Transcript Journal Of Health Communication

Welcome to my presentation
on
Health Literacy
in the Community
By
Sharon Herring
Health literacy is the ability to obtain, process and
understand basic health information and services
needed to make appropriate health decisions and
follow instructions for treatment.
American Medical Association
According to the National Assessment of Adult literacy 9
out of 10 adults have difficulty using everyday health
information.
Research from the National Science Foundation confirms
that adults have little knowledge of basic scientific and
biological processes making it even more difficult to
communicate routine health information.
Paasche-Orlow, M. K., & Wolf, M. S. (2010). Promoting Health Literacy
Research to Reduce Health Disparities. Journal Of Health Communication, 153441. doi:10.1080/10810730.2010.499994
National Assessment of Adult Learning. National Center for Education Statistics.
http://nces.ed.gov/naal/
In addition culture, linguistics, cognitive processes,
life stage, prior knowledge and message
characteristic are also an issue in health literacy.
Public health interventions need to be patient
centered and communicated from the perspective of
the lives of the target population.
Paasche-Orlow, M. K., & Wolf, M. S. (2010). Promoting Health Literacy Research to Reduce Health Disparities. Journal Of Health
Communication, 1534-41. doi:10.1080/10810730.2010.499994
National Assessment of Adult Learning. National Center for Education Statistics. http://nces.ed.gov/naal/
In society the level of health literacy affects the ability to
•Access and navigate the health care system
•Manage chronic diseases
•Use preventative services
•Understand and adhere to medical advise and instructions
•Be involved in health
Benjamin, R. (2010). Health Literacy Improvement as a National Priority. Journal Of Health Communication, 151-3.
doi:10.1080/10810730.2010.499992
According to an article in Journal of Health
Communications “health professionals contribute to the
unneeded complexity of the healthcare system with poor
communication and limited dedication to patient education.
Clinicians use jargon and rarely confirm if patients
understand what is being discussed” (Paasche-Orlow,
M.K., 2010).
Paasche-Orlow, M. K., & Wolf, M. S. (2010). Promoting Health Literacy Research to Reduce Health Disparities. Journal Of Health
Communication, 1534-41. doi:10.1080/10810730.2010.499994
In an effort to develop a patient education tool the
Stonhecypher Model was developed. This was based on
low literacy levels, behavior theories and role modeling.
Theoretically it states “Successful patient education
programs are directly related to the ability of health care
professionals to apply theories of health behavior.
Effective patient education is developed when theories
are combined to support learning” (Stonecypher, K.
(2009).
Stonecypher Model
Adult
Learning
Theory
Social
Cognitive
Theory
Self
Efficacy
Theory
Health
Belief
Model
Stonecypher, K. (2009). Creating a patient education tool. Journal Of Continuing
Education In Nursing, 40(10), 462-467. doi:10.3928/00220124-20090923-06
The integration of several theories establishes the foundation of the
Stoneocypher Model for patient education.
•The Health Belief Model was the central theory, with three
theories –
•Adult Learning Theory
•Self-Efficacy Theory and
•Social Cognitive Theory, lending support.
Stonecypher, K. (2009). Creating a patient education tool. Journal Of Continuing Education In Nursing, 40(10), 462-467.
doi:10.3928/00220124-20090923-06
The Social Cognitive Theory provides understanding and
insight that support or guide changes in behavior.
Behaviors are determined not solely by knowledge, but
rather by the outcome and efficacy expectations related
to performing them
Knowles’ Adult Learning Theory maintains that problem
solving with active participation, applying past success to
current situations and immediate use of new knowledge
by knowledge retention.
Clayman, M. L., Pandit, A. U., Bergeron, A. R., Cameron, K. A., Ross, E., & Wolf, M. S. (2010). Ask, Understand, Remember: A
Brief Measure of Patient Communication Self-Efficacy Within Clinical Encounters. Journal Of Health Communication, 1572-79.
doi:10.1080/10810730.2010.500349
Stonecypher, K. (2009). Creating a patient education tool. Journal Of Continuing Education In Nursing, 40(10), 462-467.
doi:10.3928/00220124-20090923-06
The Social Cognitive Theory provides understanding and
insight that support or guide changes in behavior.
Behaviors are determined not solely by knowledge, but
rather by the outcome and efficacy expectations related to
performing them
Knowles’ Adult Learning Theory maintains that problem
solving with active participation, applying past success to
current situations and immediate use of new knowledge by
knowledge retention.
Clayman, M. L., Pandit, A. U., Bergeron, A. R., Cameron, K. A., Ross, E., & Wolf, M. S. (2010). Ask, Understand, Remember: A Brief
Measure of Patient Communication Self-Efficacy Within Clinical Encounters. Journal Of Health Communication, 1572-79.
doi:10.1080/10810730.2010.500349
Stonecypher, K. (2009). Creating a patient education tool. Journal Of Continuing Education In Nursing, 40(10), 462-467.
doi:10.3928/00220124-20090923-06
Here are two interventions that could be used by nurses in
various settings. These incorporate patient perspectives,
the culturally diverse and lower literate populations.
