Transcript Integrating Health Literacy with Basic Skills & Family

INTEGRATING HEALTH
LITERACY WITH BASIC SKILLS
& FAMILY LITERACY PRACTICE
J. Kimbrough, PhD & J. Gore, MSW
What is health literacy?
Health literacy is the ability to obtain, understand and use health
information.

Health literacy is an essential life skill for individuals. It helps
people seek and use information to take control over their health.

Health literacy is a public health imperative. Building health
literacy improves overall population health

Health literacy is an essential part of social capital. Low health
literacy is a strong contributor to health inequities.

Health literacy is a critical economic issue. A recent US study
estimated that low health literacy costs the economy $73 billion per
year.

Who Is at Risk for Low Health Literacy?
 Anyone in the US – regardless of age, race,
education, income or social class – can be at risk for low
health literacy
– Ethnic minority groups are disproportionately affected
by low health literacy
– The majority of people with low literacy skills in the US
are white, native-born Americans
– Older patients, recent immigrants, people with chronic
diseases and those with low socioeconomic status are
especially vulnerable to low health literacy
Why does it matter???
 Adults with low health literacy:
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Are often less likely to comply with prescribed treatment and self-care
regimens
Make more medication or treatment errors
Fail to seek preventive care
Are at a higher risk for hospitalization than people with adequate
literacy skills
Remain in hospital nearly 2 days longer
Lack the skills needed to negotiate the health care system
 People with low health literacy AND diabetes:
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Were found to be less likely to have effective glycemic control
Were more likely to report vision problems caused by their diabetes
The Largest Study Conducted to Date
on Health Literacy Found That…
33% Were unable to read basic health care
materials
42% Could not comprehend directions for taking
medication on an empty stomach
26% Were unable to understand information on an
appointment slip
43% Did not understand the rights and responsibilities
section of a Medicaid application
60% Did not understand a standard informed consent
Health Literacy Status
US
NC
• clinical research efforts to
• 2005 state conference
identify best practices
• increased prioritization of
health literacy issue;
evidenced by policy &
national health goals
• national conferences to share
findings
• leadership from NCSALL
•
clinical research at UNC
•
localized projects
health department
emphasis on readability
•
2007 NC Institute of
Medicine report & emphasis
•
Making an Impact…
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Provider awareness & teaching skills
Consumer awareness & self-advocacy skills
General public awareness & demand for high
quality healthcare for all
Consumer Awareness
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One-on-one teaching in a healthcare setting
Health education materials at appropriate literacy
levels
Group teaching in an adult education classroom or
community-based setting
Teaching Health Literacy
Content vs. skills
Critical thinking
Shared learning
Shared Goals… Different Roles
Content vs. Skills
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Medical Professionals
Make health care services &
resources available
Offer & explain appropriate
screening procedures
Diagnose illnesses & develop a
plan for patient care
Prescribe medicines & explain
their purposes & side effects
Teach patients how to use
medical tools
Suggest measures to protect
individual & family health
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Adult Educators
Enhance students’ ability to
complete forms, make inquiries &
navigate new environments
Teach students to ask questions
about tests, procedures & results
Develop students’ capacity to
participate in planning by
seeking clarification & offering
suggestions
Teach students how to read
medicine labels, calculate
amounts & timing of dosages
Strengthen students’ ability to
read charts and interpret ranges
Help students learn to locate
information to guide their healthrelated decisions
Health Literacy Skills
Basic Skills
 Vocabulary
 Navigation/reading
maps/using health
systems
 Charts & graphs
 Communicating with
health professionals
 Empowered decisionmaking
Higher Skills
 Researching health
information – quality vs
quackery
 Risk & probability
 Deconstructing media
messages
 Advocacy
Teaching Health Literacy Skills
Health
Activities
Health
Promotion
Focus
Materials Adults are
Expected to Use
Enhance and Food labels & recipes
maintain
Articles in newspapers
& magazines
health
Charts & graphs
Health ed. Booklets
Tasks Adults are
Expected to
Accomplish
Purchase food
Prepare food from
recipes
Plan exercise
Maintain healthy habits
Take care of everyday
health (self & family)
Teaching Health Literacy Skills
Health
Activities
Health
Protection
Focus
Safeguard
health of
individuals &
communities
Materials Adults are
Expected to Use
Newspaper articles
Water report in mail
Health & safety
posting at work
Labels on cleaning
products
Tasks Adults are
Expected to
Accomplish
Decide among product
options
Use products safely
Vote on community
issues
Avoid harmful exposures
Teaching Health Literacy Skills
Health
Activities
Focus
Disease
Engage in
Prevention screening &
early
detection
Materials Adults are
Expected to Use
Postings for
vaccinations & screenings
Letters reporting test
results
Articles in newspapers
& magazines
Charts & graphs
Tasks Adults are
Expected to
Accomplish
Take preventive action
Determine risk
Engage in screening or
diagnostic tests
Follow up on
recommendations
Teaching Health Literacy Skills
Health
Activities
Focus
Health Care Seek health
&
care &
Maintenance form
relationship
with health
care
providers
Materials Adults are
Expected to Use
Health history forms
Medicine labels
Health education
materials
Directions for using
health care tools
Tasks Adults are
Expected to
Accomplish
Seek professional care
when needed
Describe symptoms
Follow directions
Measure symptoms
Manage a chronic
disease (follow a regimen,
monitor symptoms, adjust
regimen as needed, seek
care when appropriate)
Teaching Health Literacy Skills
Health
Activities
Focus
Materials Adults are
Expected to Use
Tasks Adults are
Expected to
Accomplish
Navigation
Access
health
services
including
coverage
and
benefits
Application forms
Statements of rights &
responsibilities
Informed consent forms
Benefit packages &
forms
Locate facilities
Apply for benefits
Fill out forms
Offer informed consent
ADULT ESOL LESSON PLAN – TAKING MEDICATIONS
LOW BEGINNING – HIGH BEGINNING
ESOL COMPETENCY: Life Skills – Health and Nutrition

