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[HealthLiteracy 2529] Re: Treatment refusal and verbal abilities

Lisa Bernstein

lisab at whattoexpect.org
Mon Dec 1 15:19:55 EST 2008


Hi Tammy,
What a nice post-thanksgiving treat. First Chris and Rima reinforce my
favorite health literacy topic -- you can make the most gorgeous written
materials in the world, but if providers don't use them, and our audience
doesn't read them - you haven't created real change. And now, my second
favorite topic: KNOW YOUR AUDIENCE..

The immunization scare is being perpetuated amongst sophisticated, highly
literate parents. A question: is it fair to say that people with extremely
high functional literacy may at times have low heath literacy?

For those unaware of the issue, rates of vaccinations are falling for the
first time in decades because parents are nervous that immunizations may be
the cause of a host of diseases - mostly autism. These claims were based on
a faulty, unscientific article - and though countless research has proven
them false the claims are being perpetuated by some very commited parents,
with very frightening consequences. Parents who do not immunize their
children are misreading statistics, and reading unscientific information.
Is this a health literacy issue or a communication issue?

By the way,
The What To Expect Foundation has created an immunization campaign - that
includes a 16 page guide called "The What To Expect Guide To Immunizations"
and a video webcast that will launch in January. As many of you on this
list know, the Foundation's Baby Basics program is focussed on helping
underserved families. But you may not know about the other work we do for
"What To Expect" families.

The What To Expect Guide to Immunization is written to a much higher
reading level (the same level as the What To Expect When You''re Expecting
and What To Expect The First Year Guides) Why? Because in our research we
found (as have others) that it is actually moms and dads with higher
literacy levels that are the most concerned about immunizing their children
- these are parents that are more likely to purchase pregnancy and early
education information and more likely to go on-line to research
information. They wanted and needed comprehensive answers to their
questions - and some of their questions are very detailed in nature. So our
audience was not the Baby Basics audience.

Wait...before you say all good writing should be in plain language - this is
not complicated language, it is complicated science written and parsed very
clearly --but it is not something that a parent in a literacy class would or
could read.

So we've employed tactics out of Social marketing 101
1. A brand name that parents trust "What To Expect"
2. We've provided complete information, well organized and spelled out
without falling in to the twin pitfalls of condescencion or medicalese with
confusing statistics,
3. We've created a tool that providers can use and refer to so that correct
information is standardized (pediatricians have been telling us that
they are "freaked out" about how to talk to a parent about immunizing their
children.) and we've created a short training for doctors on how to address
the issue.


Unfortunately... the media has done a pretty good job of stirring up fear
about vaccinations - so underserved families are starting to hear that
there's "something to worry about" with immunizations. We will address
those issues - in our Family's First Year Basics program to launch this
spring.

For anyone who is interested in the What To Expect Guide To Immunizations, a
downloadable PDF is on our website www.whattoexpect.org.

Lisa
--
BABY BASICS IN THE NEWS:

Watch the story on WB 11:
http://weblogs.cw11.com/news/local/morningnews/blogs/2008/07/baby_basics_for_queens_familie.html#more

Read the article in USA TODAY:
http://www.usatoday.com/news/health/2008-07-01-what-to-expect-baby-basics_N.htm


Lisa Bernstein
Executive Director
The What To Expect Foundation
211 W. 80th Street, Lower Level
New York, NY 10024
212-712-9764
www.whattoexpect.org

Providing prenatal health and literacy support so that women in need know
what to expect when expecting.
On Mon, Dec 1, 2008 at 12:54 PM, Pilisuk, Tammy (CDPH-CID-DCDC-IMM) <
Tammy.Pilisuk at cdph.ca.gov> wrote:


> Hi all,

>

>

>

> I joined this ListServ recently. I'm impressed by the wisdom and exchange

> of valuable information by so many knowledgeable professionals. The

> resources noted by Mark Hochhauser are of particular interest to me working

> in immunization health education. We've seen a surge of parents who question

> or refuse immunizations for their kids.

