Title: E Volution: Health Education In The Information Age
1E Volution Health Education In The Information
Age
- Robert S. Gold
- Nancy L. Atkinson
2- As for the future,
- your task is not to foresee,
- but to enable it
- www.phi.umd.edu
- Antoine de Saint-Exupery, The Wisdom of the
Sands
3Before we start?
4The Digital Divide?
5Or Does It Look Like This?
ACCESS
LITERACY
LANGUAGE
DIVERSITY
QUALITY
JUDGEMENT
6Purpose
- What role do divides such as access and
literacy play in the future of health education? - What are the implications of the digital
e-volution for health and health education? - What are the challenges and opportunities for
health education? - What are the opportunities?
7ACCESS
- Healthy People 2010 Objective 11-1 Increase the
proportion of households with access to the
Internet at home. - Target 80 percent.
- Baseline 26 percent of households had access to
the Internet at home in 1998. - Data source Computer and Internet Use Supplement
to the Current Population Survey, U.S. Department
of Commerce, Bureau of the Census. - National Educational Technology Goal 1 All
students and teachers will have access to
information technology in their classrooms,
schools, communities and homes.
8People with disabilities
9LITERACY
- Healthy People 2010 Objective 11-2
(Developmental) Improve the health literacy of
persons with inadequate or marginal literacy
skills. - Potential data source National Adult Literacy
Survey, 2002, U.S. Department of Education. - National Education Technology Goal 3 All
children will have technology and information
literacy skills
10World Health Organization (WHO)
- has recently defined health literacy more
broadly, as follows - Health literacy represents the cognitive and
social skills which determine the motivation and
ability of individuals to gain access to,
understand and use information in ways which
promote and maintain good health. - Health literacy means more than being able to
read pamphlets and successfully make
appointments. - By improving peoples access to health
information and their capacity to use it
effectively, health literacy is critical to
empowerment. (WHO, 1998)
11Health literacy . . .
- This definition significantly broadens the scope
of the content of health education, indicates
that health literacy may have both personal and
social benefits, and has profound implications
for education methods.
12One direction . . .
Or two?
13How do you know when youve made it in todays
world?
14Why cant we decode this?
15- If we can figure out how to read this
Why cant we figure out how to read this?
16Why cant we land here?
17Why cant we build this?
18- If we know how to tailor messages
Why cant we figure out how to tailor
interventions?
19- If this is a cultural phenomenon
Why cant we figure out how to effectively apply
this kind of technology for health education?
20- If we have so many best practices
- Why cant we figure out how to get health
educators to use them effectively?
21So here we are!
22Core Technologies
- EDI
- Advanced satellites
- Digital imaging
- Simulations
- Fuzzy logic
- Superconductors
- Fiber optics
- Digital electronics
- Optical data storage
- Advanced video displays
- Advanced computers
- Distributed computing
- Expert systems
- Object oriented programming
- The Web
- Wireless applications
- Handheld technologies
- Biometrics
23Appropriate technology can revolutionize
- The delivery system of products and services
- The way we communicate
- The way we use and view television
- The way we individualize and personalize
education - The way we internalize, understand, and use
massive amounts of data
24Is This Vision Possible?
25Vision Statement
- Equitable access to information technology
- Ability to use information technology effectively
- Quality health promotion interventions and
information for all audiences - Ability to evaluate the quality of information
delivered through new media
26Vision Effective Use
- Just supplying hardware and software is
insufficient - Need to provide training and technical assistance
on computer and Internet use - Need to provide support staff for computer
maintenance and trouble shooting - Need to prepare gate keepers (e.g., teachers) to
use technology with their constituents / end
users (e.g., students)
27Vision Quality Information Interventions
- How do we maintain and improve on the efficiency
of current public health interventions without
dramatically increasing cost? - How do we contribute to the reduction in the
disparity in morbidity and mortality for
underserved populations? - How do we take appropriate advantage of advanced
communications technologies to accomplish the
first two?
28- The dominant training and public health
educational media strategies today, and
electronic media are insufficient to accommodate
the full potential of todays and tomorrows
needs. - More effective educational and communication
tools are necessary.
29If we are to . . .
