Your's is a common dilemma.  It's why I chose to do researchin this area.  I'd summate the evidence for them.  Try this reference.
               
         Calderón JL, Smith Sandra. ‘Health Literacy’, Sahler OJZ, Carr JE (eds. ) The Behavioral Science and H       Health Care (2nd edition). Cambridge, MA: Hogrefe & Huber; In press: Spring 2007
   
José Luis Calderón, MD
Research Associate Professor
College of Pharmacy, Health Professions Division
Nova Southeastern University

Ft. Lauderdale, FL  
3301 College Ave
Fort Lauderdale-Davie 33314
(O) 954-262-1295 
(F) 954-262-2278
 
Research Associate Professor
Center for Health Services Research
The Charles R. Drew University of Medicine & Science
2594 Lynwood Ave
Lynwood, CA 90262





 



----- Original Message ----
From: Janet Sorensen <Jsorensen at afmc.org>
To: healthliteracy at nifl.gov
Sent: Wednesday, March 26, 2008 11:42:41 AM
Subject: [HealthLiteracy 1867] help


Since I'm not quite as formally educated or experienced on this subject as the rest of you, I have a question from a personal as well as professional perspective.
 
As I'm sure many of you have experienced, I'm often handed printed materials in the course of my own health care (or a loved one's), or asked to fill out forms that I am tempted to rewrite, redesign and hand back to the health care provider or staff member. As a writer, I've seriously considered doing this (but waiting until my or my relative's health care crisis or issue has been resolved). Is there a graceful, persuasive and nonoffensive way to make suggestions to health care providers regarding, say, written materials, preop and postop materials and processes, and so forth? Anything that has worked or specifically NOT worked for you in winning support from health care providers or others who are in a position to make seemingly simple changes? I don't want to come across as a know-it-all because, for one thing, I don't know it all, and also because such an approach or attitude would not serve our purpose.
 
An example -- during my pregnancy, I was referred for a diagnostic ultrasound because of my "advanced maternal age" and because I had decided against amniocentesis. After the ultrasound, the high-risk OB again tried to talk me into amnio and again I politely refused. He said the ultrasound looked ok but would be read in more detail later. A few days later, I got a form letter. The first four paragraphs talked about Down syndrome, what it is, risk factors, "markers," and so forth, and how women with "advanced maternal age" are at greater risk. In the fifth paragraph, it explained that my ultrasound was (fill in the blank) negative for all of the Down syndrome markers. But by then I had already assumed my unborn child had Down syndrome and was freaking completely out. I ran the Gunning-Fog on it out of curiosity, and it was higher than 12th grade, besides just being badly written and badly organized.
 
When I mentioned this experience to my own personal OB (not the high-risk guy) and said that I thought the letter could have been written more effectively for the audience, he said it's too bad these uneducated people can't read nowadays. I agreed and said it's also too bad some educated people can't write nowadays. It occurs to me now, that probably wasn't the best response for building collaboration and support...I'm blaming hormones.
 
I'm asking now because I just went through a grueling pre-op process at an academic medical center with my 76-year-old mom, and we had to fill out the exact same detailed form at five different clinics, although they have electronic records there. I had to help an old man in one of the various waiting rooms, who could not bend his arm and had no one to help him write. And that's just the beginning. But I will stop now.
 
Any words of advice on how I could effectively offer my own, for the sake of my blood pressure if nothing else? I realize health literacy and health communication are huge and evolving fields of study, and we need scholarly papers and more research, but we also need front-line fighters. Or maybe guerilla is a better term. Polite and respectful, of course. Any response will be appreciated. thx jps
 
Janet Sorensen
Web Writer
Arkansas Foundation for Medical Care
501-212-8644
 
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