Promoting Health Literacy to Encourage Prevention and Wellness Workshop Summary (2011) / Chapter Skim
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Appendix C: Commissioned Paper
Appendix C: Commissioned Paper
Pages 77-102
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From page 77... ...
Vice President, Global Health, Johnson & Johnson and Editor-in-Chief, Journal of Health Communication: International Perspectives September 15, 2009 Institute of Medicine Roundtable on Health Literacy Washington, DC ACKNOWLEDGMENTS Wendy Meltzer, M.P.H., Managing Editor of the Journal of Health Communication provided expert research and editing to this paper. Ruth Parker, M.D., and Ken Moritsugu, M.D., also provided expertise and review to earlier versions of this draft.
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From page 78... ...
. Health literacy is "the capacity to obtain, interpret and understand basic health information and services and the competence to use such infor mation and services to enhance health." (IOM, 2004; Ratzan and Parker, 2000)
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From page 79... ...
report titled Improving Health in the Community: A Role for Performance Monitoring. The model, as described by Evans and Stoddart (1994)
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Such a health literacy helix serves as the fabric for improving health in America as it translates primary and secondary prevention into (1) what we need to know and do to stay healthy, and (2)
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. Finally, as much as 88 percent of adults have difficulty with the way health information is currently presented and most do not have the ability to recognize and understand risk, sort through conflicting information, act upon information, and navigate our frequently complex health systems (WHCA, 2009)
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In looking at the recent literature on health literacy and prevention, relatively few studies examined low health literacy and its effect on primary prevention efforts that target risk factors for chronic disease (such as obesity, blood pressure) and few studies describe health literacy interventions in this specific area.
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. 4-1 xed Health literacy occurs when the skills and ability of those requiring health information and services are aligned with the demand and complexity of information and services.
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For each, we look at how efforts can work simultaneously to systematically address the demand and complexity of tasks and advance the population's skills to obtain, process and turn good information into action. Further, to best advance health literacy with primary prevention in these areas, a parsimonious idea is first presented: a "scorecard" that could possibly reflect an individual or population's level of alignment of predetermined goals and actual level of health achievements.
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From page 85... ...
. These scorecards and variable could be developed and updated on a national level with appropriate evidence and expertise from multistakeholders -- pediatric health literacy chaired by AAP, maternal health literacy by ACOG, secondary prevention for people with diabetes by ADA, (see commissioned paper appendix for an example on the D5)
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The health system can be a cornerstone with interventions that promote healthful behaviors with the provision of health information addressing common risk factors for chronic disease such as diet, physical inactivity and blood pressure control and interventions that help patients (and the public) understand how to manage their existing disease and its effects through early detection and appropriate treatment.
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To make appropriate "self-management" decisions, people must locate health information, evaluate the information for cred ibility and quality, and analyze risks and benefits. Furthermore, people must be able to understand the available medical information, ask pertinent questions and express health concerns clearly by describing symp toms in ways the providers can understand (IOM, 2004)
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Promoting better interactions between patients and providers, reorganizing, streamlining health care delivery; embracing a 21st-century field model approach with a community level and ecological perspective that acknowledges the various factors influencing health and health care for those with limited literacy. Each of these factors affects how we communicate, understand, and respond to health information.
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As we read and interpret product labels and warnings; make lifestyle choices regarding eating, activity, smoking and drugs; evaluate the safety of chemicals in products we buy, find and interpret trustworthy health information on the Internet, we use our health literacy skills. Such everyday demands require individuals to be able to assess their current health and recognize the many socioeconomic factors and cultural values that influence it.
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As the current health insurance system is largely employment based, this puts employers in the role of shaping the health information and services available to Americans. There is value in a "health literate workforce." Employers are positioned to know the skills of their workforce and can use this knowledge about their employees to create on-site programs that build employees' health literacy skills and help insurance companies and health information providers create employee-friendly information and services.
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Adults at all levels of health literacy use multiple sources to obtain health information. But, for all levels of health literacy, no single type of print material was as important as nonprint sources, such as radio or television.
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Active citizens can "speakup" when institutional, community, and governmental policies and structures need to be changed. "Political" health literacy competencies include advocacy skills that promote policy change, informed voting behavior in the political arena, knowledge of health rights, and participation in civil society such as community, patient and health organizations.
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Further, with impending challenges of pandemic flu and the challenges of educating and mobilizing a number of people with limited or poor health literacy, the exigency to advance a national health literacy action plan is timely. Moreover, most Americans are aware of this issue as they have faced problems at some point understanding health information for themselves or for a family member.
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in each state at a minimum to meet basic prevention and well ness awareness and behaviors such as the population knowledge and skills and a system that supports attainment of the prevention activities. Recommendation 3 The National Governors' Association, mayors, civic organizations, and other leading organizations could similarly address and adopt health literacy measures of their constituents that integrate primary and secondary prevention into sustainability and other social sector goals.
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Recommendation 8 Congress should adopt a healthy workplace policy for all companies that advances primary and secondary prevention that is consistent with evidence based research and strategies. An attainable scorecard with economic incentives for employees and employers such as tax credits should also be hallmark to advance adoption of health promoting behaviors Recommendation 9 The AAMC and other accrediting boards for health professional schools and professional continuing education programs in health and related fields, including medicine, dentistry, pharmacy, social work,
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should integrate health literacy among the six interventions under consideration -- notably the behavior change and prevention areas of interest. COMMISSIONED PAPER APPENDIX OF CASES IN HEALTH LITERACY AND PREVENTION DOMAIN ONE: HEALTH SYSTEMS Case 1 Pittsburgh Regional Health Initiative -- Proper use of chronic obstructive pulmonary disease medications requires many steps that are difficult to remember and do correctly.
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For diabetes and anticoagulation, completed studies have found that these programs can offset the adverse effects of low literacy. DOMAIN TWO: EDUCATIONAL SYSTEM, HOME, COMMUNITY, AND WORKPLACE Case 1 Head Start Program Health Literacy Study -- Parents of 20,000 children in 35 states were provided with health information and training to help them address their children's health needs.
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Although basic maternal health information that can help reduce the chances of preterm labor and improve the health of mothers and babies is readily available in baby books and on web sites for women with access, it is not getting to the women who need it most. There is a unique opportunity for reaching lower-income women with cell phones as they are more than twice as likely to have a cell phone as broadband Internet (63 percent to 31 percent)
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2008. America's health literacy: Why we need accessible health information.
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2006. Functional health literacy: Health information in everyday life.
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From page 101... ...
:328-333. WHCA (World Health Communication Associates)
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