Health Literacy Out Loud Podcast

Health Literacy Out Loud #78: A Tool That Pictures Pain

Helen Osborne — Tue, 29 May 2012 06:00:12 +0000

Kim Kristiansen MD lives and works in Denmark. He not only is practicing physician but also CEO of a company called EvidenceProfile ApS. Dr. Kristiansen’s work often focuses on pain, pain management, and pain research. He, along with two colleagues, invented DoloTest®– a validated, multidimensional pain assessment tool that actively involves the patient.

In this podcast, Dr. Kristiansen talks with Helen Osborne about:

Why it is so important, yet difficult, for providers and patients to talk about pain.
How chronic (persistent) pain affects many aspects of a person’s life.
Ways DoloTest® helps patients and providers reach a shared understanding about pain.

More Ways to Learn:

DoloTest, at www.dolotest.com
Picture of Pain Blog, at www.pictureofpain.com
Kristiansen K, Lyngholm-Kjaerby P, Moe C. ”Introduction and validation of DoloTest®: A new health-related quality of life tool used in pain patients,” Pain Pract 2010, Sep;10(5):396-403. Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20384966
Kristiansen K, Shafiei R, Lyngholm-Kjaerby P, Moe C.” DoloTest® and Cognitive Dysfunction: A Sudy of Use and Understanding,” Journal of the American Geriatrics Society 2010;58(12):2430-2. Abstract at http://onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.2010.03165.x/abstract
Kristiansen K, Lyngholm-Kjærby, Moe C. Pain and Depression Profiles in Primary care using DoloTest®. [Submitted for publication]

Health Literacy Out Loud #77: Dr Howard Koh, Assistant Secretary for HHS, Talks About Boosting Health Literacy to Move Beyond the Cycle of Costly Crisis Care

Helen Osborne — Tue, 08 May 2012 06:00:07 +0000

Dr. Howard K. Koh serves as the 14th Assistant Secretary for Health for the U.S. Department of Health and Human Services (HHS). Dr. Koh is dedicated to the mission of creating better public health systems for prevention and care so that all people can reach their highest attainable standard of health. Health literacy is key to accomplishing this goal.

In this podcast, Dr. Koh talks with Helen Osborne about:

How health literacy is a dynamic systems issue and public health challenge.
Why health literacy is at a “tipping point,” moving from the margins to mainstream.
New Federal policies, initiatives, and tools that boost health literacy.

More Ways to Learn:

“New Federal Policy Initiatives To Boost Health Literacy Can Help the Nation Move Beyond the Cycle of Costly ‘Crisis Care’,” by Koh HK, Berwick DM, Clancy CM, Baur C, Brach C, Harris LM, Zerhusen EG. Health Affairs, January 2012. Abstract at http://content.healthaffairs.org/content/early/2012/01/18/hlthaff.2011.1169.abstract
National Action Plan to Improve Health Literacy. At http://www.health.gov/communication/hlactionplan/
Health Literacy Out Loud #39: National Action Plan to Improve Health Literacy. At http://healthliteracy.com/hlol-national-health-literacy-action-plan
Plain Writing Act of 2010. At http://www.plainlanguage.gov/plLaw/index.cfm
Health Literacy Out Loud #73: Plain Writing Act of 2010. At http://healthliteracy.com/hlol-plain-language-act
Healthcare.gov. At http://www.healthcare.gov/
Healthfinder.gov. At http://www.healthfinder.gov/
Health Literacy Out Loud #34: Creating Usable, Useful Health Websites for Readers at All Levels. At http://healthliteracy.com/hlol-websites-for-all-readers
Health Literacy Universal Precautions Toolkit, from AHRQ. At http://www.ahrq.gov/qual/literacy/

For a transcript of this podcast, click here: http://healthliteracy.com/transcript.asp?PageID=11149

Health Literacy Out Loud #76: Ergonomics–Staying Healthy When Using Technology.

Helen Osborne — Tue, 17 Apr 2012 06:00:52 +0000

Karen Jacobs Ed.D., OTR/L, CPE, FAOTA is an occupational therapist and a board certified ergonomist. Her extensive list of accomplishments includes being a professor and program director for the post-professional distance education OT programs at Boston University and editing/ authoring numerous books and articles. She is the founding editor of WORK and former president and vice president of the American Occupational Therapy Association.