- motivate ever larger numbers to achieve their
potential - deliver and track our efforts to remote and
diverse populations - build societal databases that allow us to monitor
the multiplicity of factors that determine the
capacity and productivity of individuals,
families, communities, and nations
30Given the context of
- A favorable atmosphere for building on technology
infrastructure - Growing recognition of the importance of
alternative technology based solutions to human
problems, needs and interests and, - The philosophical guideposts provided by public
healths traditions and vision
31Then
- . . . we must establish and act on a vision of a
communications technology research and
development paradigm that propels public health
into its future of choice. - We must invest in a complex, diverse, well
organized technology research and development
infrastructure that will ensure that our vision
is realized.
32- . . . it is an opportune time to examine ways to
apply communications technologies to catalyze,
instigate, guide, support, and monitor our
progress. Yet, at the same time, we must
recognize the importance of putting the tools
and capacity in the hands of communities rather
than limit them to governments and/or
professionals
33Imagine . . .
- an array of strategies and tools that facilitate
the active and systematic engagement of
communities in defining and dealing equitably and
intersectorally with their real issues and
concerns. - Not only will we do good work
- we will also do good.
34Heres where we are today
- e-networks
- Exquisite illustrations of effective community
building - Second and third generation tailoring
technologies - Fully developed computer and web-based education
and training courses and programs - Real-time data collection and analyses for
assessments, survey and other research - Web-based data access, data-mining
- Early, and some well developed decision-support
systems - Interesting and useful simulations
- Real time interaction with and without video
35Where do we need to look?
- To more highly refined applications for
individuals - To an understanding and application of group
applications - To an understanding and application of
system-level applications
36Heres where were going
- More of the same, only highly refined
- e-meeting technologies
- Smart card technologies
- Knowledge engineering
- Understanding new types of data (e.g., video,
audio) - Tacit knowledge
- Knowledge management
- High end decision-support and expert systems
- Simulations
- Neural networks
- Real world systems
37- As for the future,
- your task is not to foresee,
- but to enable it
- www.phi.umd.edu
- Antoine de Saint-Exupery, The Wisdom of the
Sands
38The Internet
39Digital inclusion
40People online (in millions)
41Population characteristics
42Extent of the problem
- A recent study of health literacy among Medicare
enrollees in a managed care organization
(Gazmararian, JA. JAMA, Feb 10, 1999) found that
low health literacy was far more widespread than
expected. - Overall 33.9 of English-speaking respondents had
inadequate or marginal health literacy - 53.9 of Spanish-speaking respondents had low
health literacy and, - Researchers found that health literacy declined
dramatically with age, even after researchers
made adjustments for years of school completed
and cognitive impairment.
43- A 1995 study (Williams, MV. JAMA, December 6,
1995), found - that 33 of patients at two public hospitals did
not understand instructions for a common
radiographic procedure written at the 4th grade
level - from 24.3 to 58.2 of patients did not
understand directions to take medication on an
empty stomach - 20 of patients answered questions incorrectly
regarding information on an appointment slip, and
- 40.7 to 74.5 of patients surveyed did not
understand the standard informed consent
document. - The inability to understand informed consent
documents is especially troubling because of the
implied legal and ethical implications.
44- The estimated additional health care expenditures
due to low health literacy skills are about 73
billion in 1998 health care dollars. This
includes an estimated 30 billion for the
population that is functionally illiterate plus
43 billion for the population that is marginally
literate.
45Literacy for the 21st Century
- Literacy involves a complex set of abilities to
understand and use the dominant symbol systems of
a culture for personal and community development.
The need and demand for these abilities vary in
different societies. - In a technological society, the concept is
expanding to include the media and electronic
text in addition to alphabets and numbers. - Individuals must be given life-long learning
opportunities to move along a continuum that
includes reading, writing, and the critical
understanding and decision-making abilities they
need in their communities. - The center for literacy of Quebec
http//www.nald.ca/province/que/litcent/litWD.htm
46QUALITY JUDGEMENT
- Healthy People 2010 Objective 11-4
(Developmental) Increase the proportion of
health-related World Wide Web sites that disclose
information that can be used to assess the
quality of the site. - Potential data sources Health on the Net
Foundation Health Internet Ethics (Hi-Ethics)
Internet Healthcare Coalition. - National Educational Technology Goal 4 Research
and evaluation will improve the next generation
of technology applications for teaching and
learning.