«Understanding health literacy Switzerland» Looking back Current activities (ehealth Suisse, Swiss Alliance on Health Literacy) Dr. Jörg Haslbeck, 24.11.2011, Careum Patientenbildung 3
HEALTH LITERACY IN SWITZERLAND Therese Stutz Steiger, MD, MSc Workshop Graz; November 24-25, 2011
2. Overview 1 2 3 Health Literacy in Switzerland 2005-2009 The situakon in 2011 Ideas for cooperakon with the field of educakon
Health Literacy in Switzerland 2005-2009
Federal Office of Public Health Workshop 2005 PragmaKc definikon ehealth strategy New challenges Who is ackve Who should become ackve? First concepts Official concept
2.1. Annäherung an den Begriff Gesundheitskompetenz ist die Fähigkeit im täglichen Leben Entscheidungen zu treffen, die sich positiv auf die Gesundheit auswirken. Kompetenzbereich «Persönliche Gesundheit» Umfeld Kompetenzbereich «Gesundheitssystem» Kompetenzbereich «(Gesundheits) Markt» Kompetenzbereich «Arbeitsplatz» Kompetenzbereich «(Gesundheits)Politik» Kickbusch, Maag 2005
New challenges New technologies,new channels New roles of cikzens, consumers, pakents, insured persons New roles of experts, of health care persons Special axenkon to vulnerable groups Special axenkon to quality of life, to selfdeterminakon and to crikcal clients (pakents)
Self Care zu Medical Care Medical Care Self Care
ehealth strategy: Vision Die Menschen in der Schweiz können im Gesundheitswesen......are ackve to decide about there health problems and they are empowered to promote their own health competence... InformaKon and communicakontechnologies are compakble and improve processes.
Strategie ehealth Schweiz
The situakon In 2011
Projects of the Alliance Health literacy award Analysis of activities in the cantons on health literacy Masterclass with Richard Osborne
Other projects Universities Universities of applied sciences Careum patient education dialogue health ehealth strategy focussing on human competences? Coordination? Quality assurance? Focus on persons who can improve their potential?
Health educakon:
Health educakon In the health sector Some of hospital based inikakves Primary care inikakves Community based inikakves Outside the health sector Formal educakon Non formal educakon
«Careum activities» Examples in fostering health literacy self-management support for people living with chronic conditions Dr. Jörg Haslbeck, 23.11.2011, Careum Patientenbildung 5
Providing information and supporting skills No one-size-fits-all various strategies needed! «Self-management works proactive strategies work best» Dr. Jörg Haslbeck, 20.10.2011, Careum Patientenbildung The Health Foundation (2011, S. 11) 6
Implementing self-management support Evivo living healthy and active with chronic conditions An evidence-based Stanford Selfmanagement Program Dr. Jörg Haslbeck, 23.11.2011, Careum Patientenbildung 7
What is Evivo? The Stanford model workshop for «patients» and their families Evivo workshop and book A workshop with meetings; trained leaders with chronic conditions support selfmanagement skills for living with chronic conditions Who can participate? People living with chronic conditions; generic approach Duration? 6 weeks, ca. 2,5 h meetings per week Self-management support «to support people living with chronic conditions in creating and succeding their personal strategies in everyday life to better adapt and to self-manage» Dr. Jörg Haslbeck, 23.11.2011, Careum Patientenbildung 8
«User involvement» in fostering health literacy Kate Lorig s self-management classic adapted with «patients» Health information on Active self-management Symptom management Exercising (flexibility, endurance, strength) Communicating with health professionals and significant others Healthy eating Medication management Making treatment decisions Country-specific literature and service information for Austria, Germany and Switzerland Dr. Jörg Haslbeck, 22.09.2011, Careum Patientenbildung Kate Lorig et al. (2011), Careum Verlag, Zurich
Examples of implemented patient feedback Structural aids clarity «warm language» Marginal text useful for «skimming», loosening up, Eye-Catcher for important messages... Adapted and optimized figures Dr. Jörg Haslbeck, 23.11.2011, Careum Patientenbildung Excerpts Lorig et al. (2011) 10
