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Health Literacy for Better Public Health

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Selected Category: Public health practice

Health Literacy Basics: Who is the Audience and What is the Purpose?

Categories: Public health practice

In his book The Checklist Manifesto, Dr. Atul Gawande argues that people, even experts, often skip basic, critical steps that can determine success or failure in a project or task. He proposes that people use checklists to increase the accuracy and consistency of their performance.  Checklists draw our attention to all the elements in a process, not just a selective few that we remember or feel most comfortable doing.  

Last week’s health literacy workshop at the National Conference on Health Communication, Marketing and Media illustrated how often we overlook basic, critical steps in public health communication. Workshop participants used a health literacy checklist to evaluate 2 public health materials. Although the checklist had almost 3 dozen items, the first 2 items – audience and purpose – took up the majority of the discussion period in the exercise.

Participants identified multiple audiences and purposes for each piece. Without a clearly defined audience and purpose, it was difficult, and in some cases, meaningless to go through the rest of the checklist. For example, you can’t decide if a material is filled with jargon if you don’t have a clearly defined audience. Jargon for one audience might be everyday language for another.  Or, you can’t determine if you’ve included the correct health behaviors if you don’t know audience and purpose.

If you want to try a full checklist, see CDC’s plain language manual, Simply Put, Appendix A . Whether you use a checklist or not, try using these 2 questions when you plan, review or revise your next health material.

1)      Who is the primary audience?

2)      What is the primary purpose of this material?

Do you agree these are the 2 most important questions? Can you think of other, equally important questions that have made a difference in your materials?

Health Literacy Sessions at National Conference on Health Communication, Marketing and Media

Categories: Public health practice

This week marks the Sixth National Conference on Health Communication, Marketing and Media in Atlanta, Georgia. Each August, health communicators, educators, social marketers, media specialists, and other public health professionals discuss the state of the science in communicating about health.  

Once again, the conference includes a 3.5 hour workshop on health literacy as part of a social marketing strategy. Health literacy and social marketing approaches put the end user or “customer” at the center of exchange and focus on creating useable products and services.

Although social marketers will tell you information is not a product, information is a critical component of how people make decisions that can affect their use of products and services.  When we design information that reduces the demand to understand information about symptoms, for example, we can positively affect people’s use of medicines and visits to healthcare providers.

In addition to the workshop, a breakout session includes four presentations on health literacy. One previews a new tool for CDC staff to evaluate health messages and materials. Another reports findings of a content analysis and consumer interviews on public messages about H1N1 pandemic influenza. A third presentation describes changes to CDC’s immunization campaigns based on parents’ feedback. The fourth presentation describes how a manual for health professionals was revised using plain language. 

For the first time, parts of the conference will be streamed live. You can watch the plenary sessions and a limited number of special and breakout sessions. To register, visit  https://cdc.6connex.com/portal/2012NCHCMM/login

Health Literacy Outcomes and Public Health

Categories: Public health practice

How do we know that focusing on health literacy makes a difference?  The passing of Len Doak, co-author of the classic text Teaching Patients with Low Literacy Skills, places this question in a personal context. The question is also relevant for health research, evaluation and policy. Policymakers, managers, project funders, and professional and administrative staff want to know if paying attention to health literacy makes a difference.

Len and Ceci Doak and Jane Root wrote the book on health literacy practice in clinical settings. They were tireless advocates and made a difference by explaining health literacy and engaging others in the work.  The large number of people drawn into health literacy because of their book and gracious mentorship is one type of difference.

But, decisionmakers typically want evidence of a different kind. They want measurable outcomes aligned with organizational or policy requirements to know if a change or intervention is worthwhile.  Quality, cost and access are typical healthcare outcomes of interest. The two systematic reviews of evidence along with many single studies suggest that limited health literacy decreases healthcare quality and access and increases costs.

Defining outcomes for health literacy practice in public health is equally important. If we aim to reduce illness and death on a large scale, how can attention to health literacy help us get better public health outcomes? 

For example, many different organizations provide health information to the public. Sometimes they use highly visible mass media campaigns directed at millions of people; other times they may use a web site and targeted promotion to a very specific audience.

The outcomes for mass media campaigns might include reach (did we reach the audiences we intended to reach?), recall (does the audience recall seeing our messages and do they recall specific messages?), and attitude change (did our messages change their attitudes?). Web site metrics might include most popular features, time spent on pages and number of downloads of site products.  How might these outcomes help us learn about health literacy?   

As we think about the many types of public health work that could benefit from health literacy insights, we should also think about the outcomes we want. Please share your ideas about outcomes you already address and outcomes you’d like to address from a health literacy perspective.

Limited Health Literacy and Public Health Practice

Categories: Public health practice

If you work in public health, you probably have experience with the impact of limited health literacy on your everyday work. Public health communicators are responsible for getting out vital information.  This information is often technical or unfamiliar to the public at large and to specific groups affected by a public health threat. We may rely on other government agencies, community groups, schools, the media – traditional and social media – and partner organizations to help us reach as broadly as possible into the community.

Limited health literacy, however, affects more than communication. It affects how we design, implement and assess public health programs, conduct outbreak investigations, respond to public health emergencies, and monitor and track health conditions in communities.

When we

  • provide screening services that require people to fill out forms they don’t understand,
  • ask residents questions about community conditions that don’t make sense to them, or
  • provide jargon-filled information about a public health threat that doesn’t provide a clear action step to lower the threat

we’ve missed an opportunity to improve public health.     

The National Action Plan to Improve Health Literacy includes goals and strategies that any public health organization can use to improve its own practices and identify local partners to help connect with the community. Adult literacy service providers, librarians, social service agencies, such as those that meet the needs of homebound elders, and visiting nurse associations are examples of non-traditional partners that reach people in everyday life.

If you work in public health, please share your experiences with us about the role limited health literacy plays in the work of your organization and how you are improving health literacy. 

If you work in public health, who outside of public health would you like to partner with on limited health literacy? What do you need to make these partnerships happen?

 
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