>

>

>

> We have been working at both the emotional level (sharing of personal

> stories) and factual information (fact sheets, expert speakers). The

> audience is typically highly educated and claim to want to do lots of

> research, but defining scientific credibility of "credible" sources can also

> be construed as some sort of a government/big Pharma/western medical model

> conspiracy.

>

>

>

> I'd be curious to learn of any application of the resources Mark noted.

>

>

>

> Tammy Pilisuk, MPH

>

> CDPH Immunization Branch

>

> Richmond CA

>

>

> ------------------------------

>

> *From:* healthliteracy-bounces at nifl.gov [mailto:

> healthliteracy-bounces at nifl.gov] *On Behalf Of *Mary Jane Jerde

> *Sent:* Wednesday, November 26, 2008 10:17 AM

> *To:* The Health and Literacy Discussion List

> *Subject:* [HealthLiteracy 2517] Re: Treatment refusal and verbal

> abilities

>

>

>

> Hi,

>

> I hope that this is not too late.

>

> The points you make are excellent.

>

> It also pays to remember that the medical professionals are also going

> through similar processes in their decision making and conversations with a

> patient.

>

> Mary Jane Jerde

> NEDP Assessor

> Howard Community College

>

>

> ------------------------------

>

> *From:* "MarkH38514 at aol.com" <MarkH38514 at aol.com>

> *To:* healthliteracy at nifl.gov

> *Sent:* Tuesday, November 18, 2008 3:12:06 PM

> *Subject:* [HealthLiteracy 2474] Re: Treatment refusal and verbal

> abilities

>

>

> Mary:

>

>

>

> Much of the research on informed consent philosophically assumes that the

> decision to be treated or not be treated is a logical one. But there is much

> emerging research on the brain's role in decision making and the importance

> of emotion, logic, and even intuition.

>

>

>

> For example, psychologist George Lowenstein and his colleagues published a

> paper on "Risk as Feelings." (Lowenstein, G.F., et al. Risk as feelings. *Psychological

> Bulletin*, 2001, 127: 267-286). Because decisions aren't just logical

> thoughts, but emotional reactions, it's not surprising that patients may

> find it difficult to articulate why they don't want treatment.

>

>

>

> Malcolm Gladwell's 2005 book "blink. The Power of Thinking without

> Thinking" described how people use "thin slicing" to extract relevant

> information from all the information around them. David Myers, in his book

> "Intuition" (2002) describes "knowing without awareness"--how people can

> know things automatically (unconsciously) or cognitively (consciously). He

> summarized Seymour Epstein's description of *experiential knowing*(intuitive, automatic and nonverbal) or

> *rational knowing* (rational, analytic, verbal). Consent decisions based

> on experiential knowing may not be easy for patients to explain verbally.

>

>

>

> I've done a few articles that touch on the issue, but may not be specific

> enough for your needs. One is available online:

>

>

>

> Hochhauser, M. The anatomy of informed consent. *Applied Clinical Trials*,

> March 2005, 82.

>

>

> http://appliedclinicaltrialsonline.findpharma.com/appliedclinicaltrials/Sites+Articles/The-Anatomy-of-Informed-Consent/ArticleStandard/Article/detail/149967

>

>

>

> I can send you pdf versions of:

>

>

>

> Hochhauser, M. Emotion and logic in the informed consent process. *Research

> Practitioner*, 2005, 5(4), 138-141.

>

>

>

> Hochhauser, M. Informed consent or intuitive consent? *SoCRA Source, *February

> 2006, (Publication of the Society of Clinical Research Associates, #47,

> 32-33.

>

>

>

> Mark

>

>

>

> Mark Hochhauser, Ph.D.

>

> Readability Consultant

>

> 3344 Scott Avenue North

>

> Golden Valley, MN 55422

>

> Phone: 763-521-4672

>

> Fax: 763-521-5069

>

> Cell: 612-281-1517

>

> email: MarkH38514 at aol.com

>

>

>

>

>

>

>

>

>

>

>

>

>

> ------------------------------

>

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