Writing and Designing Effective Communication: A Comprehensive Course

From left to right: Janet Ohene-Frempong, MS, Jann Keenan, EdS

From left to right: Janet Ohene-Frempong, MS, Jann Keenan, EdS

Jann Keenan and Janet Ohene-Frempong gave a daylong workshop. They provided detailed strategies for how to communicate effectively through both print and online materials. They used samples to illustrate what works and what doesn’t work.

“Health literacy is a subset of health communication,” said Ohene-Frempong. “How we communicate — across all these different media — that’s the issue. The other issue is navigation.”

The presenters explained the reader-centered approach: to engage, support, and motivate readers. And they offered tips for how to implement this approach.

We all have our preconceptions and ignorance. “Each of us is in our own little universe,” said Ohene-Frempong. “That’s why you need to check with the end-user.”

The presenters discussed how to write effective materials. They offered tips on content, organization, and style. They also discussed effective design and page layout.

It’s important to raise awareness in your designer about why design needs to be done a certain way. “You need to get buy-in early on,” Keenan said.

“There tends to be a tension between information and space,” said Ohene-Frempong. “If the information you’re giving readers is crucial, you don’t want to cut out information just to make space. You need to be an advocate for your reader.”

The presenters explained how to assess the readability of text and design and told how to use readability tools and field-testing. They discussed how to revise text and design to improve readability. They also told how to plan a writing project.

The workshop included two group exercises: a writing exercise and a revising exercise. The presenters led the group through the exercises step by step.

“If you have one takeaway from today, it’s that you really have to write for your reader — write for your end-user,” said Keenan. “That’s the only way to make the material clear and effective.”

Cultural Competency and the CLAS Standards

Marian Ryan, PhD, MA, MPH, CHES

Marian Ryan, PhD, MA, MPH, CHES

Marian Ryan began the session with a discussion on defining culture and cultural competence.  She said individuals view the world through a cultural lens and different thoughts and experiences are perceived differently depending on their culture.   She went on to explain that culture is dynamic and “many of us can evolve if we are open to it”.  She explained cultural competence as the ability to “communicate effectively with people that are different than ourselves” and stressed the importance of recognizing “cultural-based practices that dictate or organize us”.

Dr. Ryan commented that cultural competence is important to consider due to the changing of demographics in the US, the impact it can have on the sustainability of a business, and the critical role it plays in healthcare. The socio-cultural background of our clients can also have a large impact on individual members’ health values, beliefs, behaviors, quality of care and health outcomes.

Dr. Ryan stressed on the importance of understanding health disparities and the individuals that are directly impacted by these inequities, such as those with mental illness or low literacy rates.  Providing culturally competent cross-cultural care is key to combating these inequities and she provided effective frameworks that can be used to facilitate cross-cultural communication, such as the LEARN and BATHE models. She concluded with an explanation of the federal mandates that exist to address cultural competency, such as the CLAS Standards, ADA requirements and NCQA MultiCultural Standards.

Adapting Health Interventions for Improved Cultural Relevance

Cathy Meade, PhD, RN, FAAN

Cathy Meade, PhD, RN, FAAN

Cathy Meade began the session by discussing ways in which organizations can develop interventions that are tailored to the communities they serve.   In order to establish these interventions, Dr. Meade suggests pulling together different members of the community to gather their perspective on issues that surround the community.

Dr. Meade suggested interventions involve a “top down then bottom up” methodology.  This methodology implies that an evidence based curriculum is reviewed by the target population and then should be tailored to meet their needs.

To conclude the session, Dr. Meade gave an example from her field work of how utilization of all the components can lead to culturally relevant interventions.

Health Literacy 101: An Introduction to the Field

Michael Villaire, MSLM

Michael Villaire, MSLM

Michael Villaire gave an introduction to the field of health literacy. He began by defining health literacy. His favorite definition is the one from the 2008 Calgary Charter: “Health literacy allows the public and personnel working in all health-related contexts to find, understand, evaluate, communicate, and use information.” Villaire prefers this definition because “it puts the onus for health literacy on the provider, as well as the consumer.”

The healthcare system is bewildering to many people, Villaire said. He gave the example of the challenges people face in signing up for health insurance under the Affordable Care Act. Villaire talked about the components of health literacy: reading and writing, listening and verbal communication, numeracy, and self-efficacy. He gave some illustrations of how challenging numeracy is for many of us.

Villaire talked about the relationship between health literacy and culture. He noted that there is often a mismatch between provider demand and patient skill level, as well as between reading level and materials. And he discussed health literacy’s strong relationship with safety, quality, and health disparities. It can be hard to move an organization forward to health literacy. But “there are certain terms that will help you move forward with your goals. Two words: safety, quality,” Villaire said.

Examples were shared of how patients can be harmed when providers fail to give clear instructions. He put the burden on providers to improve their communication. “The fact that someone does not understand the way we choose to communicate is not their problem. It’s a barrier. It’s something we need to address,” Villaire said. “Health literacy is about dealing with the barriers.”

Villaire discussed health literacy myths and listed the barriers to health literacy. He also offered health literacy statistics and noted that people don’t like to admit they don’t read well because they are ashamed, therefore limited literacy is under-reported. He closed the session by explaining why health literacy matters and discussed the impact of low health literacy.

Integrating Health Literacy into Your Organization: Subtle Issues to Consider

From left to right: Jann Keenan, EdS, Janet Ohene-Frempong, MS

From left to right: Jann Keenan, EdS, Janet Ohene-Frempong, MS

Jann Keenan and Janet Ohene-Frempong explained how to integrate health literacy into your organization. They listed issues to consider along the way.

They noted that health literacy reform has worked in pharmaceutical companies, the insurance industry, state health departments, hospitals, and government agencies. They believe that this is “a golden age for organizational change”.

A health literate organization makes it easier for people to navigate, understand, and use information and services so they can take care of their health, the presenters said. They listed the Institute of Medicine’s implied action steps for becoming a health literate organization:

  1. Make health literacy integral to your mission, structure, and operations.
  2. Integrate health literacy into planning, evaluation measures, patient safety, and quality improvement.
  3. Prepare your workforce to be health literate and monitor your progress at doing so.
  4. Include populations served in the design, implementation, and evaluation of health information and services.
  5. Meet the needs of populations that have a range of health literacy skills, while avoiding stigmatization.
  6. Use health literacy strategies in interpersonal communication and confirm understanding at all points of contact.
  7. Provide easy access to health information and services and navigation assistance.
  8. Design and distributes print, audiovisual, and social media content that is easy to understand and act on.
  9. Address health literacy in high-risk situations, including care transitions and communications about medicines.
  10. Communicate clearly what health plans cover and what individuals will have to pay for services.

The presenters discussed some common roadblocks to integrating health literacy into an organization:

  • A lack of compassion and commitment
  • A lack of time and money
  • Legal and regulatory requirements
  • The need to hire, train, and retain staff
  • The need for industry specific guidelines
  • The challenge of including marginal readers
  • The challenges of health system complexity

They offered detailed strategies for how to navigate these roadblocks, based on the IOM’s guidelines.