A primary focus of Dr. Jacobs’ research is about ergonomics. Specifically, how using notebook computers, tablets, backpacks, and other technology affects students of all ages. Ergonomics matters to professionals, too. In this podcast, Karen Jacobs talks with Helen Osborne about:

Ergonomics: How workplace tools, equipment, and the environment affects individuals and populations
Why ergonomics matters to health communicators
What we can do to stay healthy when using technology

More Ways to Learn:

Stretch Break for Kids. At http://Blogs.bu.edu/kjacobs/
Work: A Journal of Prevention, Assessment and Rehabilitation. At http://blogs.bu.edu/kjacobs/work-journal/
Health Literacy Out Loud #46: Universal Design and Health Communication. At http://healthliteracy.com/hlol-universal-design

Health Literacy Out Loud #75: Consumer Reports Health Ratings

Helen Osborne — Tue, 27 Mar 2012 06:00:31 +0000

John Santa MD, MPH is Director of the Consumer Reports Health Ratings Center. For many years, he worked as a primary care physician, healthcare executive, researcher, and policy maker. Now Dr. Santa and others work to evaluate and compare health services, products and practitioners based on current, robust, and independent sources of information.

In this podcast, Dr. Santa and Helen Osborne talk about:

Consumer Reports: How it helps consumers make purchasing decisions.
Why it is important for individuals to understand health ratings.
How Consumer Reports uses symbols, summaries, and narratives.
Strategies and resources for listeners to use in day-to-day practice.

More Ways to Learn:

Consumer Reports, at http://www.consumerreports.org
Consumer Reports Health Ratings. At http://www.consumerreports.org/health/home.htm
Consumer Reports Best Buy Drugs. At http://www.consumerreports.org/health/best-buy-drugs/index.htm
“Can you read this drug label?” (Consumer Reports video), at http://www.consumerreports.org/health/best-buy-drugs/prescription-labels/overview/index.htm
Consumer Union: Safe Patient Project. At http://Safepatientproject.org/
Health Literacy Out Loud #47: Legislation Giving Voice to Patients and Families. At http://healthliteracy.com/hlol-legislation

Health Literacy Out Loud #74: Advocacy–From Aha to Action

Helen Osborne — Tue, 13 Mar 2012 06:00:42 +0000

Rich Sagall MD is a retired family physician. About 25 years ago, he left clinical practice to devote all his efforts to running NeedyMeds – offering information about programs to help those who are medically needy. Beyond his work with NeedyMeds, Dr. Sagall also publishes the newsletter, Pediatrics for Parents.

In this podcast, Dr. Sagall talks with Helen Osborne about his journey from being a practicing physician to following his passion and creating a non-profit organization. Topics include:

Journey from clinical practice to following your interests and passion
Lessons learned about starting and sustaining a non-profit business
Finding inspiration in unexpected places

More Ways to Learn:

NeedyMeds, http://www.needymeds.org/
Pediatrics for Parents, http://www.pedsforparents.com/
Health Literacy Out Loud #71: Talking About Medical Debt. At http://healthliteracy.com/hlol-medical-debt

Health Literacy Out Loud #73: Plain Writing Act of 2010

Helen Osborne — Tue, 28 Feb 2012 06:00:09 +0000

Annetta Cheek Ph.D. is an ongoing champion of plain language. With a background in anthropology and many years experience as a federal employee, Cheek helped lead the way to convincing the U.S. Congress to pass the Plain Writing Act of 2010. Now she and others are supporting new legislation to streamline government regulations.

Annetta Cheek’s commitment to plain language is long-standing. Among her many accomplishments, she served as an expert for Vice President Gore’s plain language initiative. More recently, she helped found the non-profit organization, the Center for Plain Language.

In this podcast, Annetta Cheek talks with Helen Osborne about:

Plain language: What it is and why it is needed for all types of documents.
Plain language legislation: How government communications affect everyone.
Practical ways to help overcome a “culture of complex communication.”

