Introduction to Health Information Literacy

Developed by the Medical Library Association working with the National Library of Medicine

under contract HHSN276200663511/NO1-LM-6-3511

April 2008

Learning Objectives

Describe the impact low health literacy has on quality patient care

Define health information literacy and the challenges patients face

Identify health information literacy resources and tools available to you and your patients

What is Health Literacy?

“The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”

Healthy People 2010

What factor affect Health Literacy?

Health literacy is dependent on the individual and system factors:

Communication skills Information and knowledge Culture and language Demands of the system

Health Literacy From the Patient’s Perspective?

Source: Source: Help Your Patients UnderstandHelp Your Patients Understand. AMA Foundation Health Literacy.. AMA Foundation Health Literacy. www/.a-ssn.org/ama/pub/ category/8115.html www/.a-ssn.org/ama/pub/ category/8115.html

Mrs. CordellMr. Bell

Why is Health Literacy Important?

Health literacy is linked to:

Under utilization of services Increased medication error Poor knowledge about health Poor health outcomes Increased hospitalization Increased health care costs

Why Now?

Healthy People 2010 (DHHS 2000)

Health Literacy: A Prescription to End Confusion (IOM 2004)

Evidence Report/Literacy and Health (AHRQ 2004)

17th Surgeon General of the United States - Dr. Richard Carmona (2006)

Why Hospitals?

“The safety of patients cannot be assured without mitigating the negative effects of low health literacy and ineffective communication on patient care.”

The Joint Commission

Source: “What did the Doctor Say?:” Improving Health Literacy To Protect Patient Safety. The Joint Commission Source: “What did the Doctor Say?:” Improving Health Literacy To Protect Patient Safety. The Joint Commission (2007). (2007). www.jointcommission.org/PublicPolicy/health_literacy.htmwww.jointcommission.org/PublicPolicy/health_literacy.htm

How is Information Critical to Health Literacy?

Health information is key to:

Patient and provider communication Shared health care decision making Understanding and following a

treatment plan Recognizing when to seek care Learning about and adopting healthy

behaviors

What is Health Information Literacy?

The abilities needed to:

Recognize a health information need

Identify relevant sources of information

Assess the quality of the information

Understand and use the information to make informed health care decisions

What are the Health Information Literacy Challenges?

Health Literacy Levels

Readability of Health Materials

Health Information and the Internet

Health Literacy in the U.S.

Over 75 million Over 75 million adults have adults have BasicBasic and and Below Below BasicBasic health health literacyliteracy

Only 1 in 9 Only 1 in 9 adults have adults have proficient health proficient health literacy skillsliteracy skills

Number & Percentage of Adults in Each Number & Percentage of Adults in Each Health Literacy LevelHealth Literacy Level

Source: The Health Literacy of American Adults. Results from the 2003 National Assessment of Adult Literacy. Source: The Health Literacy of American Adults. Results from the 2003 National Assessment of Adult Literacy. National Center for Education Statistics (2006).National Center for Education Statistics (2006). http://nces.ed.gov/Pubsearch/pubsinfo.asp?pubid=2006483http://nces.ed.gov/Pubsearch/pubsinfo.asp?pubid=2006483

Readability of Health Information

Numerous studies document health materials written at reading levels far exceeding patient skills

More recent studies find similar results looking at the readability and usability of online health resources

Source: NLM Bibliography—Understanding Health Literacy and Its Barriers (2004): http://www.nlm.nih.gov/pubs/cbm/healthliteracybarriers.html

Computers and the Internet

80% of Internet users search for health information

86% do not seek advice about which websites to use

72% express trust in most or all information found online

75% said they rarely or never check for source and date

Source: Fox, S. Vital Decisions (2003). Online Health Search (2006). Washington, DC:Source: Fox, S. Vital Decisions (2003). Online Health Search (2006). Washington, DC: Pew Internet & Pew Internet & American Life Project. American Life Project. http://www.pewinternet.org/PPF/c/5/topics.asp

