What is health literacy and how can we measure it?

Transcription

1 What is health literacy and how can we measure it? Laura Mackey, BSc Physiotherapy, PhD Student UCD School of Public Health, Physiotherapy and Sports Science UCD School of Public Health, Physiotherapy and Population Science Scoil na Sláinte Poiblí, na Fisiteiripe agus Eolaíocht an Daonra UCD

2 Presentation Aims Overview and definition of health literacy. Understand the evolving nature of health literacy definitions to conceptual frameworks. Impact of low health literacy. Health literacy assessment tools. Management strategies in a clinical setting.

3 Health Literacy Definitions the degree to which individuals have the capacity to obtain, process & understand basic information & services needed to make appropriate decisions about their health (IOM, 2004). the cognitive & social skills which determine the motivation and ability of individuals to gain access to, understand & use information in ways which promote and maintain good health (WHO, 1998).

4 Health Literacy Clinical Perspective Patient skills/capacities HCP skills/capacities Prior knowledge Understanding Confidence Decision-making Motivation Cognitive skills Language used Communication Assessment Written material HL Interventions Building/signage

5 Models/Conceptual Frameworks Baker, 2006 Paasche-Orlow and Wolf, 2007 Nutbeam, 2008 Von Wagner et al, 2009 Sorensen et al, 2012 Squiers et al, 2012

6 Paasche-Orlow & Wolf, 2007

7 Squiers et al, 2012

8 HLS-EU Survey

9 Why Health Literacy?

10 Self-management

11 Examples

12 Healthcare professionals role.. Educators Communicate effectively with patients. Traditional passive approach vs. Biopsychosocial. Need patients to buy into our treatment strategies. Via: - Self-management development. - Motivation, desire, and volition. - Shared decision making. - Goal orientated treatments. + HEALTH LITERACY DEVELOPMENT.

13 Who is at risk? Older adults. Lower SES. Lower educational attainment. Ethnic minorities. Non-English speaking. Beware!! higher education does not always suggest adequate health literacy.

14 Common Red Flags.. I forgot my glasses I ll take the form home with me My son sorts all that stuff out for me

15 How to assess? Validated tools: Test of Functional Health Literacy in Adults (TOFHLA) (Parker et al, 1995). Rapid Estimate of Adult Literacy in Medicine (REALM) (Davis & Crouch, 1991). Newest Vital Sign (NVS) (Weiss et al, 2006). Patient s understanding of their condition? Gut instinct leads to overestimation of health literacy in patients? (Mackert et al, 2011).

16 Short test of functional health literacy (s-tofhla) (Baker et al, 1999). 4 sections: Modified cloze procedure. Reading comprehension. Numeracy skills. Administration time: 7 minutes.

17 Rapid Estimate of Adult Literacy in Medicine (REALM) (Davis & Crouch, 1991). 66 words: Reading comprehension. Pronunciation. Administration time: 3-7 minutes.

18 The Newest Vital Sign (NVS) (Weiss et al, 2006). 6 questions: reading comprehension quantitative capacity cognitive capacities (i.e. critical thinking) Administration time: 3 minutes

19 Interventions Plain English documents. Teach back method. Signage in hospitals / clinics. Individual and/or group based education or counselling services (Taggart et al, 2011).? HL-sensitive interventions in COPD (Kiser et al, 2011), and Coronary Artery Disease (Eckman et al, 2012).

20 Health Literacy. In conclusion Umbrella term for patient characteristics and attributes, that are necessary for the subsequent development of health related skills. These skills enable people to build their knowledge, more skills, and potential to make positive and sustainable health behaviour changes of their own volition. May be modifiable from patients experiences in health care settings Healthcare professionals can positively facilitate this with suitable interventions and strategies. Recognising low health literacy is important.