More Ways to Learn:

Center for Plain Language, http://centerforplainlanguage.org/
Health Literacy Out Loud #19: Communicating Clearly on the Web, http://healthliteracy.com/hlol-web
Plain Language Association International, http://www.plainlanguagenetwork.org/
Plainlanguage.gov: Improving Communication from the Federal Government to the Public. At http://www.plainlanguage.gov/
Plain Writing Act of 2010. At http://www.fdic.gov/plainlanguage/plainwritingact.pdf
Redish & Associates, Inc. Includes information about Redish’s book, Letting Go of the Words. At http://www.redish.net/

For a transcript of this podcast, please visit http://healthliteracy.com/transcript.asp?PageID=11098

Health Literacy Out Loud #72: Power of Stories in Patient and Family-Centered Care

Helen Osborne — Tue, 31 Jan 2012 06:00:18 +0000

Marlene Fondrick helps patients share their stories as a way to advance the practice of patient and family-centered care. This work builds on Fondrick’s clinical and administrative experiences as a nurse and hospital vice president. Fondrick adds to this mix her perspective as grandmother of a young child who was diagnosed with cancer.

In this podcast, Marlene Fondrick talks with Helen Osborne about:

The power of stories in patient- and family-centered care.
Examples of real-life stories that have made a difference in patient care.
Ways to help patients share their stories, including the most important questions to ask.

More Ways to Learn:

Institute for Patient- and Family-Centered Care. Available at http://www.ipfcc.org/
Crocker L, Johnson B, Privileged Presence: Personal Stories of Connection in Health Care. 2006, Bull Publishing Company.
Osborne, H. “In Other Words…Tool of Change: Telling and Listening to Stories,” On Call, October 16, 2008. Available at http://healthliteracy.com/telling-stories

Click here for a transcript of this podcast on HealthLiteracy.com

Health Literacy Out Loud #71: Talking About Medical Debt

Helen Osborne — Tue, 10 Jan 2012 06:00:45 +0000

Erin Moaratty is Chief of External Communications for the Patient Advocate Foundation (PAF). For many years, Erin was PAF’s senior case manager – helping people who have catastrophic illnesses deal with issues about access to care, health insurance, employment retention, and medical debt.

In this podcast, Erin Moaratty talks with Helen Osborne about:

Medical debt: What this term means, who it affects, why it matters so much.
Patient Advocacy Foundation (PAF): Services, resources, and examples of how PAF helps patients with catastrophic illnesses.
Ways you can help: Strategies for professionals, friends, family members, and organizations.

More ways to learn:

Patient Advocate Foundation. Visit http://www.patientadvocate.org/ or call 1-800-532-5274.
Co-Pay Relief, http://copays.org/
insureUStoday, http://insureustoday.org/drupal/PAC/
National Financial Resource Guidebook for Patients: A State-by-State Directory, http://www.patientadvocate.org/report.php
National UNDERinsured Resource Directory, http://www.patientadvocate.org/help4u.php
NeedyMeds, http://www.needymeds.org/
Partnership for Prescription Assistance, http://www.pparx.org/

Click here for a transcript of this podcast on HealthLiteracy.com

Health Literacy Out Loud #70: Animal-Human Bond in Healthcare

Helen Osborne — Tue, 06 Dec 2011 06:00:08 +0000

Alice Villalobos, DVM, DPNAP is Director of Pawspice in Hermosa Beach and Animal Oncology Consultation Service in Woodland Hills, CA. Among her many accomplishments, Dr. Villalobos is a founding member of the Veterinary Cancer Society and president of the Society for Veterinary Medical Ethics. She writes and lectures worldwide on veterinary oncology, quality of life, bioethics, palliative/hospice care for animals, and the human-animal bond.

In this podcast, Dr. Villalobos talks with Helen Osborne about:

How the animal-human bond enriches people, pets, and the environment.
Ways that animals help humans during sickness as well as health.
Strategies practitioners can use when talking with patients who have pets.

More Ways to Learn:

American Association of Human-Animal Bond Veterinarians, http://aahabv.org/
Delta Society, http://www.deltasociety.org/
Healing Heart Foundation, Inc. and Pet Hospice, http://www.hhfipethospice.org/
PAWS (Pets Are Wonderful Support), http://www.hhfipethospice.org/ Go to the Contact page to find your city or state.
Pawspice Library and Quality of Life Scale at www.pawspice.com
Society for Veterinary Medical Ethics, http://www.svme.org/

Click here for a transcript of this podcast on HealthLiteracy.com

Health Literacy Out Loud #69: Problematic Words in Health Research

Helen Osborne — Tue, 15 Nov 2011 06:00:24 +0000

Jessica Ridpath founded a research-centric plain language initiative called Program for Readability In Science & Medicine (PRISM) at Group Health Research Institute in Seattle, WA. In this initiative, Ridpath provides plain language editing, training, and consultation for health researchers, health education writers, hospital staff, and public health employees. Her focus is often on writing clear and understandable informed consent forms for research.