Read and interpret medical instructions for prescription and
over the counter drugs.
CULTURAL FOCUS: A person must follow medical instructions
carefully in order to get well. If not taken as directed, medication can
be dangerous.
CLASSROOM PROCEDURE:
1. Teacher elicits and lists medication vocabulary.
Teacher models pronunciation; students repeat.
2. Teacher explains the importance of following for
using medication: for example take 2 tablets
once a day; take with food. Students add
additional common instructions.
3. Teacher elicits definitions of related vocabulary
terms such as pill, capsule and teaspoon.
Teacher shows examples of empty prescription
bottles and over the counter drugs.
4. Teacher models and writes on board a sample
conversation between patient and pharmacist.
Teacher elicits important questions to prepare
when talking to a pharmacist. Students practice
role-playing.
5. In small groups, students discuss what is needed
in a medicine cabinet. Name purpose for each
item. (aspirin/headache, bandages/bleeding).
GRAMMATICAL FOCUS:
Imperatives and simple instructions:
Shake well before using. Use this
medicine in your ears. Do not
operate machinery while using this
medication.
TEXT BOOKS:
Navigator book 2, p. 84-85
MATERIALS/ADDITIONAL RESOURCES:
Activity sheets: Taking Medications, Identifying Over-the-counter
Medication
EVALUATION:
Students show what is needed to stock a medicine cabinet. Students
describe uses of medication.
Students answer questions about sample medications.
PRONUNCIATION:
Produce the beginning, middle and
ending sounds in words.
ness: drowsiness, dizziness
tion: medication, information,
prescription
ine: medicine
add s to pluralize nouns:
pill(s), teaspoon(s), capsule(s)
COMMUNITY RESOURCES:
Bring in First Aid Kit or a variety of
medical items (Tylenol, bandages,
antibiotic creams, etc.) and empty
medication bottles, measuring
spoons, etc.
VOCABULARY:
label
medicine
medication / drugs
information
prescription
over the counter
pharmacy
shake well
drowsiness/dizziness
empty/refill
pharmacist
side effects
pills / tablets / capsules
appetite
teaspoon / tablespoon
overdose
external use only
emergency
avoid
take with meals
take on an empty stomach
take with a glass of water
finish all medication unless
otherwise prescribed
What does this medicine treat?
18
Anthony
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12 years old and weighs 93 lbs.
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Soccer goalie.
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Championship game today.
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Anthony has allergies: stuffy, runny nose and
sneezing; watery eyes.
Should he take this medicine? If so, how much? How
often? What side effects should he look for?
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Active Ingredients
And what they do
Drug
Facts
Label
20
Becoming an Advocate for Health Literacy
Health literacy education
Ask Me 3
Coalition Building
What Is Ask Me 3

Promotes three simple, but essential, questions
and answers for every healthcare interaction:
What Is My
Main Problem?
What Do I
Need to Do?
Diagnosis
Treatment
Why Is It
Important for Me
to Do This?
Context
Resources
UNCG ESOL lesson plans:
http://www.uncg.edu/csr/pubhealthinitiatives.htm
Resources on creating additional lesson plans:
http://healthliteracy.worlded.org/docs/comp/Materials/curricula.html
Picture Stories for Adult ESL Health Literacy:
http://www.cal.org/caela/esl_resources/Health/healthindex.html
Vocabulary Games
http://iteslj.org/Techniques.Koprowski-RecyclyingVocabulary.html
Practice Health Forms
www.fda.gov/usemedicinesafely/my_medicine_record.htm
Take Action!
Find out more about how you can help improve health literacy in your community.
Contact the North Carolina Council on Health Literacy for more information and to
join our state’s collaborative health literacy effort.