Health Literacy for Public Health Professionals (CDC Training)

what is personal health literacy"?

the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others

what is organizational health literacy"?

degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others

what approach should be used in health communication?

audience-centered approach

Health literacy for individuals and communities is essential for

• understanding a health risk,

• voting on an environmental issue,

• recognizing biases in health information reported by the media,

• or responding to alerts and warnings, such as those for severe weather.

Health literacy for professionals also includes the following:

• Critical evaluation of how we do our work

• Creating standards of practice that support and incorporate health literacy principles as a fundamental component of our programs, information, and services

Health professionals develop and disseminate information and services to address a wide range of health issues and topics, including the following:

Smoking and exposure to second-hand smoke

Using sunscreen

Throwing away our trash

Getting immunizations and stopping the spread of communicable diseases

Wearing a seat belt

Many factors within the public health system affect how people understand and use health information. The factors include the following:

• Communication skills of public health professionals

• Level of complexity and novelty of the health information

• Cultural and linguistic suitability of health information and services.

• Public health infrastructure that facilitates and supports healthy behaviors

The U.S. Department of Education defines literacy as

the ability to understand, evaluate, use, and engage with written text to participate in society, to achieve one's goals, and to develop one's knowledge and potential.

Literacy gives us the skills to understand and communicate health information and concerns. When we apply these skills in a health context, such as reading a nutrition label or getting a flu shot, it is called

health literacy

% of high school graduates are not health literate

45%

According to the NAAL, the majority of adults (%) do not have the full range of health literacy skills needed to prevent disease and protect their health

88%

what are the four NAAL Health Literacy Levels

1. below basic

2. basic

3. intermediate

4. proficient

Which of the following are factors that affect health literacy?

Communication skills of public health professionals

Level of complexity of the health information

Information dissemination channels

All of the above

All of the above

Adults with below basic health literacy are more likely than the general population to

Have graduated from high school

Search for health information on the Internet

Be in excellent health

Be age 65 or older

Be age 65 or older

Only % of adults have the skills needed to effectively manage their health and prevent disease

12

characteristics of indiivduals with limited health litercy

• Are less frequent users of preventive services such as mammograms, pap smears, and flu shots

• Are less effective at managing chronic diseases such as high blood pressure, diabetes, asthma, and HIV/AIDS

• Have higher rates of hospitalization and use of emergency services

• Are more likely to report their health as poor

• Report a sense of shame about their literacy skills

At the community level, limited health literacy can result in

• Misunderstandings about public health warnings about food safety

 

• Missed opportunities for services, such as free vaccines and preventive screenings

 

• Lack of preparation for emergencies, such as severe weather, bioterrorism attacks, and evacuations

 

• Missed warnings regarding environmental health and safety, such as contaminated water

Which of the following is or are associated with people who have limited health literacy?     

Less frequent use of preventive services, such as mammograms, pap smears, and flu shots

Less effective management of chronic diseases such as high blood pressure, asthma, and HIV/AIDS

Lower likelihood of understanding food labels

Greater likelihood of feeling embarrassed when asking questions or seeking health information

all of the above

Which of the following might people with limited health literacy experience?

Silence

Shame

Lost rights if, for example, a person doesn't fully understand the paperwork to give informed consent

Compromised health

all of the above

Which of the following benefit from gains in personal or organizational health literacy?

Consumers

Healthcare professionals

Public health professionals

Academic institutions

Faith-based organizations

all of the above

In 1988, the Institute of Medicine, now known as the National Academy of Medicine, recommended that federal, state, and local health agencies increase their administrative capabilities in the following three core functional areas:

• Assessment

• Policy development

• Assurance

the two essential services in public health assessment are

• Assess and monitor population health status, factors that influence health, and community health needs.

• Investigate, diagnose, and address health problems and hazards affecting populations

The four essential services of policy development include the following:

• Communicate effectively to inform and educate people about health, factors that influence it, and how to improve it.

• Strengthen, support, and mobilize communities and partnerships to improve health.

• Create, champion, and implement policies, plans, and laws that impact health.

• Utilize legal and regulatory actions designed to improve and protect the public's health.

The four essential services of assurance include the following:

• Assure an effective system that enables equitable access to the individual services and care needed to be healthy.

• Build and support a diverse and skilled public health workforce.

• Improve and innovate public health functions through ongoing evaluation, research, and continuous quality improvement.

• Build and maintain a strong organizational infrastructure for public health.

You are a prevention specialist assigned to the DeKalb County Health Department in Georgia. Over the past five years, DeKalb County has had the highest rates of stroke and heart disease in the state. You are working on a project in collaboration with Grady Memorial Hospital to assess, develop, and implement an innovative program that focuses on heart disease and stroke prevention.

