Plain Language Sweeping the Plains: Health Literacy initiatives in

Report
Plain Language on the Plains:
Introduction to Health Literacy in Nebraska
Susan Bockrath, MPH, CHES
Steering Committee Chair,
Health Literacy Nebraska
Health Literacy Nebraska
Scottsbluff
Kearney
Adults with Below Basic Literacy
Percent (%) across Nebraska
100
Nebraska
Sarpy
Lancaster
Colfax
California
North Dakota
80
60
40
20
0
Low Literacy
Health Literacy in America (NAAL 2003 Data)
Proficient (12%): Define medical
terms from complex document,
calculate share of employee health
insurance.
Intermediate (53%): Determine
healthy weight from body mass
index (BMI) chart, interpret
prescription and over-the-counter
drug labels.
Basic (22%): Understand simple
patient education handout.
Below Basic (14%): Circle date
on appointment slip. Understand
simple pamphlet about pre-test
instructions.
(Kutner, Greenberg, Jin, & Paulsen, 2006 )
Health Literacy Nebraska
Health Literacy
“Health literacy allows
the public and personnel
working in all healthrelated contexts to
Literacy Demands
Systems &
Organizations
• find,
• understand,
• evaluate,
• communicate, and
• use information.”
(Calgary Charter, 2008)
Patient
Provider
Skills &
Experience
Skills &
Experience
Demands of providers
and systems
Health Literacy
Skills of patients,
clients, communities
11
Demands of
providers and
systems
etHhla ityeLrac
Skills of
patients, clients,
communities
How much does
Health Literacy matter?
• Limited literacy and health literacy are
associated with negative health outcomes, less
knowledge of medical conditions, less use of
preventive services, poor disease self
management, treatment mistakes, increased
hospitalization and hospital readmissions, and
death.
(DeWalt, Berkman, Sheridan, Lohr, Pignone, 2004)
Predictors of Health Status
 Literacy Skills
• Age
• Income
• Employment Status
• Education Level
• Racial or Ethnic Group
14
Strong Associations Between
Health Literacy and…
Lower educational
attainment
Limited exposure to higherlevel language
Limited baseline knowledge
Older age
Diminished cognitive
function
Increased medical
encounters as one ages
Different expectations
related to
patient/provider roles
Racial or ethnic
minority
Consistent with other
health disparities
15
Not attending to Health Literacy
Costs Money
Estimated annual
health care costs for
people with low
literacy are 4 times
higher than for those
with higher literacy
skills.
Low
Literacy
Higher
Literacy
Comparative
Costs
(Weiss, 1999)
16
70
80
90
100
Not Attending to Health Literacy
Costs Lives
Adjusted HR 1.52
(95% CI 1.26 -1.83)
Inadequate vs Adequate
50
60
Adequate
Marginal
Inadequate
0
20
40
60
80
Months
(Baker, Wolf, Feinglass, Thompson, Gazmararian, Huang, 2007)
17
Health Literate Strategies
• Plain Language
Literacy Demands
• Easy-to-Read
Systems &
Organizations
• Examples & Visuals
• Brown Bag Checks
Patient
Provider
Skills &
Experience
Skills &
Experience
• Teach Back
• Ask Me 3
• Interpreters
18
Health Literate Strategies
• Plain Language
Literacy Demands
• Easy-to-Read
Systems &
Organizations
• Examples & Visuals
• Brown Bag Checks
Patient
Provider
Skills &
Experience
Skills &
Experience
• Teach Back
• Ask Me 3
• Interpreters
19
Work to Date
•
230 local and tribal health department staff participated in a baseline
survey assessing their perceptions related to the health literacy.
•
Project staff visited 19 sites where over 144 staff took part in on-site
trainings introducing health literacy and in focus groups and
interviews.
OPIHL project staff established a Health Literacy Listserv for
collaboration specific to health literacy
Project staff has provided Health Literate Writers’ Workshops
in 4 communities across the state. More than 100 health department
staff and community partners participated in these workshops
between May 1 and August 1, 2013. A fifth workshop is scheduled in
September 2013.
All participating health departments have been trained in and have at
least one license to use Health Literacy Advisor software
www.nalhd.org
Mission
To connect and coordinate health literacy
projects and expertise in Nebraska.
Who is
• Partnership of:
•
•
•
•
•
•
•
•
Medical providers
Pharmacists
Public Health practitioners
Librarians
Educators
Interpreters
Students
Consumers
?
What do we do?
Connect Nebraskans interested
in improving health literacy
• Bi-annual Summit
• Multi-disciplinary work
groups
• Health literacy training
• Including health literacy
items on Behavioral Risk
Factor Surveillance
Survey (BRFSS)
More of what
ht does…
• Nebraska-focused training opportunities…..
• Quarterly newsletter coming soon.
• Developing state-level data:
• With partners, ensuring that 2013-2014 Behavioral
Risk Factor Surveillance Survey (BRFSS) in
Nebraska includes 3 questions about health
literacy.
• Completed a provider survey in 2012 asking about
health literacy perceptions.
Why Join
?
• Be connected to this exciting work!
• Value priced
• $20 annually for individual
• $100 annually for organization
www.healthliteracyne.org
Resources
Find information and links to health
literacy resources at…
www.healthliteracyne.org
www.nalhd.org/healthliteracy

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