In this podcast, Ridpath talks with Helen Osborne about:

Informed consent forms for research. Why these forms can be difficult to read and ways to make them easier for the lay public to understand.
Problematic words. Examples of words and terms that may cause confusion even though these words are short and familiar.
Strategies and tools to improve understanding of health research concepts.

More Ways to Learn:

Program for Readability In Science & Medicine (PRISM). Learn more at http://www.grouphealthresearch.org/capabilities/readability/readability_home.html
PRISM Readability Toolkit. Available at http://www.tinyurl.com/prismtoolkit
PRISM Online Training, at http://prism.grouphealthresearch.org

Click here for a transcript of this podcast on HealthLiteracy.com

Health Literacy Out Loud #68: Health Literacy Journey

Helen Osborne — Tue, 01 Nov 2011 06:00:26 +0000

Maureen Johnson is Manager of Women’s Consumer Health Information at the Royal Women’s Hospital in Melbourne, Australia. She is committed to a patient-centered approach to health literacy and believes that large hospitals and health services need high-level support and robust systems to ensure that these efforts are sustained over time.

Johnson received a Victorian Travelling Fellowship from the Victorian Quality Council. This fellowship allows emerging leaders to conduct international investigations into innovative responses to health care quality and safety. As part of this program, Johnson recently visited the USA, Canada, England, the Netherlands and Finland.

In this podcast, Maureen Johnson talks with Helen Osborne about:

Johnson’s health literacy journey. Why she traveled, who she met, what she learned along the way.
The value of health literacy networking. How it extends beyond hospitals and healthcare settings.
Salutogenesis. A way of looking at individual health factors, not just causes of disease.

More Ways to Learn:

Maureen Johnson’s blog, healthliteracyvic.blogspot.com
Salutogenesis. Learn more at http://www.salutogenesis.fi/
Women’s Consumer Health Information at the Royal Women’s Hospital, www.thewomens.org.au/HealthInformation
Victorian Quality Council, http://www.health.vic.gov.au/travelfellowships/
Hill S (ed), The Knowledgeable Patient: Communication and Participation in Health, Wiley-Blackwell. Released October 2011. Maureen Johnson co-authored one chapter.
Osborne H (podcast). November 23, 2009. Health Literacy Out Loud #28: Applying Adult Education Principles to Medicine & Public Health. Available at http://healthliteracy.com/hlol-adult-education
Osborne H (podcast). August 26, 2009. Health Literacy Out Loud #20: Selina Maphorogo Talks About Community Health Education in South Africa. Available at http://healthliteracy.com/hlol-health-education-south-africa

Health Literacy Out Loud #67: Leading a Health Literacy Task Force

Helen Osborne — Tue, 18 Oct 2011 06:00:07 +0000

Susan Pisano is the Vice President of Communications for America’s Health Insurance Plans (AHIP) — a national association whose member companies provide health insurance coverage to more than 200 million Americans. As Vice President for Communications, Pisano acts as a spokesperson for AHIP and is responsible for outreach to member companies, the news media, and other major audiences. Pisano also serves as the primary staffer for AHIP’s Health Literacy Task Force.

In this podcast, Susan Pisano talks with Helen Osborne about:

Organizing a health literacy task force. How, who, what, why, and when of leading a large and diverse committee.
Making a strategic plan and being clear about goals.
Creating tools, tookits, and policies to help task force members.
Measuring success as a way move projects and ideas forward.

More Ways to Learn:

America’s Health Insurance Plans (AHIP), http://www.ahip.org/
AHIP’s health literacy resources. Includes “Health Plan Organizational Assessment of Health Literacy Activities.” Learn more and access health literacy tools at http://www.ahip.org/content/default.aspx?bc=39|341|22050
Peterson PN, Shetterly SM, Clarke CL et al. “Health Literacy and Outcomes Among Patients with Heart Failure, JAMA 2011:305(16):1695-1701.
Osborne H (podcast), April 26, 2011. Health Literacy Out Loud #57: Texting Important Health Messages. An audio interview with Julie Gazmararian. Available at http://healthliteracy.com/hlol-texting

Health Literacy Out Loud #66: Health Literacy from A to Z

Helen Osborne — Tue, 04 Oct 2011 06:00:39 +0000

Helen Osborne M.Ed., OTR/L helps others communicate health information in ways that patients, families, and caregivers can understand. Helen is president of Health Literacy Consulting, founder of Health Literacy Month, and host of the podcast series, “Health Literacy Out Loud.” She is also the author of “Health Literacy from A to Z: Practical Ways to Communicate Your Health Message.”

