A collection of health literacy curricula

Links to health literacy curricula collected after a discussion on the National Institute for Literacy Health and Literacy listserv.

"The curricula are organized by the following types: University courses, Medical School courses, Professional training programs, and Adult Basic Education/ESL/ENL program courses."
http://www.advancinghealthliteracy.com/curricula.html

New article: "Literacy and Health: Implications for Active Living"

"Literacy and Health: Implications for Active Living"
by Irving Rootman and Joan Wharf-Higgins in
Alberta Centre for Active Living's WellSpring (October 2007 Vol 18, No. 4)

"What’s in this article for you? This article focuses on the following main topics:

• What is literacy and health literacy?
• Why should active living practitioners be interested in literacy and health literacy?
• Do people understand communications about physical activity?
• What can you do to address literacy or health literacy in your practice?"

Read more:
http://www.centre4activeliving.ca/publications/wellspring/2007/october.pdf

How to be a "pleasantly assertive" patient

Researchers at University of North Carolina at Chapel Hill offer five ways to get more from your doctor.

These days, going to the doctor may seem more like speed dating than care giving. Patients get a few minutes with the clinician, and he or she does most of the talking. How can a person get the information they need and the outcome they desire in a 15-minute office visit? What if the treatment options don’t feel right? Is it too much for a patient to feel they are considered a partner in their own well-being?

Often, people leave their doctor’s office with more questions than answers, according to researchers at the University of North Carolina at Chapel Hill School of Medicine who are looking at how patients can get more of what they need from the health-care system. They have found that patients (or their advocates) who talk to physicians about their beliefs, values, lifestyle and
concerns can get better results from their health-care experience.

“Research shows if you ask doctors what they think is important to patients, and then ask patients what’s important to them, there’s not a great match,” said Dr. Michael Pignone, chief of the UNC division of general internal medicine.

But, as smart as doctors are, they aren’t mind readers, Pignone and his colleagues note. “A common problem is patients thinking that their physician will know how they – the patient – feels about specific decisions” said Dr. Carmen Lewis, assistant professor of medicine of general internal medicine and clinical epidemiology. “Doctors don’t – you need to tell them. People feel the doctor is the expert, but the individual is the expert about his or her lifestyle and how he or she values options and outcomes.”

Pignone offered some tips for becoming what he calls a “pleasantly assertive” patient, so that patients’ health-care providers can better help them.

1. Prepare for your visit. “It might seem silly, but it’s really helpful to write down your symptoms, complaint or problem, then summarize it into a couple of sentences,” Pignone said. “Bring your list and your summary with you to the visit. This allows the doctor to quickly review your condition and ask specific questions, instead of spending time focused on general issues. This one step can make visits 25 percent to 50 percent more effective.”
2. Have an agenda. “Before your appointment, decide what you want from the visit,” Pignone recommends. “For instance, if you’re suffering back pain, you might want to know what is causing the pain as well as a treatment plan for getting better. Make sure you share that with your doctor at the very beginning of your visit. It might feel funny at first, but your doctor will appreciate it. Sharing this information will help you all make better decisions about treatment, make the visit more efficient, and improve the chance that your health-care needs will be met effectively.”
3. Know your medical history and medications. “To help you get the treatment you need, doctors need to know what tests you’ve had – and when – as well as what medications you’re taking,” Pignone said. “Without that information, they might mistakenly re-order tests or prescribe medication that has a bad interaction with something you’re already taking. That can have adverse effects for your health and your wallet.”
4. Tell your provider about your values or lifestyle preferences that could affect your treatment. “It doesn’t make sense to agree to a treatment plan you know you won’t follow – it won’t result in your feeling better,” Pignone cautioned. “For example, if a Wednesday night smoking cessation class conflicts with your book club, it’s not going to be an effective intervention for you. On a more serious level, if you don’t want to deal with the uncertainty of a possible recurrence of cancer, you might prefer a mastectomy to a lumpectomy. Similarly, if you can’t afford medication or to take off work for recurring visits, tell your provider even if you’re embarrassed. There are often ways to work around the challenges if your care team knows about them.”
5. Clarify the decision to be made. “Sometimes you’re offered several options, so be sure you understand the alternatives and if you don’t, ask for clarification,” Pignone said. “Your doctor should be able to give you important details about each option either during the visit, or on a follow-up call. In addition to the details, ask them how good the medical information is.”