You begin the project by conducting a needs assessment. This assessment should include which of the following:

Health status monitoring to identify health problems and related factors, determining which segments of the population are most affected, and assessing the health literacy skills of the population

Health status monitoring to identify health problems and related factors, determining which segments of the population are most affected, and developing policies that address issues for the most affected populations  

Health status monitoring to identify the health problems and related factors, determining which segments of the population are most affected, and mobilizing community partnerships to solve the health problem

Health status monitoring to identify health problems and related factors, determining which segments of the population are most affected, and assessing the health literacy skills of the population

You are a prevention specialist assigned to the DeKalb County Health Department in Georgia. Over the past five years, while conducting the needs assessment, you discover that certain population segments in the community are more likely to have heart disease or to have had a stroke. Your assessment reveals that health literacy skills are limited among these segments. Individuals within these segments are not aware of the importance of preventing and controlling risk factors, such as high blood pressure, tobacco use, and obesity to reduce the risk. When presented with health information, the prioritized population has trouble associating risk factors with personal actions they can take to prevent these illnesses. You are working on a project in collaboration with Grady Memorial Hospital to assess, develop, and implement an innovative program focusing on heart disease and stroke prevention.

Now that limited health literacy skills have been identified as one of the community's issues, which essential services will be important when addressing the health literacy needs of the population?

Forge partnerships with those who serve and understand your audience. These partners, such as churches or civic groups, can provide expertise or support initiatives that are relevant to your audience.

Ensure a competent public health workforce that understands the consequences of limited health literacy and is trained to provide information to those with limited health literacy skills.

Educate and empower people about the risk of heart disease and stroke and provide actionable recommendations to prevent each illness.

All of the above are essential services that are important in addressing health literacy needs

All of the above are essential services that are important in addressing health literacy needs

After more research, you learn that most individuals in the prioritized population with limited health literacy rely upon the hospital emergency room when they are ill because they do not have a primary care physician. Most of the information this population receives is written at inappropriately high reading levels. Also, these materials explain what heart disease and stoke are, but do not provide clear prevention actions.

What factor should NOT be considered to ensure the heart and stroke program will meet the needs of this population?

Involve members of the prioritized population at every stage of the program, from initial planning to evaluation, to develop a program that will be effective and well received.

Ensure that all messages and materials developed are in the appropriate language and at the appropriate reading level for the prioritized population.

Disseminate well-developed materials in waiting rooms in public or private clinics.

None of the above

Disseminate well-developed materials in waiting rooms in public or private clinics.

Which is NOT a possible challenge in applying an approach for individuals with limited health literacy skills?

Obtaining resources to develop more tailored prevention programs

Encouraging members of the intended audience to advocate for themselves, their families, and their communities to receive appropriate healthcare and information

Inaccurately assessing knowledge and needs of the intended audience, as individuals with limited health literacy often feel stigma and shame, prohibiting public health professionals from gaining correct information

None of the above. All are possible barriers or challenges

None of the above. All are possible barriers or challenges

Which of the following is NOT a strategy for improving health literacy?

Using plain language

Focusing efforts on improving awareness

Using culturally and linguistically appropriate communication

Employing participatory, user-centered design

Focusing efforts on improving awareness

As public health professionals, it is important that we address barriers that can prevent audiences from understanding and acting on vital health and safety messages. The most common barriers include

• use of technical or medical terminology

• reliance on print communication

• focusing on info rather than actions

• limited awareness of cultural difference

Ensure public health information and services are __________, __________, and __________ __________.

Ensure public health information and services are appropriate, actionable, and easy to understand and use.

Examples of health information and services

• Health promotion materials

• Forms and instructions

• Warnings and public advisories

• Test results

• Press releases and other media

• One-on-one instruction and community education

• Family planning

• Vaccinations and immunizations

• Preventive screenings

Plain language is a communication style that users can understand the first time they read or hear it. Plain language includes

• Familiar language in an active voice

• Placement of important information first

• "Chunking” similar information into smaller groups

• Using bulleted items for information in a series or a list

Each of the following can be implemented to improve the usability of health information EXCEPT

Limit the number of messages.

Use plain language.

Supplement text with pictures.

Include multiple messages

Include multiple messages

Involve ____________ from your intended audiences in planning, implementing, disseminating, and evaluating health information and services.

representatives

Always consider ______-centered design principles when planning your health communication materials.

user

A product development method that involves users in all stages of the development process to create products that meet users' needs is called ________.

User-centered design

Process evaluation

Plain language

Usability testing

User-centered design

Which of the following organizations could serve as a potential partner for disseminating health information to the community?

Libraries

Adult education programs

Social service providers

All of the above

All of the above