Infopeople Webcast Series:Health e-Shows

Infopeople webcasts are supported by the U.S. Institute of Museum and Library Services under the provisions of the Library Services and Technology Act, administered in California by the State Librarian.

Understanding Health Literacy: Why It Is So Important and What Librarians Can Do to Help

An Infopeople WebinarAn Infopeople WebinarAugust 14, 2008August 14, 200812pm – 1pm12pm – 1pm

Kelli HamKelli Hamkkham@library.ucla.edukkham@library.ucla.edu

Objectives

Participants will be able to:

describe the correlations and differences between literacy and health literacy

recommend appropriate resources for users with low health literacy

help patrons communicate better with doctors

Agenda

Scenarios

Overview

Working with library user

Choosing appropriate materials

Improving health literacy in the community

Definitions

Literacy – the ability to read and write

Health Information Literacy– the degree to which individuals have the

capacity obtain, process, and understand the basic health information and services they need to make appropriate health decisions.

The Patient’s Experience

Mrs. Walker– lupus patient– 3rd Grade reading level

Over-the-counter Products

Mrs. Stuart– 7th Grade

reading level– mother of two

Reading Prescription Labels

Mr. Dallas– 3rd grade reading level– prostate cancer patient

The Patient’s Perspective

“She is very busy; I don’t want to bother her.”

“I’m embarrassed to tell her I don’t understand.”

“I’ll just ask at the drugstore; they will explain it to me.”

Where Understanding Fails

Consent forms Appointment slips Prescription drug labels Instructions prior to surgery or procedure Medical education brochures Insurance paperwork Verbal instructions

NAAL Study Findings

Literacy – assessments– Prose– Document– Quantitative

Health literacy• Clinical• Prevention• Navigating the system

Groups at Highest Risk

Elderly

Minorities

Low income

Homeless persons

Those with lower education levels

Implications

Medical errors

Non-compliance

Poor outcomes

Higher mortality

What else?

Tackling the Problem

Now part of LiteracyWorks, California Health Literacy Initiative launched in 2003 with three objectives:– provide health material in plain English, in

easy-to-read format

– train medical professionals to recognize and respond to patients with low literacy skills

– teach adults how to ask questions and clarify information with healthcare provider

Easy-to-Read Conundrum Definitions

– Depends on who you ask

Lack of standards

Reading Level Tests

Example of “Easy-to-Read”

Plain Language

Also called “living room language” What are the common terms for these?

– neoplasm– hypertension– cholecystectomy– tinea pedis– inoculation– hematoma

Some examples

Definitions of hematoma:– a mass of usually clotted blood that forms

in a tissue, organ, or body space as a result of a broken blood vessel

– Bruise. A bruise is an area of discolored skin. A bruise occurs when small blood vessels break and leak their contents into the soft tissue beneath the skin.

Helping the Patient Understand

New standards for OTC drug labeling

Creation of patient materials with simple language and illustrations

Use of trained health educators or communicators

Medication Labeling – Old Style

Improved Labeling Standard

Plain Language Example

diabetes.niddk.nih.gov

Starting at the Source

Programs for health care professionals– American Medical Association Foundation

toolkits, training materials, videos and more

– Medical Library Association Health Information Literacy Project, curriculum

available in September 2008

– Harvard School of Public Health materials for health professionals, educators curricula for health literacy programs

Working with the Library User

Determining literacy levels - you can’t tell by appearance

Possible clues– forgot eyeglasses– ask you to read it to them– reluctant to fill out a form

Strategies

Your approach

– be aware of word choice

– use same terms as patron

– most important concepts first– start with basic information, and offer

more when patron is ready

Who is the End-user?

Determine who is asking the question– Caregiver, patient, friend– Ask what kind of information would be useful

Choosing Appropriate Resources

Books

DVDs, videos

Internet resources

Article

Encyclopedia

Pictures and Diagrams

Audio and Video

Often requested – easier to understand by seeing and hearing

Library’s collection– search by type of item (CD, Video etc)

Free, quality multimedia resources– healthyroadsmedia.org is a free resource

with streaming video and other formats

MedlinePlus.gov Resources Easy-to-Read

Interactive Tutorials

MedlinePlus en español and multilingual resources

NIHSeniorHealth

Relevant health topic pages

MedlinePlus Home Page

Finding All Easy-to-Read Materials

On Health Topics Page:

Links to all Easy to Read and Interactive

Tutorials

Multilingual Materials

But are they easy to read? Typically not designated as such

New collection on MedlinePlus– All include English version– Not comprehensive

Consumer Health Information in Many Languages page– nnlm.gov/outreach/consumer/multi.html

Multilingual Materials on MedlinePlus - Asthma

Asthma Languages Available

Asthma Hindi Example

Additional Online Resources Plain language brochures– Deciphering Medspeak brochures (Medical

Library Association)– Plain Language Glossaries (Harvard School

of Public Health) NIH Publications– Numerous consumer publications in easy-to-

read language

Advanced Search in Google publications “easy to read” site:nih.gov

Information Rx

• From the National Library of Medicine

•Looks like a prescription pad

• Physicians, librarians and other health care professionals can write an “information prescription”

InfoRx in Practice

Formulating Questions

Help them formulate questions to take back to their healthcare provider– Ask Me Threewww.npsf.org/askme3/

– Agency for Healthcare Research and Quality

www.ahrq.gov

Ask Me Three

askme3.org

Questions Are the Answer

ahrq.gov/

Question Builder Tool

Ideas for Added Value

Ask if you can help them generate a question list to print out (use the AHRQ question builder)

Offer to set up computer with Interactive Tutorial on topic

Generate easy-to-read materials for library users with help from resource tools

Health Literacy in your Community

Know the demographics Programming ideas

– National Health Observances– topics of interest to community

Beneficial partnerships– talks by local physicians– local literacy groups

Your Collection & Services Know what you have Know your community Considerations for your collection Programming

– bulletin boards– informational sessions

Partnerships

Kelli Ham, Consumer Health Coordinatorkkham@library.ucla.edu

NN/LM Pacific Southwest RegionUCLA Louise M. Darling Biomedical Library