In this podcast, Helen talks with Adam Weiss about the second edition of her book, “Health Literacy from A to Z: Practical Ways to Communicate Your Health Message.”

Together, Helen and Adam discuss:

Who this book is for. What is new and different in the second edition.
Why health literacy matters to everyone communicating health information.
How health literacy is about mutual understanding between providers (anyone on the giving end of health communication) and patients (everyone on the receiving end of such communication).

More Ways to Learn:

Jones & Bartlett Learning. To learn more and order copies of “Health Literacy from A to Z,” go to http://go.jblearning.com/healthliteracy
Health Literacy Consulting, www.healthliteracy.com
Health Literacy Out Loud, at www.healthliteracyoutloud.com
Health Literacy Month, at www.healthliteracymonth.org
Osborne H, May/June 2006. “In Other Words…Communicating When Naked: My Perspective as a Patient,” On Call. Available at http://www.healthliteracy.com/communicating-when-naked
Adam Weiss, at www.adamweiss.net and www.podcastconsultant.net

Health Literacy Out Loud #65: Helping Patients Take Medication Safely and Effectively

Helen Osborne — Tue, 20 Sep 2011 06:00:04 +0000

Rebecca Burkholder JD is a healthcare attorney and Vice President of Health Policy at the National Consumers League–a national, nonprofit membership organization that has been representing consumers and workers since1899. Burkholder coordinates the League’s work on various health care issues including safe use of medication, patient safety, doctor-patient communication, and direct-to-consumer advertising. She also coordinates the League’s new national medication adherence campaign, “Script Your Future.”

In this Health Literacy Out Loud podcast, Burkholder talks with Helen Osborne about:

Medication adherence. What it is and why it is so important today.
Research about why patients do not take medication as directed.
Script Your Future, a broad-based educational campaign with tools, resources, and links to help improve medication adherence.

More Ways to Learn:

Script Your Future, at http://scriptyourfuture.org/
National Council for Patient Information and Education (NCPIE) Medication Adherence National Action Plan, http://www.scriptyourfuture.org/hcp/download/fact_sheet/Medication%20Adherence%20National%20Action%20Plan.pdf
World Health Organization (WHO) Report on Adherence http://www.who.int/chp/knowledge/publications/adherence_introduction.pdf
Questions are the Answer, from AHRQ. Available at http://www.ahrq.gov/questionsaretheanswer/
Osborne H, June 25, 2008. “In Other Words…’Questions Are the Answer’ to Helping Patients Understand Their Health,” On Call. Available at http://healthliteracy.com/question-asking

Health Literacy Out Loud #64: Chronic Engagement: Habits That Support Good Health

Helen Osborne — Tue, 06 Sep 2011 06:00:09 +0000

Jan Berger, MD, MJ, is the Chief Medical Officer at Silverlink Communications. She leads Silverlink’s population health initiatives in areas such as adherence, clinical messaging, engagement and health behavior change. Dr. Berger also is active on numerous national committees on quality and is the Editor in Chief of the American Journal of Pharmacy Benefit. In all these roles, Dr. Berger is passionate that communications can significantly improve health outcomes.

In this podcast, Dr. Berger talks with Helen Osborne about:

“Chronic engagement,” a positive term referring to lifelong habits that support good health.
Using technology to communicate health information in scalable, personalized, cost-effective ways.
Measuring the effectiveness of health communication and chronic engagement.

