All good points. Depending on a readability formula is never a good idea
-- it's just a tool and has to be used correctly.

As a writer, I can't do much about staffing or time -- but we do these
publications for doctors to hand out, to encourage patient/provider
communication, not to replace it. They are free for Arkansas physicians
to order or download, and they do order them. We do not distribute them
directly to patients because that is not our role according to our state
and federal contracts. To date, we've distributed more than 9 million
patient and provider tools statewide, and the vast majority were
specifically requested by physicians.

I've seen our publications littering the hallways myself. But
fortunately I've also seen them in patients' hands. Physician feedback
on our tools is mostly positive. I wish I could do more of them and
spend more time testing them to make them as effective as possible --
but we are usually rushed too.

This may not be a popular opinion, but to me "health literacy" is not
the biggest problem. It's health communication -- or a lack of it.
Effective communication is hard under the best of circumstances. Doctors
have their hands full, so we just try to make it a little bit easier as
one small part of our mission to improve health and health care. Maybe
I'm wrong, but I'd like to think I'm making a small difference in my own
way. I may not be adding much to this listserve, as I'm not involved
directly in health literacy research, but I've learned a lot by hanging
out with you all. 

Thank you!
Janet Sorensen, Writer
Arkansas Foundation for Medical Care
-----Original Message-----
From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Cheryl Pasternack
Sent: Tuesday, August 26, 2008 8:13 AM
To: The Health and Literacy Discussion List
Subject: [HealthLiteracy 2265] Re: CAUTION in printing out Medline
tutorials!

The issue is not so much "readability", but knowing whether the patient
understands the material.  You can write a paragraph with one and
two-syllable words that have no meaning when put together, and they will
come up as having a low reading grade, but will be completely not
understandable.

Handing out brochures without reinforcing the content is often
meaningless.  How many handouts do you find littering the hallways and
stairwells?  Having patients teach back what they are reading or what is
being explained is the goal.  The problem is having adequate staffing
and time to accomplish this.



Cheryl Pasternack, CHES
Director, Grants Management
Lincoln Medical & Mental Health Center
234 E. 149th  Street, Room 4C-162
Bronx, NY  10451
Email:   Cheryl.Pasternack at nychhc.org 
Phone: (718) 579-5697
Fax:     (718) 579-4602




>>> "Janet Sorensen" <Jsorensen at afmc.org> 8/25/2008 6:06 PM >>>

I'm glad to see this discussion and hope to learn from it. I've always
assumed that a person with diabetes will be familiar with the word, and
so I admit I haven't always counted it as a three-syllable word in doing
readability formulas. But some words are unavoidable and probably
unfamiliar to the audience.

Case in point: We're currently drafting materials for Arkansans who are
on Medicaid and have sickle cell disease, to let them know about a
medicine that may be helpful, particularly in severe cases, in
preventing painful episodes and reducing the need for transfusions. A
poster will encourage them to ask their doctor about it, and a brochure
will give physicians something to hand out to patients to improve
communication about this rather harsh but potentially helpful drug.

The name of the drug is hydroxyurea. So far, I'm putting the
pronunciation key after the drug name on first reference.

Janet Sorensen, Writer
Arkansas Foundation for Medical Care

-----Original Message-----
From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Nielsen, Lynn
Sent: Monday, August 25, 2008 10:41 AM
To: The Health and Literacy Discussion List
Subject: [HealthLiteracy 2262] Re: CAUTION in printing out Medline
tutorials!

"And I think we all agree that medical terms are necessary and also
important to include in some written materials." 

They are, and you raise excellent points.  I want to add that while
medical terms may be necessary, it is also necessary to restate medical
terms in commonly used words.



--------------------------------------------------------------------
This e-mail and any files transmitted with it are confidential and are
intended solely for the use of the individual or entity to whom they are
addressed.  This communication may contain material protected by the
attorney-client privilege.  If you are not the intended recipient or the
person responsible for delivering the e-mail to the intended recipient,
be advised that you have received this e-mail in error and that any use,
dissemination, forwarding, printing, or copying of this e-mail is
strictly prohibited.  If you have received this e-mail in error, please
immediately notify the offices designated information technology person
by telephone at 800-325-0900.  You will be reimbursed for reasonable
costs incurred in notifying us.
----------------------------------------------------
National Institute for Literacy
Health and Literacy mailing list
HealthLiteracy at nifl.gov
To unsubscribe or change your subscription settings, please go to
http://www.nifl.gov/mailman/listinfo/healthliteracy
Email delivered to jsorensen at afmc.org
************************************************************************
***
CONFIDENTIALITY NOTICE: The information in this E-mail is confidential
and may be privileged. This E-mail is intended solely for the named
recipient or recipients. If you are not the intended recipient, any use,
disclosure, copying or distribution of this E-mail is prohibited. If you
are not the intended recipient, please inform us by replying with the
subject line marked "Wrong Address" and then deleting this E-mail and
any attachments.  Arkansas Foundation for Medical Care, Inc.
(AFMC) uses regularly updated anti-virus software in an attempt to
reduce the possibility of transmitting computer viruses. We do not
guarantee, however, that any attachments to this E-mail are virus-free.
************************************************************************
***

----------------------------------------------------
National Institute for Literacy
Health and Literacy mailing list
HealthLiteracy at nifl.gov
To unsubscribe or change your subscription settings, please go to
http://www.nifl.gov/mailman/listinfo/healthliteracy
Email delivered to cheryl.pasternack at nychhc.org
-----------------------------------------
Visit www.nyc.gov/hhc

CONFIDENTIALITY NOTICE: The information in this E-Mail may be
confidential and may be legally privileged. It is intended solely for
the addressee(s). If you are not the intended recipient, any disclosure,
copying, distribution or any action taken or omitted to be taken in
reliance on this e-mail, is prohibited and may be unlawful. If you have
received this E-Mail message in error, notify the sender by reply E-Mail
and delete the message. 

----------------------------------------------------
National Institute for Literacy
Health and Literacy mailing list
HealthLiteracy at nifl.gov
To unsubscribe or change your subscription settings, please go to
http://www.nifl.gov/mailman/listinfo/healthliteracy
Email delivered to jsorensen at afmc.org
***************************************************************************
CONFIDENTIALITY NOTICE: The information in this E-mail is 
confidential and may be privileged. This E-mail is intended solely
for the named recipient or recipients. If you are not the intended
recipient, any use, disclosure, copying or distribution of this
E-mail is prohibited. If you are not the intended recipient, please
inform us by replying with the subject line marked
"Wrong Address" and then deleting this E-mail and any
attachments.  Arkansas Foundation for Medical Care, Inc.
(AFMC) uses regularly updated anti-virus software in an attempt
to reduce the possibility of transmitting computer viruses. We do
not guarantee, however, that any attachments to this E-mail are
virus-free.
***************************************************************************