Transcript Health and Literacy Crouse Nurse Practice Council Marsha L. Tait, National Coalition for Literacy Donna Valerino, Literacy Volunteers of Greater Syracuse.

Health and Literacy
Crouse Nurse Practice Council
Marsha L. Tait, National Coalition for Literacy
Donna Valerino, Literacy Volunteers of Greater Syracuse
Presentation Highlights
 The Scope of Adult Literacy Globally and in the US
 The 2003 National Assessment of Adult Literacy
 The NAAL Health Literacy Report
 Tips and Techniques for Health Care Providers
 Resources
Global Adult Literacy
 The UN defines illiteracy as:
Having no reading and writing skills at all
 UNESCO estimates more than 770 million adults are
illiterate
 Two-thirds of illiterate adults are women
 UN Decade of Literacy: Cut illiteracy in half by 2015
 The 2003 National Assessment of Adult Literacy
(NAAL) was the first examination of the literacy
skills of America’s adults in more than a decade
 A nationally representative household survey of
more than 19,000 adults, including adults in prison
NAAL: What is Adult
Literacy in the US?
Definition: using printed
and written information
to function in society, to
achieve goals, and to
develop knowledge and
potential.
2003 NAAL Key Findings
11 million adults are Non-literate in
English
30 million adults have Below Basic
Literacy skills
63 million adults have Basic Literacy
skills
Why Should You Care?
Poor Health Outcomes:
 Poor Health Knowledge
 Less Frequent Screening and Preventive Care
 Increased Use of Emergency Rooms
 Increased Hospitalization
 Higher Rates of Disease and Mortality
Baker et al, 1997
Patient Interviews
Special NAAL Report:
Health Literacy
?
Definition: The degree to
which individuals have the
capacity to obtain, process,
and understand basic health
literacy information and
services needed to make
appropriate health decisions.
AMA Definition of
Health Literacy
Definition: the ability to read and
comprehend prescription bottles,
appointment slips and other
essential health-related materials
required to successfully function
as a patient.
NAAL Estimate of
Health Literacy Skills
Not Proficient
Proficient
Who needs help with
health literacy?
"We are your family-members; we are your
neighbors; we are your co-workers. We
are small-business owners; we are firstresponders. We are among the working
poor; we are millionaires. Few ever
know our truth. Because of shame and
stigma, we keep it hidden."
Characteristics of Population
with Low Health Literacy
Gender
 More men (16%) than women (12%) had Below Basic or
Basic Literacy Skills
 Less men (51%) than women (55%) had Intermediate
literacy skills
 Men had lower average health literacy scores (242) than
women (248)
Older Americans
 Adults aged 65+ had the lowest average health literacy
scores
 More Americans aged 65+ had Below Basic or Basic Skills
than any other age group (29 + 30%)
 Adults with Medicare and Medicaid or no health
insurance had the lowest average health literacy scores
Health Condition Self-Assessment
Sources of Health
Information
Information from Professionals
Health Care Professionals
100%
80%
60%
18
17
29
11
8
8
19
21
23
33
37
None
39
40%
20%
A little
Some
36
37
34
0%
Below
Basic
Intermediate
30
A lot
Information From Other People
Information From Print
Newspapers
100%
80%
60%
37
24
19
20
27
31
38
22
40%
29
A little
35
36
15
14
32
20%
12
0%
Below
Basic
None
Intermediate
Some
A lot
10
Information From The Internet
Internet
100%
15
33
80%
60%
80
0%
None
19
37
40%
20%
22
58
12
5
7
7
Below
Basic
27
16
14
21
Intermediate
A little
Some
26
A lot
Where are they getting it?
A higher percent of adults
with Below Basic or Basic
literacy skills cited radio
and television as their
primary source of health
information.
Factors Affecting
Patient Provider Communication
Additional factors that may hinder understanding:




Intimidation, fear, vulnerability
Shock upon hearing a diagnosis
Extenuating stress within the patient's family
Multiple health conditions to understand and treat
Make Effective Communications an Organizational
Priority
Address Patients’ Communication Needs Across the
Continuum of Care
Pursue Policy Changes that Promote Improved
Provider-Patient Communications
Signage
1. What is my main problem?
2. What do I need to do?
3. Why is it important for me to do this?
What Can You Do?
 Create a safe environment where patients feel
comfortable talking openly with you
 Use plain language instead of technical language or
medical jargon
 Sit down (instead of standing) to achieve eye level
with your patient
 Use visual models to illustrate a procedure or
condition
 Ask patients to "teach back" the care instructions
you give to them
From “Askme3.org
Avoid Jargon
 “Hypertension” vs “High Blood Pressure”
 “Fatigued” vs “Tired”
 “Acetaminophen” vs “Tylenol”
 “Febrile” vs “Feverish”
 “Myopathy” vs “Muscle Aches”
NYS Patients’ Rights
“Advance directives are verbal or written
instructions made by you before an
incapacitating illness or injury… Advance
directives communicate that your wishes
about your treatment be followed if you are
too sick or unable to make decisions about
your care. Advance directives include but are
not limited to a health care proxy, a consent
to a do-not-resuscitate (DNR) order recorded
in your medical record, and a living will.”
Simplify, Simplify,
Simplify!
Colonoscopy is the endoscopic examination
of the large colon and the distal part of the
small bowel with a CCD camera or a fiber
optic camera on a flexible tube passed
through the anus. It may provide a visual
diagnosis (e.g. ulceration, polyps) and grants
the opportunity for biopsy or removal of
suspected lesions.
Wikipedia
Is Consent Informed?
Advocacy
Americans are
anticipated
to spend
$45.5 Billion
on their pets
in 2009!
American Pet Products Association
Health Literacy
Resources
 www.askme3.org
 www.cdc.gov/az/a.html
 www.healthliteracy.worlded.org/index
 www.hsph.harvard.edu/healthliteracy/
 www.lvgs.org
 www.jointcommission.org
 www.national-coalition-literacy.org
 www.proliteracy.org
 www.rwjf.org
Clear Communication
“What is clear to you is clear to you. Every patient should
be a full partner in his or her medical decisions. This
requires crystal-clear communication that is done with
compassion and mutual respect.”
~~ Toni Cordell, former adult literacy student
and health literacy advocate
And Remember…
Marsha L. Tait [email protected]
Donna Valerino [email protected]