More Ways to Learn:

Silverlink Communcations, at http://www.silverlink.com
Gerencher K, “Your Health is Calling: Get That Screening Test,” MarketWatch June 27, 2011. Available at http://www.marketwatch.com/story/your-health-is-calling-get-that-screening-test-2011-06-27
Russo F, “Wellness: Does Your Doc Know What to Look For?” Time Magazine, January 29, 2011. Available at http://www.time.com/time/magazine/article/0,9171,2040210,00.html

Health Literacy Out Loud #63: Mammograms: Clearly Communicating New Guidelines

Helen Osborne — Tue, 09 Aug 2011 06:00:39 +0000

Diana Zuckerman, Ph.D. is the President of the National Research Center for Women & Families–a nonpartisan, nonprofit research and education organization that works to evaluate and improve policies and programs that affect the health and safety of adults and children.

Dr. Zuckerman is a nationally respected expert on health and health policy, including the safety and effectiveness of medical treatments and the impact of violence on women and families. She has testified dozens of times before U.S. Congressional hearings and other federal and state agencies. Dr. Zuckerman is often interviewed or quoted on television, radio, and the national press.

In this podcast, Dr. Zuckerman talks with Helen Osborne about:

Why and how national guidelines, policies, and recommendations change.
How to clearly communicate ever-changing, nuanced health messages.
Communication challenges ahead as science continues to evolve.

More Ways to Learn:

National Research Center for Women & Families, http://www.center4research.org/
Cancer Prevention and Treatment Fund, a new program of the National Research Center for Women & Families. Available at http://www.stopcancerfund.org
Osborne H (host). 2011, April 5. Health Literacy Out Loud #56: Helping Others Understand Health Messages. Available at http://healthliteracy.com/hlol-helping-others-understand
Schousboe JT, Kerlikowske K, Loh A, Cummings SR, “Personalizing Mammography by Breast Density and Other Risk Factors for Breast Cancer: Analysis of Health Benefits and Cost-Effectiveness,” Annals of Internal Medicine. July 5, 2011, 155:10-20.
Welch HG, Schwartz LM, Woloshin, Overdiagnosed. Beacon Press, 2011.
Woloshin S, Schwartz LM, Welch HG, Know Your Chances: Understanding Health Statistics. University of California Press, 2008. (The book can be downloaded for free from http://www.jameslindlibrary.org/testing-treatments.html

Health Literacy Out Loud #62: Using the Internet for Health

Helen Osborne — Tue, 12 Jul 2011 06:00:47 +0000

Lee Rainie is Director of the Pew Research Center’s Internet & American Life Project. Since 1999, this non-profit, non–partisan “fact tank” has studied the social impact of the internet. The Pew Research Center has examined and reported how people’s Internet use affects their families, communities, work places, education, civic and political life. It also studies how people use the Internet for health.

In this podcast, Rainie talks with Helen Osborne about:

The rise of “e-patients.” Who they are. How they use the Internet for health.
The Internet as a way to increase patient engagement. How Internet usage may differ for those with chronic conditions versus new diagnoses.
Ways that health professionals can be active members of online conversations, too.
Rainie’s vision of what health communication might be like in years ahead.

More Ways to Learn:

Pew Internet & American Life Project. You can access all its reports and datasets for free at http://www.pewinternet.org.
Health Literacy Out Loud Podcast #54: Dr. David Blumenthal Talks About Health Information Technology. At http://healthliteracy.com/hlol-healthIT
Health Literacy Out Loud Podcast #53: Blogging to Communicate the Experience of Illness. At http://healthliteracy.com/hlol-blogging

Health Literacy Out Loud Podcast #61: The Importance of Empathy in Health Communication

Helen Osborne — Tue, 28 Jun 2011 06:00:14 +0000

Leslie Bank is Director of Customer Service at Montefiore Health Care System in Bronx, New York. She is also the co-author of, “I’m Sorry to Hear That…Real Life Responses to Patients’ 101 Most Common Complaints About Health Care.”

Bank has worked as a healthcare “change agent” for over three decades, always striving to assure that the patient’s voice is heard in all aspects of care. This includes her ongoing work in billing reform. In fact, many refer to Leslie Bank as “The Mother of Patient Friendly Billing.”

In this podcast, she talks with Helen Osborne about:

What empathy is and how it helps build trusting healthcare relationships.
Strategies and suggestions for using empathy in day-to-day practice.
Stories and examples of empathy in action.

