Lisa, 

 

Thanks for responding! And I actually have a copy of the "What to
Expect" guide on my desk. It's nicely done. But one minor unfortunate
aspect is that it bears the GSK logo on the back. Suspicious parents may
dismiss information they feel is tied to the pharmaceutical industry. 

 

My constant quandary is how to balance science and emotional impact. The
audience tends to be highly educated, but the issues are complex and not
everyone worries about the same thing. Some worry about thimerosal, some
about government intrusion, some about the medical establishment, some
that vaccine-preventable diseases aren't really that dangerous. We're
trying to approach the issue at different levels. But I'd welcome any
feedback from this group about how to use the psychology to get at what
influences parents' decision-making.

 

We've recently completed some fact sheets in cooperation with the
California Immunization Coalition. If you or others would like to check
them out, they're online on the coalitions' homepage at:
www.immunizeca.org <http://www.immunizeca.org/>  

 

Tammy

 

________________________________

From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Lisa Bernstein
Sent: Monday, December 01, 2008 12:20 PM
To: The Health and Literacy Discussion List
Subject: [HealthLiteracy 2529] Re: Treatment refusal and verbal
abilities

 

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
<http://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-basic
s_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/d
etail/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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