June 24, 2003

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Health Communications Progress Review
June 24, 2003
Focus Area 11
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11-1. Household internet access by race and
ethnicity, 1998-2001
Percent
2010 target
Asian/Pacific Islander
White
Total
Hispanic
Black
Note Asian/Pacific Islander, Black, and White
are not Hispanic Hispanic can be of any
race. Source U.S. Department of Commerce, Bureau
of the Census, Computer and Internet
Use Supplement to the Current Population Survey.
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11-1. Household internet access by gender,
1998-2001
Percent
2010 target
Male
Female
Source U.S. Department of Commerce, Bureau of
the Census, Computer and Internet Use Supplement
to the Current Population Survey.
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11-1. Household internet access by education
level of head of household, 1998-2001
Percent
2010 target
At least some college
High school graduate
Less than high school
Source U.S. Department of Commerce, Bureau of
the Census, Computer and Internet Use Supplement
to the Current Population Survey.
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11-1. Household internet access by geographic
location, 1998-2001
Percent
2010 target
Urban
Rural
Source U.S. Department of Commerce, Bureau of
the Census, Computer and Internet Use Supplement
to the Current Population Survey.
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11-1. Household internet access, 2001
Percent
2010 target
Urban
Rural
A/PI
Black
White
Male
Female
Hispanic
High school
Less than high school
At least some college
Note A/PI (Asian/Pacific Islander), Black, and
White are not Hispanic Hispanic can be of any
race. Source U.S. Department of Commerce, Bureau
of the Census, Computer and Internet
Use Supplement to the Current Population Survey.
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11-6 a-d. Provider-patient communication, 2000
2010 target
Percent of patients who report providers always
Listen carefully
Explain things clearly
Show respect
Spend enough time
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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11-6a-d. Provider-patient communication by
race/ethnicity, 2000
Percent of patients who report providers always
Listen carefully
Show respect
Explain things clearly
Spend enough time
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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11-6a-d. Provider-patient communication by health
insurance status, 2000
Percent of patients who report providers always
Listen carefully
Show respect
Explain things clearly
Spend enough time
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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11-6a-d. Provider-patient communication by age,
2000
Percent of patients who report providers always
Listen carefully
Show respect
Explain things clearly
Spend enough time
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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11-6a. Patients reporting that doctors or other
health providers always listen to them by
race/ethnicity and gender, 2000
Percent
2010 Target
Total Not Hispanic
Hispanic Female Male
Black White
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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11-6a. Patients reporting that doctors or other
health providers always listen to them by
education level, geographic location, and health
insurance status, 2000
Percent
2010 Target
Urban Rural
Education lt12 12 13
Health insurance status Private Public None
years years years
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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11-6a. Patients reporting that doctors or other
health providers always listen to them by
disability status and age, 2000
Percent
2010 Target
Disabilities With Without
Age groups 18-24 25-44 45-64 65
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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11-6b. Patients reporting that doctors or other
health providers always explain things clearly by
race/ethnicity and gender, 2000
Percent
2010 Target
Total Not Hispanic
Hispanic Female Male
Black White
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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11-6b. Patients reporting that doctors or other
health providers always explain things clearly by
education level, geographic location, and health
insurance status, 2000
Percent
2010 Target
Urban Rural
Education lt12 12 13
years years years
Health insurance status Private Public None
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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11-6b. Patients reporting that doctors or other
health providers always explain things clearly by
disability status and age, 2000
Percent
2010 Target
Disabilities With Without
Age groups 18-24 25-44 45-64 65
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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11-6c. Patients reporting that doctors or other
health providers always show respect for what
they have to say by race/ethnicity and gender,
2000
Percent
2010 Target
Total Not Hispanic
Hispanic Female Male
Black White
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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11-6c. Patients reporting that doctors or other
health providers always show respect for what
they have to say by education level, geographic
location, and health insurance status, 2000
Percent
2010 Target
Urban Rural
Education lt12 12 13
years years years
Health insurance status Private Public None
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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11-6c. Patients reporting that doctors or other
health providers always show respect for what
they have to say by disability status and age,
2000
Percent
2010 Target
Disabilities With Without
Age groups 18-24 25-44 45-64 65
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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11-6d. Patients reporting that doctors or other
health providers always spend enough time with
them by race/ethnicity and gender, 2000
Percent
2010 Target
Total Not Hispanic
Hispanic Female Male
Black White
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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11-6d. Patients reporting that doctors or other
health providers always spend enough time with
them by education level, geographic location, and
health insurance status, 2000
Percent
2010 Target
Urban Rural
Education lt12 12 13
years years years
Health insurance status Private Public None
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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11-6d. Patients reporting that doctors or other
health providers always spend enough time with
them by disability status and age, 2000
Percent
2010 Target
Disabilities With Without
Age groups 18-24 25-44 45-64 65
Source Agency for Healthcare Research and
Quality (AHRQ), Medical Expenditure Panel Survey.
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Developmental Objectives
11-2 Improve the health literacy among persons
with inadequate or marginal literacy skills
11-3 Increase the proportion of health
communication activities that include research
and evaluation 11-4 Increase the proportion of
health-related World Wide Web sites that
disclose information that can be used to assess
the quality of the site. 11-5 Increase the
number of centers for excellence that seek to
advance the research and practice of health
communication (now has baseline)
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11-2. Health literacy