Pignone and Lewis acknowledged that this approach results in a very different doctor-patient relationship, but evidence shows that proactive patients tend to get more effective and efficient care.

“The sicker you are, the more this matters,” Pignone said. “But it’s harder to do. If you’re not comfortable interacting this way, involve other people who support you in your life to come with you and play this role.”

US health education in barbershops and beauty salons

As part of its mission to train the next generation of physicians and scientists, the Mayo Clinic Center for Translational Science Activities (CTSA) offers the Health Disparities Field Experience, a unique course through Mayo Graduate School. For this year's fieldwork, course scholars and faculty are joining with the Center for Minority Health (CMH) at the University of Pittsburgh's Graduate School of Public Health in its innovative program called 'Take a Health Professional to the People Day' on Sept. 18, 2008. This event has been recognized nationally with a feature on the Web site of the National Center on Minority Health and Health Disparities (NCMHD), National Institutes of Health (NIH).

Health disparities — the gaps in health care access and outcomes among different populations — lead to higher rates of chronic illness, disability and death from preventable causes for minorities. Now in its seventh year, Take a Health Professional to the People Day deploys teams of physicians, nurses, pharmacists, dentists and public health educators to 10 barbershops and beauty salons in inner-city Pittsburgh to deliver health information and health screenings to customers. In 2007, 150 health professionals screened more than 556 African-Americans in these neighborhood settings.

Why take health education efforts to barbershops and beauty salons?

These settings are effective because they are familiar community assets and trusted institutions in African-American neighborhoods where people gather to connect and exchange information. "Far too many African-Americans have no 'medical home' to access health care services, so government programs that promote 'taking a loved one to the doctor' are not as effective for this community," explains Stephen B. Thomas, Ph.D., director of CMH and the Philip Hallen Professor of Community Health and Social Justice. "Therefore, CMH created Take a Health Professional to the People Day. By focusing our efforts on a single day, we believe we can help generate a greater understanding of the importance of regular health screenings while at the same time reaching people who tend to have the least access to health care." In addition, the program serves as an excellent training opportunity for health professionals, who benefit from engaging minority populations outside of the clinical environment.

For more information about Take A Health Professional to the People Day, the NIH-NCMHD Research Center for Excellence in Minority Health Disparities, and other activities of the University of Pittsburgh Center for Minority Health, visit the University of Pittsburg Center for Minority Health Web site.

Study Explores Value of Recording Medical Visits for Cancer Patients

Patients can find it hard to absorb what their doctors tell them during stressful moments. Recordings or transcripts of office visits could help people with cancer—or their family members—recall medical information they might otherwise have missed, a new review suggests.

“It is important to consider anything that can improve the cancer patient’s experience, especially interventions that can be easily accommodated within the normal office visit,” said lead author Marie Pitkethly, co-coordinator of the Scottish Primary Care Research Network in Dundee.

The review included 16 studies of 2,318 adults who either had cancer themselves or were dealing with a close relative with cancer. The researchers looked at the effects of providing recordings or summaries of doctor-patient interactions on information recall and understanding, participation in follow-up visits, satisfaction and other concerns.

The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews like this one draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Richard Frankel Ph.D., a professor of medicine and geriatrics at the Indiana University School of Medicine, said many people who receive cancer information at the doctor’s office do not accurately remember what the physician said.

“Anything that can be done to increase their potential for retaining information is worth trying,” he said. “This review shows that the use of audio or videotapes can be very useful in some patients, but not all patients. The primary lesson this review teaches us that there needs to be an individualized approach to having difficult conversations with patients.”

For more on this study:
Pitkethly M, et al. Recordings or summaries of consultations for people with cancer. Cochrane Database of Systematic Reviews. Issue 3, 2008.

