From left to right: Michael Villaire, MSLM, Julie McKinney, MS, and Sabrina Kurtz-Rossi, MEd
Conversations about forming a Health Literacy Association started about a year ago, right around the time of the 2012 IHA Health Literacy Conference. Similar conversations continued at this year’s conference with an open discussion on what the next steps should be for a Health Literacy Association becoming a reality.
The discussion opened with the question: “How many here tonight have a job position that has a title with ‘health literacy’ in it?” About four people raised their hands. Kurtz-Rossi acknowledged that many more in the crowd do health literacy work as some part of their job. “As health literacy continues to become a rising profession, it’s time to take the formation of an association seriously,” Kurtz-Rossi asserted. “Tonight is about discussing what types of things you would benefit from in having an association.”
The session quickly fashioned itself into a town hall meeting where the ideas and thoughts of the community were shared. Kurtz-Rossi and many others agreed that the association should be a “very large umbrella” that provides a community for people of various professions.
McKinney added: “The idea that special interest groups from other associations become a part of the Health Literacy Association sprouted from the Listserv. Many people at this conference come from various groups, but we want to be able to centralize our supporters into an association that can produce research results, set standards, and ultimately, improve the quality of care.”
A few questions were left for reflection:
- Would the association be more community-oriented or regulatory?
- If regulatory, what will be the standards of practice?
- If we are more community-oriented, what types of services are we going to provide?
- Are we sure that we would like a new organization? Should we keep the possibility of merging with another organization open?
Michael Villaire, MSLM
Michael Villaire’s preconference session provided an introduction to the topic of health literacy for the conference’s first-year attendees, or as a refresher for those who had attended before.
He began his talk by reviewing definitions of literacy and health literacy. He noted that commonly used definitions of health literacy emphasize patients’ ability to obtain, use, and apply health information in their everyday life. He noted most definitions place the burden of understanding and using health information on the patients themselves, rather than the providers. He stated his preference for the Calgary Charter definition of health literacy: “Allowing the public and personnel working in all health-related contexts to find, understand, evaluate, communicate, and use information.”
There are many components of health literacy: reading, writing, listening, speaking, numeracy, self-efficacy, and cultural and belief systems. “People will have different interpretations of the information you present to them; remember to always be mindful of that,” he said.
Villaire provided a number of examples to show how easy it is for a patient to misinterpret information. He also shared clips from the AMA Foundation video of patients with limited health literacy. He closed the session with data on the costs of limited health literacy, amounting to between $106 billion and $238 billion per year.
Cliff Coleman, MD
Cliff Coleman, MD, described the importance of taking a “universal precautions” approach to healthcare. With this approach, one assumes that patients of all educational levels may misunderstand a document. For this reason, it’s best to use plain language to communicate health information to all patients.
This “universal precautions” approach starkly contrasts with the current healthcare culture, which places the burden of understanding on the patient.
Dr. Coleman commented that the healthcare system is set up to reward health professionals for poor communication.
Dr. Coleman went over best practice approaches for clear verbal communication. He highlighted some of his “must-knows” for attendees. These included knowing that patients may have different priorities than the healthcare provider. He also encouraged attendees to focus on no more than 3 “need to know” items, avoid medical jargon, and other tips.
Dr. Coleman ended his lecture by stating: “In 2010, half of the medical schools taught health literacy on average for only about 3 to 4 hours throughout the 4-year program. However, in residency programs, approximately 300 hours were devoted solely to communication on average. Although we still have a long way to go and much work to be done, we can take comfort in the fact that we have taken our first few baby steps.”
Samuel Pettyjohn, MPH
Sam Pettyjohn’s session focused on promoting your organization through social media. Participants learned steps to take as they incorporated social media into their own organization.
Pettyjohn started the session with introductions and a general overview of all of the different types of social media that are now available to organizations. The focus then shifted to sharing good and bad examples of social media use out in the field. After sharing examples from the group, participants were given time to work on planning their own social media efforts when they returned to their organization.
Michael Villaire, MSLM
Michael Villaire set the tone for the conference with a hands-on, fundamental session of how to write for a low literacy audience to accomplish the goal of improving health literacy and understanding. He began his session by explaining the key point when writing for a low literacy audience: “For a message to be readable, understandable, and comprehensible you must remove the barriers for poor readers. Removing the barriers increases the likelihood that the reader will get the message.”
There are many avenues by which poor readers can be challenged. These challenges are compounded by typical document problems, such as high reading levels, too many words, jargon, formal style, passive writing, long sentences, and either no visuals or inappropriate graphics.
Villaire then provided attendees with tools to help overcome these challenges.
Attendees broke into groups to rewrite sample documents from a 9th grade reading level to a 3rd- to 5th-grade level. Groups presented their rewritten documents to the class and were given feedback on the rewrites.