Infopeople Webcast Series: Health e-Shows

1. Infopeople Webcast Series:Health e-Shows Infopeople webcasts are supported by the U.S. Institute of Museum and Library Services under the provisions of the Library Services and Technology Act, administered in California by the State Librarian.

2. Understanding Health Literacy: Why It Is So Important and What Librarians Can Do to Help An Infopeople Webinar August 14, 2008 12pm – 1pm Kelli Ham kkham@library.ucla.edu

3. Objectives Participants will be able to: • describe the correlations and differences between literacy and health literacy • recommend appropriate resources for users with low health literacy • help patrons communicate better with doctors

4. Agenda • Scenarios • Overview • Working with library user • Choosing appropriate materials • Improving health literacy in the community

5. Definitions • Literacy • the ability to read and write • Health Information Literacy • the degree to which individuals have the capacity obtain, process, and understand the basic health information and services they need to make appropriate health decisions.

6. The Patient’s Experience • Mrs. Walker • lupus patient • 3rd Grade reading level

7. Over-the-counter Products • Mrs. Stuart • 7th Grade reading level • mother of two

8. Reading Prescription Labels • Mr. Dallas • 3rd grade reading level • prostate cancer patient

9. The Patient’s Perspective • “She is very busy; I don’t want to bother her.” • “I’m embarrassed to tell her I don’t understand.” • “I’ll just ask at the drugstore; they will explain it to me.”

10. Where Understanding Fails • Consent forms • Appointment slips • Prescription drug labels • Instructions prior to surgery or procedure • Medical education brochures • Insurance paperwork • Verbal instructions

11. NAAL Study Findings • Literacy – assessments • Prose • Document • Quantitative • Health literacy • Clinical • Prevention • Navigating the system

12. Groups at Highest Risk • Elderly • Minorities • Low income • Homeless persons • Those with lower education levels

13. Implications • Medical errors • Non-compliance • Poor outcomes • Higher mortality • What else?

14. Tackling the Problem • Now part of LiteracyWorks, California Health Literacy Initiative launched in 2003 with three objectives: • provide health material in plain English, in easy-to-read format • train medical professionals to recognize and respond to patients with low literacy skills • teach adults how to ask questions and clarify information with healthcare provider

15. Easy-to-Read Conundrum • Definitions • Depends on who you ask • Lack of standards • Reading Level Tests

16. Example of “Easy-to-Read”

17. Plain Language • Also called “living room language” • What are the common terms for these? • neoplasm • hypertension • cholecystectomy • tinea pedis • inoculation • hematoma

18. Some examples • Definitions of hematoma: • a mass of usually clotted blood that forms in a tissue, organ, or body space as a result of a broken blood vessel • Bruise. A bruise is an area of discolored skin. A bruise occurs when small blood vessels break and leak their contents into the soft tissue beneath the skin.

19. Helping the Patient Understand • New standards for OTC drug labeling • Creation of patient materials with simple language and illustrations • Use of trained health educators or communicators

20. Medication Labeling – Old Style

21. Improved Labeling Standard

22. Plain Language Example diabetes.niddk.nih.gov

23. Starting at the Source • Programs for health care professionals • American Medical Association Foundation • toolkits, training materials, videos and more • Medical Library Association • Health Information Literacy Project, curriculum available in September 2008 • Harvard School of Public Health • materials for health professionals, educators • curricula for health literacy programs

24. Working with the Library User • Determining literacy levels - you can’t tell by appearance • Possible clues • forgot eyeglasses • ask you to read it to them • reluctant to fill out a form

25. Strategies • Your approach • be aware of word choice • use same terms as patron • most important concepts first • start with basic information, and offer more when patron is ready

26. Who is the End-user? • Determine who is asking the question • Caregiver, patient, friend • Ask what kind of information would be useful

27. Choosing Appropriate Resources • Books • DVDs, videos • Internet resources • Article • Encyclopedia

28. Pictures and Diagrams

29. Audio and Video • Often requested – easier to understand by seeing and hearing • Library’s collection • search by type of item (CD, Video etc) • Free, quality multimedia resources • healthyroadsmedia.org is a free resource with streaming video and other formats

30. MedlinePlus.gov Resources • Easy-to-Read • Interactive Tutorials • MedlinePlus en español and multilingual resources • NIHSeniorHealth • Relevant health topic pages

31. MedlinePlus Home Page

32. Finding All Easy-to-Read Materials On Health Topics Page: Links to all Easy to Read and Interactive Tutorials

33. Multilingual Materials • But are they easy to read? Typically not designated as such • New collection on MedlinePlus • All include English version • Not comprehensive • Consumer Health Information in Many Languages page • nnlm.gov/outreach/consumer/multi.html

34. Multilingual Materials on MedlinePlus - Asthma

35. Asthma Languages Available

36. Asthma Hindi Example

37. Additional Online Resources • Plain language brochures • Deciphering Medspeak brochures (Medical Library Association) • Plain Language Glossaries (Harvard School of Public Health) • NIH Publications • Numerous consumer publications in easy-to-read language

38. Advanced Search in Google • publications “easy to read” site:nih.gov

39. Information Rx • From the National Library of Medicine • Looks like a prescription pad • Physicians, librarians and other health • care professionals can write an • “information prescription”

40. InfoRx in Practice

41. Formulating Questions • Help them formulate questions to take back to their healthcare provider • Ask Me Three www.npsf.org/askme3/ • Agency for Healthcare Research and Quality www.ahrq.gov

42. Ask Me Three askme3.org

43. Questions Are the Answer ahrq.gov/

44. Question Builder Tool

45. Ideas for Added Value • Ask if you can help them generate a question list to print out (use the AHRQ question builder) • Offer to set up computer with Interactive Tutorial on topic • Generate easy-to-read materials for library users with help from resource tools

46. Health Literacy in your Community • Know the demographics • Programming ideas • National Health Observances • topics of interest to community • Beneficial partnerships • talks by local physicians • local literacy groups

47. Your Collection & Services • Know what you have • Know your community • Considerations for your collection • Programming • bulletin boards • informational sessions • Partnerships

48. Thank You! Kelli Ham, Consumer Health Coordinator kkham@library.ucla.edu NN/LM Pacific Southwest Region UCLA Louise M. Darling Biomedical Library