Consumer Health Tip Sheets

The US Agency for Healthcare Research and Quality (AHRQ) offers many consumer health resources, including:

20 Tips to Help Prevent Medical Errors
Patient Fact Sheet
http://www.ahrq.gov/consumer/20tips.htm

20 Tips to Help Prevent Medical Errors in Children
Patient Fact Sheet
http://www.ahrq.gov/consumer/20tipkid.htm

Quick Tips—When Getting Medical Tests
http://www.ahrq.gov/consumer/quicktips/tiptests.htm

Quick Tips—When Talking with Your Doctor
http://www.ahrq.gov/consumer/quicktips/doctalk.htm

Bringing Companions to Medical Visits: US Study

According to a survey of 12,018 US Medicare beneficiaries 65 years or older, bringing a family member or friend to medical visits improves patient satisfaction with medical care. Researchers found that:

• 38.6 percent of participants reported regularly being accompanied to medical visits
• Companions included spouses (53.3 percent); adult children (31.9 percent); other relatives (6.8 percent); roommates, friends or neighbours (5.2 percent); non-relatives (2.8 percent); or nurses, nurse aides or legal or financial officers (less than 1 percent)
• 63.8 percent of companions helped with communication, including 44.1 percent who recorded physician comments and instructions, 41.5 percent who communicated information about the patient’s medical condition to the physician, 41 percent who asked questions, 29.7 percent who explained physician’s instructions and 3.3 percent who translated the English language
• 28.4 percent of companions were reported to be present for company and moral support, 52.3 percent to assist with transportation, 16.6 percent to help schedule appointments and 8.4 percent to provide physical assistance.

Beneficiaries with regular companions were more highly satisfied with their physician’s technical skills, information-giving and interpersonal skills. Those whose companions more actively helped with communication rated their physicians’ information-giving and interpersonal skills more favourably. This relationship was stronger among patients who reported themselves to be in worse health.

Article:
Jennifer L. Wolff; Debra L. Roter
Hidden in Plain Sight: Medical Visit Companions as a Resource for Vulnerable Older Adults
Arch Intern Med. 2008;168(13):1409-1415.

Health & Literacy: Constructing Curriculum for Health Care Providers--A Learning Institute

Health & Literacy: Constructing Curriculum for Health Care Providers
A Learning Institute
October 16-18, 2008
Calgary, AB

"This Institute will invite health-care providers from every branch of health-care service, curriculum developers in health-care and adult basic education and literacy, ESL providers, administrators, policy makers and anyone with an interest or expertise. You will share promising practices, models, consider the challenges and propose new directions for grounded curriculum in health literacy for health-care providers."

See brochure for details.

Daily reading linked with higher levels of health literacy

The single best predictor of higher levels of health literacy is the act of reading every day—even more so than someone’s education—says a new report released in February by the Canadian Council on Learning (CCL).

The report, Health Literacy in Canada: A Healthy Understanding, reveals that daily reading outside of work is associated with higher health-literacy scores—one-third higher than the average for those aged 16 to 65 and more than 50% higher for those 66 and older.

In 2007, CCL released initial results from an international literacy survey that showed 60% of Canadians lacked the necessary skills to manage their health and health-care needs adequately.

A Healthy Understanding builds on these results and provides new, in-depth analysis examining the relationship between levels of health literacy and the reported health of Canadians.

The report found:

• Those with the lowest levels of health literacy are more than 2.5 times as likely to report being in poor or fair health as those with the highest levels.
• Across Canada, the prevalence of diabetes increases significantly as health literacy decreases. A similar link—though not as strong—is found with high blood pressure.
• The three most vulnerable populations for low levels of health literacy are seniors, the unemployed, and immigrants (especially those who don't speak French or English).
• Health literacy is more complex than previously thought; requiring prose, document and numeracy skills, often in combination for the same task.

To view the full report and CCL’s new interactive online map, which offers health-literacy profiles for more than 49,000 communities and neighbourhoods across Canada, visit http://www.ccl-cca.ca/healthliteracy.

