studies show similar results when looking at the readability of online health information

Source: NLM Bibliography—Understanding Health Literacy and Its Barriers (2004). www.nlm.nih.gov/pubs/cbm/healthliteracybarriers.html

Health Information and the Internet

80% of Internet users search for health information

75% rarely or never check the source and date

72% express trust in most or all information found online

Source:Source: Fox, S. Vital Decisions (2003). Online Health Search (2006). Washington, DC: Fox, S. Vital Decisions (2003). Online Health Search (2006). Washington, DC: Pew Internet & Pew Internet & American Life Project. American Life Project. www.pewinternet.org/PPF/c/5/topics.asp

Health Literacy From the Patient’s Perspective

Source: Source: Help Your Patients UnderstandHelp Your Patients Understand. AMA Foundation Health Literacy. . AMA Foundation Health Literacy. www.ama-assn.org/ama/pub/ category/9913.html

Mrs. CordellMr. Bell

Strategies to Improve Health Literacy

Use “living room” language

Limit information (3-5 key points)

Use easy-to-read print materials

Practice teach-back

Use Information Rx

Address culture and language needs

“Living Room” Language

Name common terms for…

Hypertension Insomnia Benign Hazardous

Disorder Option Poultry Routinely

Ask Me 3 – National Patient Safety Foundation

www.npsf.org/askme3

Teach-Back Method

Source: Source: Help Your Patients UnderstandHelp Your Patients Understand. AMA Foundation Health Literacy. . AMA Foundation Health Literacy. www.ama-assn.org/ama/pub/category/9913.html

Information Rx

www.MedlinePlus.govwww.MedlinePlus.gov

Interactive Health TutorialsInteractive Health Tutorials

www.NIHSeniorHealth.govwww.NIHSeniorHealth.gov

www.library.tufts.edu/hsl/spiral/

“Top 10” Most Useful Consumer Health Websites

Cancer.gov * CDC.gov * Familydoctor.org * Healthfinder.gov * HIVInsite.ucsf.edu *

**Available in SpanishAvailable in Spanish

KidsHealth.org * Mayoclinic.com Medem.com MedlinePlus.gov * Noah-health.org *

Source: Medical Library Association. www.mlanet.org Source: Medical Library Association. www.mlanet.org

How Can Librarians Help?

Free access to the Internet Information Rx Program Patient information packets Consumer health collection Native language resources Teaching and training Virtual chat / email assistance Health literacy workgroup

Why Now? Why Hospitals?

“The safety of patients cannot be assured without mitigating the negative effects of low health literacy and ineffective communication on patient care.”

The Joint Commission

Source: “What did the Doctor Say?:” Improving Health Literacy To Protect Patient Safety. The Source: “What did the Doctor Say?:” Improving Health Literacy To Protect Patient Safety. The Joint Commission (2007). Joint Commission (2007). www.jointcommission.org/PublicPolicy/health_literacy.htm

Take Home Points

Accurate and reliable health information is critical to health literacy

Use Information Rx to refer patients to reliable health information and to the library for help

Librarians are available to address the health literacy needs of patients and providers

Thank You!

Questions? Comments?

References AHRQ Report—Literacy and Health Outcomes (2004)

www.ahrq.gov/clinic/epcsums/litsum.htm

AMA Foundation Health LiteracyAMA Foundation Health Literacy www.ama-assn.org/ama/pub/about-ama/our-people/affiliated-www.ama-assn.org/ama/pub/about-ama/our-people/affiliated-groups/ama-foundation/our-programs/public-health/health-groups/ama-foundation/our-programs/public-health/health-literacy-program.shtmlliteracy-program.shtml

Fox, S. & Fallows, D. (2003) Internet Health Resources. Fox, S. & Fallows, D. (2003) Internet Health Resources. Washington, DC:Washington, DC: Pew Internet & American Life Project Pew Internet & American Life Project www.pewinternet.org/Reports/2003/Internet-Health-Resources.aspx

Healthy People 2010, Health Communication, Objective 11-2 www.healthypeople.gov/Document/HTML/Volume1/11HealthCom.htm

IOM Report—Health Literacy: A Prescription To End Confusion (2004) www.iom.edu/CMS/3775/3827/19723.aspx

References NLM Bibliography—Understanding Health Literacy

and Its Barriers (2004) www.nlm.nih.gov/pubs/cbm/healthliteracybarriers.html

The Health Literacy of America’s Adults: Results The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult from the 2003 National Assessment of Adult Literacy (2007)Literacy (2007) http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483

The Joint Commission Report: “What did the The Joint Commission Report: “What did the Doctor Say?:” Improving Health Literacy To Protect Doctor Say?:” Improving Health Literacy To Protect Patient Safety (2007)Patient Safety (2007) www.jointcommission.org/PublicPolicy/health_literacy.htm

Medical Library Association “Top 10” Most Useful Medical Library Association “Top 10” Most Useful Consumer Health WebsitesConsumer Health Websites www.mlanet.org/resources/medspeak/topten.html

Pilot Site Librarians Martha Prescott, Berkshire Medical Center Health

Sciences Library Tori Koch and Kim Hart, Billings Clinic Medical Library Andrea Harrow, Good Samaritan Hospital Health

Sciences Library Holly Kimborowicz, Lake Hospital System Medical Library Jeff Mason and Mary Chipanshi, Regina General Hospital

Health Sciences Library Julie Smith, St. Joseph Hospital Burlew Library Denise Rumschlag and Carolyn Martin, St. Vincent

Hospital Library Lenora Kinzie, Stormont-Vail Healthcare Stauffer Health

Sciences Library, and Scarlett Fisher-Herreman, Topeka & Shawnee County Public Library

Geneva Bush Staggs and Beverly Rossini, University of South Alabama Biomedical Library

Acknowledgements

Project Advisors Elliot Siegel, Robert Logan, Angela Ruffin,

Lisa Boyd, Susan Barns, Cindy Olney, Kathy Schilling, Marge Kars, Terry Jankowski, Barbara Bibel, and Cathy Boss

Health Information Literacy Research Project Sabrina Kurtz-Rossi, Project Coordinator Jean P. Shipman, Co-Principal Investigator Carla J. Funk, Co-Principal Investigator

Acknowledgements