More Ways to Learn:

To speak with Leslie Bank, call 718-920-4060.
“I’m Sorry to Hear That…Real Life Responses to Patients’ 101 Most Common Complaints About Health Care.” Available at http://tinyurl.com/3e4v2g4
Susan Keane Baker (Bank’s co-author) provides many articles, tips sheets, and other resources about exceptional patient care. Available athttp://www.susanbaker.com/
The Language of Caring Video-Based Skill-Building Program, by Wendy Leebov. Available at http://www.quality-patient-experience.com/language-of-caring.html

Health Literacy Out Loud Podcast #60: Creating, Finding, and Growing in a Health Literacy Career

Helen Osborne — Tue, 14 Jun 2011 06:00:44 +0000

Geri Lynn Baumblatt has been working on health literacy projects for many years. As the editorial director at Emmi Solutions, she creates and maintains Emmi Solutions’ interactive patient education programs. Geri is also a podcaster and hosts an annual series for Health Literacy Month on the blog: Engaging the Patient.

In this podcast Baumblatt talks with Helen Osborne about:

How her health literacy journey began with an interest in science, graduate study in literature, and frustration with being a patient.
Why clarity and simplicity are needed for multimedia patient education projects.
Tips, strategies, lessons learned for people seeking health literacy careers.

More Ways to Learn:

Emmi Solutions: http://www.emmisolutions.com/
Engaging the Patient blog: http://engagingthepatient.com

Health Literacy Out Loud #59: Surgeon General Richard H. Carmona, M.D., M.P.H., FACS Talks about the Importance of Health Literacy

Helen Osborne — Tue, 31 May 2011 06:00:56 +0000

Dr. Richard Carmona is the 17th Surgeon General of the United States, Distinguished Professor at the University of Arizona, Vice Chairman of Canyon Ranch, and President of the non-profit Canyon Ranch Institute. He understands the importance of health literacy from a lifetime of personal and professional experiences.

In this podcast, Dr. Carmona talks with Helen Osborne about:

Why he is such a champion of health literacy,
How health literacy factors in all we do, including emergency and crisis situations as well as public health, and
What others can do to help. As Dr. Carmona says, “Every citizen needs to become a health literacy public health practitioner.”

More Ways to Learn:

Canyon Ranch Institute: The Power & Possibility of a Healthy World. At http://www.canyonranchinstitute.org.
Canyon Ranch Institute’s Perspectives about Health Literacy, at http://www.canyonranchinstitute.org/perspectives/healthlit/

Click here to read a transcript of this interview

Helen Osborne: Welcome to Health Literacy Out Loud. I’m Helen Osborne, President of Health Literacy Consulting, founder of Health Literacy Month and your host of Health Literacy Out Loud.

In these podcasts, you get to listen in on some amazing conversations with truly remarkable people. You will hear what health literacy is, why it matters and ways we all can help improve health understanding.

Today, I have the privilege of talking with Dr. Richard Carmona. He is the 17th Surgeon General of the United States, distinguished professor at the University of Arizona, and vice chairman of Canyon Ranch.

Dr. Carmona understands the importance of health literacy from a lifetime of personal and professional experiences.

Welcome, Dr. Carmona.

Dr. Carmona: Thank you. I’m happy to be with you.

Helen Osborne: I’m delighted. You’re our country’s foremost health literacy champion. How did all this get started?

Dr. Carmona: I don’t know that I want to accept that title. I think I’m one of many that we see here today with Wisconsin Literacy and others around the country who are very passionate about this. I’m happy to be part of the team.

This started years ago as a child with the barriers of growing up with an immigrant family and fast-forwarding into a lot of different jobs I’ve had. I learned I had to become a good communicator, especially as Surgeon General of the United States.

Helen Osborne: I think you’re modest, being the Surgeon General of the United States and touting health literacy. When I heard you speak about it, it was almost an out-of-body experience for me.

I remember way back when we didn’t have the words “health literacy.” I’d ask people, “What are we going to do about health literacy?” They would say, “Health what? Isn’t that teaching people to read?”

Somehow you’ve gotten on board with this and are championing the cause loud and clear. Why does health literacy matter so much to you?

Dr. Carmona: In my lifetime, over about 40 years and lots of different jobs around healthcare and public service, I recognize that part of our responsibility is to be able to communicate with those we serve. If we don’t effectively communicate, then sometimes we’re wasting our time.

Health literacy is simply taking what we know and translating it in such a way that the average person who has a different life, language or culture can use that information to affect behavioral change to improve their health. It’s a really simple equation, but it eludes us because we spend a lot of time on high-tech things.

