The 2006 report from Rima Rudd & Jennie Anderson, The Health Literacy 
Environment of Hospitals and Health Centers, Partners For Action 
http://www.ncsall.net/?id=1167 notes that: 
although the HHS and IOM reports defined HL as  "The degree to which 
individuals have the capacity to obtain, process and understand basic 
health information and services needed to make appropriate 
healthdecisions,"  both reports "propose an expanded understanding of the 
term so that both the skills of individuals and the demands of health 
systems are considered." (p. 1) In this report, Rudd & Anderson offer 
pragmatic suggestions, examples, needs assessment tools, and activities to 
make the healthcare environment more user friendly to foster health 
literacy. The report is devoted to conveying the concept of shared 
responsibility.

Now ... to get to your questions Julie :)
Should the definition of HL refer to health professionals as well as 
patients? YES
Should we be able to use the term "The health literacy of the 
provider/clinic/hospital/ect."? YES
Does the word "literacy" in the definition confuse this new expanded 
meaning, or are we far enough along that we can all get our minds around 
it? HL is a shared responsibility.
When referring to providers, how does HL differ from "communication"? YES: 
HL is purposeful communication.
Should the definition focus on an effective "interaction" rather than 
skills of various participants? YES

While the work of Rudd & Anderson provide a valuable guide for 
implementing these changes, the provision of a more inclusive definition 
from the IOM/HHS will draw greater attention to the importance of these 
changes.

Best to all, 
Roberta McKnight, PhD, RN 
Continuing Professional Development & Evaluation Studies (CPDE)
School of Medicine, Virginia Commonwealth University
Theater Row: 730 East Broad, Suite. 430
POB 980048, Richmond, VA  23298
Phone:  +804.828.5413 Email: rmcknight at vcu.edu

"As we express our gratitude, we must never forget that the highest 
appreciation is not to utter words, but to live by them."  John Fitzgerald 
Kennedy




"Julie McKinney" <julie_mcKinney at worlded.org> 
Sent by: healthliteracy-bounces at nifl.gov
12/05/2008 09:52 AM
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Subject
[HealthLiteracy 2562]  Back to the definition...






Hi Everyone,

First of all, let me say that you all are one neat community! Look at
what's going on here in the space of two days: the definition of HL,
emotional implications of treatment refusal, compelling research-based
facts to support our work, how to write effectively for "the masses",
plain language Spanish drug information... I feel very lucky to be part
of this!

Now to my point. The recent posts from Rima, Andrew and Bill all had
good points that I agree with and lead me to more questions about the
definition of health literacy (HL). Rima and Andrew talked about how
"disquieting" it is that we blame the patients. We all agree with this.
And when we talk about costs associated with health literacy, I agree
with Rima that we cannot differentiate between costs due to medical
errors and costs due to literacy-related issues. But as Andrew points
out, these are all health literacy issues. (...in my mind, anyway.)

When I use the term "health literacy" these days, I use it in the way
Andrew described: it refers not only to the patients' HL skills, but
also to the providers' and health systems' HL skills. The accountability
to improve HL should absolutely rest on the shoulders of providers and
health systems at least as much (if not more) than on the shoulders of
the patients. 

Bill's expanded definition of HL includes services and communities, and
the word "share" in addition to "obtain, process, understand..." I like
the way this includes health providers as having some responsibility in
the HL burden.

This is a shift in the definition. So far, it has mostly referred to
skills that patients have or don't have ("obtain, undertand, process
information..."). Even though providers need to do these things as well,
the definition was rarely interpreted this way, so it appeared to refer
only to patients' skills. Now we are talking more about a definition
that includes the providers' and systems' skills to "share" and
"communicate" in ways that allow patients to do their part more
effectively. Now many of us want to be able to refer to, evaluate and
improve the HL of providers, systems and communities as well as the HL
of patients.

What do you all think about this shift? 
Should the definition of HL refer to health professionals as well as
patients? 
     (i.e. Should we be able to use the term "The health literacy of the
provider/clinic/hospital/ect."?) 
Does the word "literacy" in the definition confuse this new expanded
meaning, or are we far enough along that we can all get our minds around
it?
When referring to providers, how does HL differ from "communication"?
Should the definition focus on an effective "interaction" rather than
skills of various participants?

Ok, I'll stop now.

Thanks for bearing with my long message... :^)

Julie

Julie McKinney
Health Literacy List Moderator
World Education
jmckinney at worlded.org
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