• The degree to which individuals have the
  capacity to obtain, process, and understand basic
  health information and services needed to make
  appropriate health decisions.

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Scope and nature of literacy problem
About 50 of U.S. adults are in the two lowest
levels of five levels of functional literacy
skills

• Lowest level Simple, routine tasks involving
  brief and uncomplicated texts and documents,
  e.g., can locate time and place of a meeting on a
  form or identify a specific piece of information
  in an article
• About 25 of Level 1 individuals are non-native
  speakers of English about 66 didnt finish high
  school about 33 are 65 and about 25 have
  disabilities
• Second lowest level More varied than Level 1 but
  still limited can make simple inferences,
  integrate easily identifiable information, and
  perform simple numerical calculations

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11-2. Nature of health literacy problem

• Health literacy requires written as well as other
  communication skills to understand and act on
  health information and services
• Selected research findings on health literacy
• Low literacy diabetic patients are less likely to
  know symptoms and disease management
• Low literacy asthma patients have less effective
  management
• Low literacy is associated with poorer
  self-reported health status and greater risk of
  hospitalization

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11-2. Baseline data source

• Health Literacy Component, 2003 National
  Assessment of Adult
• Literacy, National Center for Education
  Statistics, U.S. Dept. of
• Education
• Three clusters of health literacy
• Clinical (e.g., filling out a patient information
  form)
• Prevention (e.g., deciding to get a cancer
  screening)
• Navigation of the health care system (e.g.,
  understanding co-pays and deductibles in health
  insurance plans)
• Expected results in 2004 Health literacy index
  scores on the
• ability of U.S. population groups to understand
  health-related
• information

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11-3. Research and evaluation of health
communication activities

• Most likely focus for measurement Federal health
  communication campaigns
• Campaigns are typically assessed against internal
  goals, not external criteria related to campaign
  design
• Need for consensus-building on criteria for
  objective research and evaluation components in
  campaign designs

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11-3. What needs to be assessed

• The universe of health communication activities
  that should have research and evaluation
  components (the denominator)
• The actual number of health communication
  activities that do have research and evaluation
  components (the numerator).
• Short-term goal the measurement of research
  and evaluation within federally-funded or HHS
  communication activities.
• Long-term goal to identify and target for
  improvement any health communication programs
  not typically expected to include research and
  evaluation.

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11-4. Quality of internet health information

• Number of health-related Web sites is constantly
  changing, which makes measurement difficult
• Model of disclosure of quality criteria is still
  evolving
• Government role in assessing quality of Web sites
  is unclear

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11-4. Information that should be disclosed to
users of health Web sites

•     Identity and contact information of the
  developers and sponsors of the site and
  information about any potential conflicts of
  interest or biases
•       Explicit purpose of the site, including
  any commercial purposes and advertising
•       Original sources of content on the site
•       How the privacy and confidentiality of any
  personal information collected from users is
  protected
•      How the site is evaluated
•       How the content is updated

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11-5. Centers for excellence in health
communication criteria

• A focus on health communication research and
  practice
• An operational emphasis on multi/interdisciplinary
  research teams
• Solid institutional support
• Translation of research into practice
• Training of health communication professionals
  and integration of health communication training
  into other disciplines

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11-5. Centers for excellence in health
communication baseline

• Four centers have been identified by NCI
  (baseline) in 2003
• These centers are focused on cancer communication
• A target-setting method has been proposed

Source National Institutes of Health, National
Cancer Institute.
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• Data and slides for
• Healthy People 2010 progress reviews
• are available at
• http//www.cdc.gov/nchs/
• hphome.htm