•Ask, Understand,Remember
•TEACH Back
Help Patients Understand [from AMA Health Literacy Tool Kit]. (2008, June 3). In Cultural Competence Online for Medical Practice
(CCOMP). Retrieved October 30, 2013
UnityPoint Health. (2013, October 3). Always Use Teach Back!. In Institute for Healthcare Improvement. Retrieved October 30, 2013
AURA – Ask Understand Remember Assessment.
The AURA is a brief and simple measure of a patient’s
perceived self-efficacy to obtain, understand, and
remember health information from his or her physician.
AURA is also useful in identifying and assisting patients
who are at risk for errors or non-adherence with self-care
behaviors.
Clayman, M. L., Pandit, A. U., Bergeron, A. R., Cameron, K. A., Ross, E., & Wolf, M. S. (2010). Ask, Understand, Remember: A Brief
Measure of Patient Communication Self-Efficacy Within Clinical Encounters. Journal Of Health Communication, 1572-79.
doi:10.1080/10810730.2010.500349
The AURA assessment tool with just 4 easy questions.
Teach Back
Always Use Teach Back!
Teach back is the method, “Tell me, Show me, Ask me”
tool that is used to accomplish teach back.
This is used to confirm patient understanding of care
instructions by asking patients to repeat the instructions
using their own words.
UnityPoint Health. (2013, October 3). Always Use Teach Back!. In Institute for Healthcare Improvement. Retrieved October 01, 2013
10 Elements of Competence
for
Using Teach Back Effectively
1. Use a caring tone of voice and attitude
2. Display comfortable body language and make eye
contact
3. Use plain language
4. Ask the patient to explain back, using their own words
5. Use non shaming, open-ended questions.
UnityPoint Health. (2013, October 3). Always Use Teach Back!. In Institute for Healthcare Improvement. Retrieved October 01, 2013
6. Avoid asking questions that can be answered with a simple
yes or no
7. Emphasize that the responsibility to explain clearly is on
you, the provider
8. If the patient is not able to teach back correctly, explain
again and re-check.
9. Use reader-friendly print materials to support learning.
10. Document use of and patient response to teach-back
Unity Point Health. (2013, October 3). Always Use Teach Back!. In Institute for Healthcare Improvement. Retrieved October 01, 2013
ANA Standards of Professional Practice
The Teach Back and AURA tools for educating patients
align with the Scope and Standards of Professional
Nursing practice in that they:
1) Utilize evidence-based practice and research. ANA
Professional Nursing Practice Standard 9.
2) Ensures that nurses communicate effective in a variety
of formats in all areas of practice. ANA Professional
Nursing Practice Standard 11.
3) Allows nurses to demonstrate Leadership in
professional practice through communicating effectively
with the healthcare consumer. ANA Professional Nursing
Practice Standard 12.
These patient education tools to improve health literacy
follow the Quality and Safety Education in Nursing
(QSEN) Competencies. These competencies call for
•Patient Centered Care
•Quality Improvement
•Evidenced Based Practice
Competencies. (2013). In QSEN Institute. Retrieved Octoberr 1, 2013 from http://qsen.org/competencies/
When healthcare professionalsl use these effective
evidence-based education tools we can help eliminate
health illiteracy and improve patient outcomes.
References:
Benjamin, R. (2010). Health Literacy Improvement as a National Priority.
Journal Of Health Communication, 151-3. doi:10.1080/10810730.2010.499992
Clayman, M. L., Pandit, A. U., Bergeron, A. R., Cameron, K. A., Ross, E., &
Wolf, M. S. (2010). Ask, Understand, Remember: A Brief Measure of Patient
Communication Self-Efficacy Within Clinical Encounters. Journal Of Health
Communication, 1572-79. doi:10.1080/10810730.2010.500349
Competencies. (2013). In QSEN Institute. Retrieved Octoberr 1, 2013 from
http://qsen.org/competencies/
Health Literacy. (2013). In American Medical Association. Retrieved October
30, 2013
Help Patients Understand [from AMA Health Literacy Tool Kit]. (2008, June 3).
In Cultural Competence Online for Medical Practice (CCOMP). Retrieved
October 20, 2013
National Assessment of Adult Learning. National Center for Education
Statistics. http://nces.ed.gov/naal/
Paasche-Orlow, M. K., & Wolf, M. S. (2010). Promoting Health Literacy Research
to Reduce Health Disparities. Journal Of Health Communication, 1534-41.
doi:10.1080/10810730.2010.499994
Stonecypher, K. (2009). Creating a patient education tool. Journal Of Continuing
Education In Nursing, 40(10), 462-467. doi:10.3928/00220124-20090923-06
UnityPoint Health. (2013, October 3). Always Use Teach Back!. In Institute for
Healthcare Improvement. Retrieved October 01, 2013