Transcript Dia 1

Health Literacy and
Digital Health Communication
PhD student: Inge Dubbeldam
Supervisors:
Frans J. Meijman (VU Metamedica)
José Sanders & Wilbert Spooren (LCC)
Structure of our talk
• Introduction:
– health communication and health literacy
• Outline of our project:
– methodology and some first observations
• Discussion:
– relevance in LCC context and other fields of
interest in health communication
Health communication
• Field of growing attention in academic
education and research
• Health care and health care systems are
subject to rapid changes in many countries
• Role of health communication is ever more
important.
Current challenges
• aging population
• increasingly cultural diverse population
• tension between traditional and new,
alternative/holistic/integrative approaches
to healthcare
• changes to health insurance and managed
care
• impact of new technologies on healthcare
(Wright, Sparks & O'Hair, 2008).
Health literacy
• An implication of these developments is
the impact of health literacy:
– the capacity to obtain, process, and
understand basic health communication
information and health services
– needed to make appropriate health
decisions.
• Poor health literacy is widespread and has
negative influence on both health and
care.
Role of patient is changing
• Patient is now “health consumer”
– who wants to know more
– who is supposed to know more
• Health consumer plays an active role in
– health management and
– health decision making
Emergence of online or E-health
• Three groups participate in e-health
exchange of information:
– Health care providers (professionals)
– Patients and their caregivers
– Others, interested in health and staying
healthy
• There are various barriers to effective
comsumer e-health communication
(Keselman, Logan, Arnott, Leroy & Zeng-Treitler 2008)
Effective use of e-health requisites
On the side of providers:
– Understanding of the public’s information
needs
– Tailoring of and interaction about information
On the side of consumers:
– Access to and experience with electronic
media
– Significant lay knowledge
Current study: Health literacy and
digital health communication
Starting date
April 1, 2008 ( April 1, 2012)
Participants:
LCC
CAMeRA
VU-Metamedica
Large city hospital
Research project
Aim
identifying succesful methods for
communication with patients who have
various degrees of health literacy
Context
Large city hospital with multicultural patient
population
Research questions
1. Acces to media/sources:
which groups of the public look where for answers to
the health communication needs, based on which
motivations and capacities?
2. Genre:
which genres have been developed in health
communication on the internet; how do users
recognize, evaluate and use these genres?
3. Effect:
which applications of internet in health communication
are both effective and satisfactory to various groups
of the public?
Methodological design of our study
Our study will include
1. interviews with health professionals (JuneSeptember 2008)
2. analysis of genres within various health web
sites (Fall 2008/Spring 2009);
3. observance of health consumers exploring
digital health communication (2009);
4. testing the effect of systematically varied
communication on specific health consumer
groups (2009/2010).
Interviews: Some first observations
Contents
• Collaboration with hospital
• Findings from interviews
• Conclusions and next steps
Collaboration with hospital
• Research proposal approved
• Find the appropriate context:
interviews with 9 healthprofessionals
Findings MD’s and NP’s
• Communication with patients from nonDutch backgrounds
• Exaggeration that majority of patients refer
to online medical information
• Online information both useful and
inconvenient
• Patient education not ‘tailored’
• Selecting good online sources is based on
few variables
Findings coordinator
patient education
• No protocol or procedure for patient
education
• Units decide for themselves how they deal
with patient education
• Patient education is not ‘tailored’ to
individual patients (is desirable)
• No (pre or post) tests of patient education
material
Conclusion and next steps
• Hospital appears to be a good choice for
conducting our research
– Patient education is designed and used ‘instinctive’
– No tailoring
– No testing of patient education material
• Next steps:
– Determining the target group in dialogue with the
hospital
– Writing a protocol for medical-ethical commision
– Starting the observance of the target group
Further research in LCC context
• Health vocabulary barrier
• Emotional and social aspects of
information seeking and aquisition
behaviors
• Interaction between user groups
Health vocabulary aspects
• Lay-professional vocabulary barrier
– requires health education for consumers
– and communication education for health providers
• Relates to research on (among others)
– Comprehension with lay versus expert knowledge
– Readability: role of concrete language and
coherence in discourse
– Automatic research of lexical data
Interactional aspects
• Health communication no longer top-down or
unidirectional, but horizontal
• How can users interact
– with providers: health professionals, health insurance
– within peergroups: patients / caregivers / ethnic
minority;
– and with the public?
• Relates to research on
– Dialogue and group (e-)interaction
– Chatting and blogging language behaviour
– Health journalism and civic journalism
Emotional and social aspects
• What makes health consumers
– Select / read / learn from / behave like written
information
• Relates to research on features and effects of
genres
– Interest and attractiveness of informative discourse
– Identification and transportation while reading
(narrative) discourse
– Guilt appeal, anecdotal versus statistical evidence,
images and other mechanisms in persuasive
discourse
Further research in LCC context
• Aspects of health literacy
– Health vocabulary barrier
– Instructive health communication with images
• Effective health communication
– Interaction between user groups
– Emotional and social aspects of information
seeking and aquisition behaviors
Health vocabulary aspects
• Lay-professional vocabulary barrier
– requires health education for consumers
– and communication education for health providers
• Relates to research on (among others)
– Comprehension with lay versus expert knowledge
– Readability: role of concrete language and
coherence in discourse
– Automatic research of lexical data
Instructive health communication
• Lay-professional
image barrier
• Relates to research
on multi-modality:
• how to use various
types of images