Guide to Health Education Materials for Adults with Limited English Literacy Skills

Culture, Health and Literacy: A Guide to Health Education Materials for Adults with Limited English Literacy Skills
Authored by Julie McKinney and Sabrina Kurtz-Rossi

Contents:

• What This Guide Is About
• Introduction
• History
• Materials Selection
• A Word About Non-English Materials
• How To Use This Guide
• Definition of Terms
• Materials
• Background Information
• Fact Books, Readers and Stories
• Bibliographies and Resource Guides
• Curricula and Workbooks
• Videos and Audiocassettes
• Websites
• Organizations and Agencies
• Indices
• Subject
• Language

Developed in 2000 by World Education in collaboration with the National Institute for Literacy with a generous grant from Metropolitan Life Foundation

Available at http://healthliteracy.worlded.org/docs/culture/index.html
This guide is also available in print. Copies cost $10 each.
To order a copy e-mail lpeterson@worlded.org
or call World Education at (617) 482-9485 x 491.

How to Create a Pill Card

How to Create a Pill Card is available at the AHRQ (Agency for Healthcare Research and Quality) website.

"This guide was designed to help users create an easy-to-use 'pill card' for patients, parents, or anyone who has a hard time keeping track of their medicines. Step-by-step instructions, sample clip art, and suggestions for design and use will help to customize a reminder card."

Contents

• How to Create a Pill Card
• Why Create a Pill Card?
• What You Will Need to Create a Pill Card
• Getting Ready to Create a Personalized Pill Card
• Creating a Personalized Pill Card
• Using a Personalized Pill Card
• Pill Card Template
• Common Pill Shapes
• Common Images for Medication Uses
• Acknowledgment and Disclaimer

http://www.ahrq.gov/qual/pillcard/pillcard.htm

Creative Methodologies in Tobacco and Health Behaviour: Photography & Theatre

Time sensitive
Event: March 12, 2008
RSVP: Marhc 8, 2008

Do you like the theatre? How about photography? Want to know how these creative pursuits are being used in tobacco and health research? To find out, join us for a free public lecture and exhibit.

Creative Methodologies in Tobacco and Health Behaviour Research: Using Photography & Theatre to Foster Deeper Understandings

Health behaviour research aims to understand individual health behaviour and develop practices and policies to better support people in making positive health choices. Capturing the voices of research participants is thus a crucial aspect of health research. In addition, to communicate research in a meaningful way it is essential to engage with individuals involved in making those
choices about their health. Individual motivation and the other social and structural influences can be revealed in many different ways.

Creative methodologies - such as participant photography (photovoice) and participatory theatre (forum theatre) - allow researchers to be more inclusive of participant "voices" to explore and translate knowledge about certain health behaviours.

• Hear what researchers and participants have to say about these methodologies
• View the images created by participants about their smoking experience
• Participate in a mini-forum theatre production

Tobacco use is a particularly sensitive and personal topic which requires creative approaches to foster deeper understandings. This panel discussion, photo exhibit & screening will explore the challenges and benefits of using photovoice and forum theatre in three research projects: "Smoke, In My Eyes," "Families Controlling & Eliminating Tobacco" (FACET 2), and "Cultivating Awareness of the Context of Tobacco Use (CACTUS).

Date: Wednesday, March 12th
Time: 5:00 to 7:00 PM
Location: UBC Robson Square 800 Robson Street Vancouver, B.C.
For directions: http://www.robsonsquare.ubc.ca/
RSVP by March 8th: nexus@ubc.ca

For more information contact Ariadna
E-mail: nexus@nursing.ubc.ca
Phone: 604-822-7933
W: http://nexus.ubc.ca/

"Wall Street Journal" article on informed consent

"The Informed Patient" by Laura Landro
The Wall Street Journal Feb 6, 2008 page D1

"Informed consent may be the biggest misnomer in medicine: Studies show that most patients don't read the forms they sign before undergoing surgery or medical treatment. More than half of those who do read the forms don't understand them, and only a quarter of forms include all of the data patients need to make an informed decision."
Continued at: http://online.wsj.com/article/SB120224055435844931.html?mod=todays_us_nonsub_pj

Conference: Health Literacy in Primary Care: Best Practices and Skill Building

Time sensitive

May 1-2, 2008
Irvine, CA
The Institute for Healthcare Advancement's Seventh Annual Health Literacy Conference, Health Literacy in Primary Care: Best Practices and Skill Building, will be held May 1-2, 2008 at the Hyatt Regency in Irvine, CA.

