Lissa Power-deFur, MEd, PhD, CCC-SLP, BCS-CL: No financial or non-financial relationships to disclose
ABSTRACT The U.S. Dept. of Health and Human Services has identified that the majority of adults do not have proficient health literacy to understand health information. Persons with language barriers are most at risk for not having proficient health literacy. The ASHA Code of Ethics’ focus on the welfare of the individuals we serve guides us in ensuring that our oral and written communication enhances our clients’ ability to understand and act upon the information we provide. The session will conclude with strategies that providers and organizations can use to enable the health information and services match the person’s capacity to understand and use them.
SUMMARY
Abstract/Summary The U.S. Dept. of Health and Human Services (USDHHS)has identified that the majority of adults do not have proficient health literacy to understand health information. USDHHS's Healthy People initiative has included health literacy for 20 years. This initiatives defines personal health literacy as the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
The most recent interaction, Healthy People 2030, also addresses organization challenges the public may face, including a new concept - organizational health literacy. This is defined as the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
The US DHHS identifies certain populations that are more likely to have limited health literacy. These include those who are less educated, have no insurance, are in poor health, are English Language Learners, or are elderly. However, there are persons within these groups with health literacy and persons in other groups without health literacy. As a result, it is important for providers not to make assumptions about a client's health literacy.
Persons with communication disorders (hearing loss, cognitive disorders and language disorders) have a notable negative impact on patient’s access to and quality of care, as well as the overall cost of care.
There are a number of signs that suggest to the provider and organization that the client may have health literacy challenges. These include: • Frequently missed appointments • Missing information in forms • Difficulty naming medications, purpose or dosage • Difficulty giving coherent, sequential case history • Asks few questions • Doesn’t follow through on referrals
Research reminds us that it is difficult for patients to recall the information they receive during health care visits. In general, patients retain about 50% of information. As much of 80% of the information they've received is forgotten promptly. Additionally, research suggests that as much as 25% of the information recalled is remembered incorrectly.
The Agency for Health Care Research and Quality recommends that providers develop a universal design approach to health literacy - providing all information in the most health literate approach possible. In this way, organizations and providers can be more confident that the health information and services match the person’s capacity to understand and use them. The following strategies can improve client's comprehension when discussing information:
• Focus on what clients “need to know” or “need to do” • Use clear speech (slower rate, clear enunciation) • Use easy-to-understand language • Present most important information first • Use Teach-back method • Supplement verbal with demonstrations, drawings, written materials.
It is important to review written materials as well. To maximize health literacy, these materials should address: • Content (e.g., singular focus per form) • Word choice and style (e.g., simpler language and grammatical structures) • Organization (e.g., clear headings) • Layout and design (e.g., with minimal distractions and designs that complement the content) • Visual aids (e.g., that are clearly labeled and complement the content) • “Actionability” (e.g., provides steps the consumer can take).
The session will also share resources providers can access to learn more about cultural differences that should be considered, based on the specific populations served.
Lastly, AHRQ reminds providers to review their organization to ensure that the facility is inviting and helpful, that support is provided for completing forms, completing referrals and follow-up visits.
If accepted, may we publish this abstract in the online planner used by attendees? Yes
References/Citations
Agency for Healthcare Research and Quality. Health Literacy Universal Precautions Toolkit - https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/qualityresources/tools/literacy-toolkit/healthlittoolkit2.pdf
Agency for Healthcare Research and Quality. Patient Education Materials Assessment Tool (PEMAT) https://www.ahrq.gov/sites/default/files/publications2/files/pemat_guide_0.pdf
Agency for Healthcare Research and Quality. The SHARE Approach – Communicating numbers to your patients: A reference guide for health care providers.
American Medical Association – Health Literacy and Patient Safety: Help Patients Understand http://www.partnershiphp.org/Providers/HealthServices/Documents/Health%20Education/CandLToolKi t/2%20Manual%20for%20Clinicians.pdf
Brach, C. & Harris, L.M. (2020). Healthy People 2030 health literacy definition ells organizations: Make information and services easy to find, understand, and use. Journal General Internal Medicine. 22 January 2021
Centers for Disease Control and Prevention (CDC) – Clear Communication Index http://www.partnershiphp.org/Providers/HealthServices/Documents/Health%20Education/CandLToolKi t/2%20Manual%20for%20Clinicians.pdf
EthnoMed https://ethnomed.org/
National Center for Health Marketing (U.S. Dept. of Health and Human Services). Plain language thesaurus for health professionals. (2007).
Learning Objectives:
At the completion of this activity, participants should be able to:
Describe the status of health literacy in the United States.
Summarize the ethical principles and rules from the ASHA Code of Ethics that should influence our attention to health literacy.
List three strategies they will employ the following month to enhance health literacy in upcoming client interactions.