Innovative approach «Evivo Partnerhips» Joint engagement to sustainaby implementing self-management support European Network on Patient Empowerment Säule «Umsetzung» Rekrutierung Umsetzung Evivo-Kurs Koordination «vor Ort» Support Evaluation Säule «Kompetenz» Ausbildung / Training Koordination / Beratung QS / Evaluation / Report Publikationen, Marketing Vernetzung «Evivo Pionier Partnerschaften» Umsetzung Strategisch Säule «Strategie» Support Networking Support Rekrutierung Support Marketing Support Etablierung Gemeinsame Events Workshops Evivo Kursleitungen (jährlich) Think Tank «Plattform Evivo Pionier Partner» Dr. Jörg Haslbeck, 23.11.2011, Careum Patientenbildung 11
Evidence on CDSMP (Evivo) «CDSMP considerable influence on public health» Significant findings (low, moderate) Self-efficacy Psych. health status Fatigue Cognitive symptom management Exercise (aerobic, endurance, strength) Communication with health professionals Meta-Analysis on CDSMP, 23 anglo-american studies, 8 688 participants: «contribute[s] to improvement in psychological health status, self-efficacy, and selected health behaviors and many of those improvements are maintained over 12 months.» CDC (2011, p.19) Self-rated health (6 Mo.) Social relationship No / little influence Health care use Functional impairments, pain Dr. Jörg Haslbeck, 23.11.2011, Careum Patientenbildung CDC Centers for Disease Control and Prevention (2011) 12
«dialogue health activities» Examples in fostering health literacy using a community approach Dr. Jörg Haslbeck, 23.11.2011, Careum Patientenbildung 13
Dr. Michael Deppeler & Frau Susanna Haller
dialogue-health Switzerland Forum dialog-gesundheit Program for communities as a bottom-up project and the creation of our own Swiss-wellness-guide We maintain a wide national and international network for education and health promotion Dr. Michael Deppeler & Frau Susanna Haller
dialogue-health is.. Promoting of health literacy and Empowerment individual und communal a salutogenesis-systemic aproach Communication of medically knowless in a comprehensible form learning and teaching together networking between education system and health care system an active and social dialogue with public and partnership Public-health aproach more understanding between a bottom-up-process and top down policy bilding more confidence between (family)doctor and general public needs, mentation and act as highlight enhancement relationship between doctor and patient in a dialog Promoting discussion about moral values in the health care system.so we don t forget patients in the future!
.. and today dialogue-health is operating here d-hch d-hch d-hch
The social determinants of health..are the basics of our offer for LLL LongLifeLearning for communitys
Three demands of community members 2005 (dialogue-health forum) a better coordination of the health promoting services of the community 1. Conference presence (2006) a contactperson in the community 20% - job, for a new contactperson in the community (2007) a better information along life and the life-events (red Thread, guide rope) The Swiss Wellness Guide (2010-2011) WIE? SO! Alltagsbuch für ein besseres Leben ISBN 978-3-907663-27-1
2006: dialogue-health invites sometime also municipal authority, head teachers and other players (offerer in the process) of the health system / 1. Gegenwartskonferenz..
October 2008: Worlddidac 2008 Basel dialogue-health Switzerland demonstrates: - the Wellness-Guide-Project - and dialogue-health forum à as education in health literacy June 2009: d-gch was invited to be Worlddidac-Member and is in the central planning for Worlddidac 2010 & Didacta Schweiz 2012 Basel Principal theme will be Education for Health and LLL LongLifeLearning Wellness-Guide-Licence by HRA Health Research for Action University of California, Berkeley
Thank you for your attention! www.dialog-gesundheit.ch.and we welcome you.. Dr.med. Michael Deppeler Kirchlindachstrasse 7 CH-3052 Zollikofen +41(0)31 911 20 60 m.deppeler@hin.ch Frau Susanna Haller Schützenstrasse 15 CH-3052 Zollikofen 41(0)31 911 77 04 susanna.haller@bluewin.ch