MLA “Top 10” Most Useful Consumer Health Websites Cancer.gov * CDC.gov * Familydoctor.org * Healthfinder.gov * Kidshealth.org * AidsInfo.nih.gov Mayoclinic.com Medlineplus.gov * Medem.com Noah-health.org *

*Available in Spanish *Available in Spanish and/or other languagesand/or other languages

www.medlineplus.govwww.medlineplus.gov

Interactive Health TutorialsInteractive Health Tutorials

http://www.nlm.nih.gov/medlineplus/tutorial.htmlhttp://www.nlm.nih.gov/medlineplus/tutorial.html

NIHSeniorHealth.govNIHSeniorHealth.gov

www.aidsinfo.nih.govwww.aidsinfo.nih.gov

www.kidshealth.orgwww.kidshealth.org

www.informationrx.orgwww.informationrx.org

Deciphering Medspeak

Medical Library Association’s

Consumer Health Brochures HIV Cancer Diabetes Asthma Others

www.mlanet.org/resources/medspeak/index.htmlwww.mlanet.org/resources/medspeak/index.html

Strategies to Improve Communication

Limit information (3-5 key points)

Use easy-to-read information Be specific and concrete, demonstrate

Check for understanding, use a “Teach Back” or “Show Me” approach

Recognize culture difference and language needs

How Can Librarians Help?

Fill Information Rxs with accurate and reliable information

Free access to the Internet

Help patients find information they can use and understand

Patient information packets

How Can Librarians Help?

Patient/Consumer trainings Search skillsSearch skills Assessment skillsAssessment skills

Provider trainings Search skills Health literacy training

Community outreach

Take Home Points

Accurate and reliable information is critical to health literacy and essential to providing quality care

Info Rxs is a valuable tool for referring patients to reliable health information and to the hospital library for support

Thank You!

Questions

Comments

References

AHRQ Report—Literacy and Health Outcomes (2004): http://www.ahrq.gov/clinic/epcsums/litsum.htm

AMA Foundation Health LiteracyAMA Foundation Health Literacy: : www.ama-assn.org/ama/pub/category/8115.html

Carmona, R.H. (2006) Health Literacy: A National Priority Carmona, R.H. (2006) Health Literacy: A National Priority Journal of General Internal Medicine 21(8).Journal of General Internal Medicine 21(8). www.blackwell-synergy.com/doi/full/10.1111/j.1525-1497.2006.00569.x

Fox, S. & Fallows, D. Internet Health Resources. Washington, Fox, S. & Fallows, D. Internet Health Resources. Washington, DC:DC: Pew Internet & American Life Project (2003). Pew Internet & American Life Project (2003). http://www.pewinternet.org/PPF/c/5/topics.asphttp://www.pewinternet.org/PPF/c/5/topics.asp

Healthy People 2010 (2000): http://www.healthypeople.gov

Healthy People 2010 Health Literacy Action Plan—Communicating Health: Priorities and Strategies for Progress (2003): http://odphp.osophs.dhhs.gov/projects/healthcomm/objective2.htm

References IOM Report—Health Literacy: A Prescription To End

Confusion (2004): http://www.iom.edu/report.asp?id=19723

NIH/AHRQ program announcements—Understanding and Promoting Health Literacy: http://grants.nih.gov/grants/guide/pa-files/PAR-04-116.html; http://grants.nih.gov/grants/guide/pa-files/PAR-04-117.html

NLM Bibliography—Understanding Health Literacy and Its Barriers (2004): http://www.nlm.nih.gov/pubs/cbm/healthliteracybarriers.html

The Health Literacy of America’s Adults: Results from the The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy 2003 National Assessment of Adult Literacy http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483

The Joint Commission Report: “What did the Doctor Say?:” The Joint Commission Report: “What did the Doctor Say?:” Improving Health Literacy To Protect Patient Safety (2007):Improving Health Literacy To Protect Patient Safety (2007): www.jointcommission.org/PublicPolicy/health_literacy.htm

Medical Library Association, “Top 10” Most Useful Consumer Medical Library Association, “Top 10” Most Useful Consumer Health Websites Health Websites www.mlanet.org/resources/medspeak/topten.html