Health and Literacy Crouse Nurse Practice Council

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Health and LiteracyCrouse Nurse Practice Council

• Marsha L. Tait, National Coalition for Literacy
• Donna Valerino, Literacy Volunteers of Greater
  Syracuse

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Presentation Highlights

• The Scope of Adult Literacy Globally and in the
  US
• The 2003 National Assessment of Adult Literacy
• The NAAL Health Literacy Report
• Tips and Techniques for Health Care Providers
• Resources

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Global Adult Literacy

• The UN defines illiteracy as
• Having no reading and writing skills at all
• UNESCO estimates more than 770 million adults are
  illiterate
• Two-thirds of illiterate adults are women
• UN Decade of Literacy Cut illiteracy in half by
  2015

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• The 2003 National Assessment of Adult Literacy
  (NAAL) was the first examination of the literacy
  skills of Americas adults in more than a decade
• A nationally representative household survey of
  more than 19,000 adults, including adults in
  prison

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NAAL What is Adult Literacy in the US?
Definition using printed and written information
to function in society, to achieve goals, and to
develop knowledge and potential.
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2003 NAAL Key Findings

• 11 million adults are Non-literate in English
• 30 million adults have Below Basic Literacy
  skills
• 63 million adults have Basic Literacy skills

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Why Should You Care?

• Poor Health Outcomes
• Poor Health Knowledge
• Less Frequent Screening and Preventive Care
• Increased Use of Emergency Rooms
• Increased Hospitalization
• Higher Rates of Disease and Mortality

Baker et al, 1997
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Patient Interviews
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Special NAAL Report Health Literacy
Definition The degree to which individuals have
the capacity to obtain, process, and understand
basic health literacy information and services
needed to make appropriate health decisions.
?
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AMA Definition of Health Literacy
Definition the ability to read and comprehend
prescription bottles, appointment slips and other
essential health-related materials required to
successfully function as a patient.
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NAAL Estimate ofHealth Literacy Skills
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Who needs help with health literacy?

• "We are your family-members we are your
  neighbors we are your co-workers. We are
  small-business owners we are first-responders.
  We are among the working poor we are
  millionaires. Few ever know our truth. Because of
  shame and stigma, we keep it hidden."

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Characteristics of Population with Low Health
Literacy
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Gender

• More men (16) than women (12) had Below Basic
  or Basic Literacy Skills
• Less men (51) than women (55) had Intermediate
  literacy skills
• Men had lower average health literacy scores
  (242) than women (248)

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Older Americans

• Adults aged 65 had the lowest average health
  literacy scores
• More Americans aged 65 had Below Basic or Basic
  Skills than any other age group (29 30)
• Adults with Medicare and Medicaid or no health
  insurance had the lowest average health literacy
  scores

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Health Condition Self-Assessment
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Sources of Health Information
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Information from Professionals
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Information From Other People
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Information From Print
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Information From The Internet
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Where are they getting it?

• A higher percent of adults with Below Basic or
  Basic literacy skills cited radio and television
  as their primary source of health information.

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Factors Affecting Patient Provider Communication

• Additional factors that may hinder understanding
  
• Intimidation, fear, vulnerability
• Shock upon hearing a diagnosis
• Extenuating stress within the patient's family
• Multiple health conditions to understand and treat

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• Make Effective Communications an Organizational
  Priority
• Address Patients Communication Needs Across the
  Continuum of Care
• Pursue Policy Changes that Promote Improved
  Provider-Patient Communications

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Signage
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3
3
3

• What is my main problem?
• What do I need to do?
• Why is it important for me to do this?

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What Can You Do?

• Create a safe environment where patients feel
  comfortable talking openly with you
• Use plain language instead of technical language
  or medical jargon
• Sit down (instead of standing) to achieve eye
  level with your patient
• Use visual models to illustrate a procedure or
  condition
• Ask patients to "teach back" the care
  instructions you give to them

From Askme3.org
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Avoid Jargon

• Hypertension vs High Blood Pressure
• Fatigued vs Tired
• Acetaminophen vs Tylenol
• Febrile vs Feverish
• Myopathy vs Muscle Aches

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NYS Patients Rights

• Advance directives are verbal or written
  instructions made by you before an incapacitating
  illness or injury Advance directives communicate
  that your wishes about your treatment be followed
  if you are too sick or unable to make decisions
  about your care. Advance directives include but
  are not limited to a health care proxy, a consent
  to a do-not-resuscitate (DNR) order recorded in
  your medical record, and a living will.

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Simplify, Simplify, Simplify!

• Colonoscopy is the endoscopic examination of the
  large colon and the distal part of the small
  bowel with a CCD camera or a fiber optic camera
  on a flexible tube passed through the anus. It
  may provide a visual diagnosis (e.g. ulceration,
  polyps) and grants the opportunity for biopsy or
  removal of suspected lesions.

Wikipedia
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Is Consent Informed?
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Advocacy

• Americans are anticipated to spend
• 45.5 Billion
• on their pets in 2009!

American Pet Products Association
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(No Transcript)
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Health Literacy Resources

• www.askme3.org
• www.cdc.gov/az/a.html
• www.healthliteracy.worlded.org/index
• www.hsph.harvard.edu/healthliteracy/
• www.lvgs.org
• www.jointcommission.org
• www.national-coalition-literacy.org
• www.proliteracy.org
• www.rwjf.org

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Clear Communication

• What is clear to you is clear to you. Every
  patient should be a full partner in his or her
  medical decisions. This requires crystal-clear
  communication that is done with compassion and
  mutual respect.

Toni Cordell, former adult literacy student
and health literacy advocate
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And Remember
Marsha L. Tait mtait_at_twcny.rr.co Donna Valerino
dvalerino_at_lvgs.org