Health Literacy and Implications for Healthcare Communication

literacy

the ability to read and write

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

prevalence of low health literacy

- 36% of US adults were assessed as having limited health literacy

- 35% of adults have low health literacy

- healthy people 2030 objective is to increase the health literacy of the population

risk factors for low health literacy

- Age 65+

- lower socioeconomic status

- racial & ethnic minority

- chronic mental or physical health conditions

immigrant population

assessments of low health literacy

formal assessments:

- short assessment of health literacy (SAHL)

- rapid estimate of adult literacy in medicine (REALM)

signs of low health literacy

- frequently missed appointments

- failure to complete registration forms

- difficulty naming meds or explaining their purpose/dosing

- identification of pills by looking at the pill itself

- difficulty providing coherent, sequential med history

- lack of follow-through on tests or referrals

other observations of low health literacy

repeated use of statements such as "I forgot my reading glasses" or "I'll read this when I get home"

bringing help along frequently

quick to agree to everything with no questions

avoiding medical care altogether

related health outcomes of low health literacy

less frequent preventative screenings

disproportionately high rates of disease and mortality

increased hospitalization rates

increased use of emergency rooms for primary care

increased healthcare costs

what impact does low HL have on mental health

communication and counseling approaches goals

increase patient comprehension

decrease stigma and shame that may accompany low HL

communication and counseling approaches to improve patient comprehension

- slow down

- use living room language

- convey only the most important concepts

- involve family members

- use visual aids

- employ the teach-back method

communication and counseling approaches to create a shame-free environment

- adopt an attitude of helpfulness

- convey a safe, nonjudgmental environment

- engage the entire staff

- be alert to cues (incomplete forms, info from social history, insights from medication review)

- "how happy are you with how you read?"

patient education material (PEM)

health-related educational tools of various media - brochures, posters, infographics, models, props, podcasts, videos, social media platforms

PEMs should be written at what reading level

6th-8th grade but most education materials exceed this

Tips for creating effective PEM

education materials are generally more effective when they contain graphics/images that:

are colorful and visually appealing

are relevant and reinforce the content

accurately represent the patient population

written text in PEM should

have clear section headers

be broken up into bullet points or short bits of digestible information

NOT be in paragraph form

be ADA-accessible