Transcript How does the Public Perceive Health Messages? Limited

The National Action Plan
to Improve Health Literacy
Cynthia Baur, Ph.D.
Senior Advisor, Health Literacy
August 23, 2011
Office of the Director
Office of the Associate Director for Communication
Key Messages
Government agencies, foundations, and research
universities should prioritize funding for qualitative
and quantitative studies related to health literacy
improvement.
Goal 6, National Action Plan
Funders play a critical role in the dissemination and
use of research findings.
Goal 7, National Action Plan
What is the Gap?
Health Literacy:
Hearing the
voices of people
on the receiving
end of our
communication
What is a 2 times greater risk for pneumonia if I
don’t get a flu shot? Greater than what?
What do these survival
rates mean for me?
80%
8 of 10 women?
80 of 100?
.8?
Is one better than the other?
What is Health Literacy?
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Obtain
Process
Understand
Decide
Health Information
and Services
Sources: National Library of Medicine, Healthy People
How is Health Literacy Different
from General Literacy?
 Builds on literacy skills BUT ALSO
Cultural and contextual factors
 Beliefs, experience and preferences
 Topic area and
conceptual knowledge, such as
 knowledge of the body and how it works
 terms for specific health conditions
 scientific results and risk
Institute of Medicine Report
on Health Literacy
• Limited health literacy is a major public health issue
• Interaction of individual skills and social complexity
•
creates health literacy problems
Professionals need health literacy training
Health Literacy Dynamic
Skills/Ability
Demands/Complexity
Literacy in America
National Assessment of Adult Literacy (NAAL)
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National sample survey conducted in 1992 and 2003
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Performed by U.S. Department of Education,
National Center for Health Statistics
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In-person interviews with Americans age 16 and older
(N~19,000)
 Tested in English or alternate short test in Spanish
 Over sampling of Blacks and Hispanics
http://nces.ed.gov/naal/
NAAL Domains
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Emphasized the use of printed everyday materials
(newspapers, prescriptions, bills) needed to function
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153 items that assessed prose, document, or
quantitative literacy
Prose
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Document
Quantitative
Most items required searching text for specific
information, short written responses
http://nces.ed.gov/naal/
Categories and Sample
Health Tasks
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Proficient – Calculate employee’s share of health
insurance costs for a year
Intermediate – Determine healthy weight range;
medication timing
Basic – Explain why it is difficult to know if they have a
specific chronic condition
Below Basic – Identify what is permissible to drink
before a medical test
http://nces.ed.gov/naal/
Results from the NAAL
12%
Proficient
53%
Intermediate
Below
Basic
13%
Basic
22%
77 Million Adults have Basic or Below Basic Health Literacy
Kutner et al. National Assessment of Adult Literacy, 2006
Health Literacy by Age
59%
Kutner et al. National Assessment of Adult Literacy, 2006
Health Literacy by Race/Ethnicity
28%
58%
66%
Kutner et al. National Assessment of Adult Literacy, 2006
Health Literacy by Education
76%
44%
13%
11%
Kutner et al. National Assessment of Adult Literacy, 2006
Outcomes Associated with
Limited Health Literacy
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Health outcomes
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Taking medications appropriately
Interpreting labels and health messages
Seniors’ health status and quality of life
Mortality
Health services
 Hospitalization
 Emergency care visit
 Flu immunization
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Knowledge and comprehension
Berkman et al 2011 Health Literacy Interventions and Outcomes :An Updated Systematic Review
Why A National Action Plan?
What is the Plan?
Seven Goal Areas
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Health information creation and dissemination
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Healthcare services
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Early childhood-university education
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Community-based services
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Partnership and collaboration
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Research and evaluation
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Dissemination of evidence-based practice
HHS Health Literacy Research
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NIH/AHRQ Understanding and Promoting Health Literacy
Program Announcement (PAR-10-133)
 R01, R03 and R21
 NIH: 85 grants totaling $67 million (2004-2011)
 http://obssr.od.nih.gov/scientific_areas/social_culture_factors_in_
health/health_literacy/index.aspx
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Additional research under other Funding Opportunity
Announcements and contracts
NIH/AHRQ support of annual research conference
 http://www.bumc.bu.edu/healthliteracyconference/
Ideas for research and
intervention topics
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NIH/AHRQ Program Announcement
National Action Plan Goals
Research presented at annual conference
AHRQ systematic review
 http://www.ahrq.gov/clinic/tp/lituptp.htm
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Evaluation of tools
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Organizational audits
Universal precautions in clear communication
Clear communication training
Standards
Call to Action
The National Action Plan to Improve Health Literacy
challenges individuals, organizations and communities to
fulfill their responsibility to make
health information and services
ACCURATE, ACCESSIBLE AND ACTIONABLE
A Challenge
Is your foundation using its resources to
improve health literacy OR
perpetuate and create health literacy barriers?
What questions do you have?
www.cdc.gov/healthliteracy
http://blogs.cdc.gov/healthliteracy/
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: [email protected]
Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official
position of the Centers for Disease Control and Prevention.
Office of the Director
Office of the Associate Director for Communication