Keynote speaker is Richard H. Carmona, M.D.., M.P.H., FACS, the 17th Surgeon General of the United States (2002-2006).
To register: http://www.iha4health.org/index.cfm/MenuItemID/248.htm

A Call for Posters has been issued. Those doing research in health literacy or working on innovative programs are encouraged to apply. Join the mailing list to receive information about the conference as it becomes available.

New to health literacy and want to get up to speed on the issues?
Wednesday night, April 30, 2008: free, one-hour preconference session, Health Literacy 101

Health literacy online tutorial

Health Literacy: New Field, New Opportunities
online tutorial covering:

• Health literacy challenge
• Who are health literacy practitioners
• Successful strategies and practices
• Applying what you have learned

Produced by World Education with support from the National Network of Libraries of Medicine, New England Region
http://healthliteracy.worlded.org/docs/tutorial/SWF/flashcheck/main.htm

Health literacy resources at the Adult Literacy Education (ALE) Wiki

Visit the Health Literacy page at the Adult Literacy Education Wiki
http://wiki.literacytent.org/index.php/Health_Literacy

A great site providing links to health literacy resources (predominantly US) including:

• What's NEW in this area?
• Research
• Resources
• Discussions
• Promising Practices
• Stories from Learners and Patients
• Announcements & Upcoming Events

Maine 2008 Health Literacy Institutes

Announced by Sue Stableford on the NIFL Health Literacy listserv:
2008 National Health Literacy Institutes - the premier opportunity to learn plain language skills to plan, write, and design effective, accessible information for print and web. This Institute has been sponsored by the University of New England in Maine for the past 16 years.
See: www.HealthLiteracyInstitute.net

The 2008 Summer Institute will be held June 8-11. The 2008 Fall Institute (repeat) will be held October 26-29. Both Institutes are hosted in Freeport, Maine, home of LL Bean, and just 20 minutes from Portland. The area offers many venues to explore, both indoors and outdoors.

All details and registration information are at this website: www.HealthLiteracyInstitute.net

Each Institute is limited to 30 participants, so register early to hold your place.

Articles from Helen Osborne--Health Literacy Consulting

Recent articles by Helen Osborne of Health Literacy Consulting

• "Screening for Health Literacy Using the Newest Vital Sign" [using nutrition labels as a literacy screening tool]
• "In other words...Using Graphics and Humor to Convey Healthcare Essentials"
• "In Other Words...Confirming Understanding With the Teach-Back Technique"

These articles and much more practical information about health literacy can be found at Helen's website.

New Health Literacy Tool for Professionals Who Serve Older Adults (US)

As part of Health Literacy month, the US Department of Health and Human Services released a new health literacy tool for people who serve older adults. The Quick Guide to Health Literacy and Older Adults is designed to provide useful strategies and suggestions to professionals who work with older adults to help bridge the communication gap between professionals and older adults.

In a national assessment of health literacy, only three percent of the older adults surveyed were found to be proficient in health literacy. Persons with limited health literacy have more adverse health outcomes including less frequent use of preventive services, higher hospitalization rates, and more emergency room visits. For older Americans, difficulties with health literacy can complicate already challenging health problems since as many as 80 percent of older Americans have at least one chronic disease.

For more information visit: http://www.health.gov/communication/literacy/olderadults/default.htm.

Health Literacy Conference call for presentations

Time sensitive

Institute for Healthcare Advancement's 7th Annual Health Literacy Conference: "Health Literacy in Primary Care: Best Practices and Skill Building" to be held May 1-2, 2008

Scheduled Keynote Speaker: Richard H. Carmona, M.D., M.P.H., FACS, The 17th Surgeon General of the United States (2002-2006).

Call for Presentations Issued-- Deadline for submissions is October 1, 2007.