This is about communication. I’m so happy to see that this health literacy advocacy has grown and swelled in the United States. There are so many organizations, like here in Wisconsin, that are positive advocates because we cannot undergo healthcare transformation effectively without being good health communicators. That’s what health literacy is all about.

Helen Osborne: I know your background is in emergency medicine and crisis communication. It’s also taken a path down public health communication. Do you see health literacy as a factor in both of these spheres? They’re at very different ends of the continuum.

Dr. Carmona: Health literacy is a factor in everything I’ve done in my whole life. Even as a police officer, paramedic, registered nurse, physician assistant or physician, you have to be an effective communicator.

When a police officer shows up in an emergency and there’s somebody unconscious or down, they become the doctor of the moment. They become the savior. Communicating with the people around and giving instructions in an emergency is very important.

With every job I’ve had I see more and more, especially retrospectively, how important communication has been and continues to be for our nation.

Helen Osborne: I think that nobody else listening to this podcast will ever be Surgeon General of the United States. Maybe we will, but probably we won’t. There are people who are advocating within their organizations and communities. They are championing their cause for whatever their realm is. What would you like those people to know and do about health literacy?

Dr. Carmona: As citizens of the United States, every one of us should listen, learn and have a greater understanding of how we interact with our environment, and most importantly, what we can do to stay healthy and prevent disease. That’s health literacy.

As we look at our United States, it is so diverse. Paradoxically, the strength in this nation is its diversity, yet it’s sometimes what creates barriers for us in culture and language.

Every citizen has to understand what we know so that they can incorporate it into their life and make appropriate changes to reduce morbidity and mortality, improve the quality of life and decrease the cost of care. There are a whole lot of endpoints that are desirable.

As we go through this debate about healthcare in our nation, we’re never going to be successful unless every citizen is touched by these messages and then is able to contribute and be part of their pursuit of optimal health. That’s the bottom line.

We who have the privilege to understand health literacy have the obligation to educate our fellow citizens so they get the best benefit of all this great science that’s out there.

Helen Osborne: When you talk about education, what would that look like? In a real way, how can we help educate people to take better care of their own health?

Dr. Carmona: I look at this in a hierarchy. First of all, there are professionals who know the science, but do they really understand how to teach that science and transfer that information? Then there’s the citizen who may be health illiterate. It may be someone with a college degree, but they don’t understand how their daily behaviors ultimately contribute to their health status.

There are all types of gradations. When we move into a community and have people who are trained in health literacy, they understand the culture and environment they’re in and how to deliver resident messages that will hopefully change behavior. One size doesn’t fit all.

What needs to happen is that the concept of health literacy is embedded in everything we do in grammar school, high school and college old-fashioned home economics courses, which we don’t see too much, and all of our professional education. Health literacy needs to be part of that.

Helen Osborne: That’s inspirational hearing that there’s really room for all of us. I’ve often thought, being a health professional myself, that I’m part of the problem. For years, I communicated in ways that I think a lot of the people I worked with couldn’t understand.

I feel that in many ways we are part of the problem, but I also feel that we are part of the solution. You’re helping find ways that we can be putting that into our day-to-day work. That’s just commendable.

What do you see in about five years? What would a health literate United States or world look like?

Dr. Carmona: If I just look at the last decade from when I became Surgeon General, throughout my time as Surgeon General, and then my time working in the last few years with the Canyon Ranch Institute, which is about health literacy as well, that gives us a nice timeline.

When I first started as Surgeon General, as you alluded to earlier, when we’d say “health literacy,” people would say, “What’s that?” Even our professionals would say, “What do you mean?” People would think, “You mean we need an interpreter.” It’s not about an interpreter. This is really about truly translating not only language but culture and understanding.

What I’d like to see in the future is that this concept is embedded in everything we do. Whether you’re talking to the paramedic on the street, a nurse in a public health clinic or a teacher in a school, they all understand the concept that they have to carefully figure out how they’re going to translate what they know to an end user who needs that information so they can pursue optimal health and wellness.

That’s what I’d like to see in the future.

Helen Osborne: That’s a wonderful vision. What do you see as some of the stumbling blocks to get there?

Dr. Carmona: One stumbling block is our own culture. The fact is that those of us who have been educated in the Western world see allopathic medicine in a certain way and don’t take into account the many people who really look at what we call complementary and alternative medicine. There are people who don’t have understanding and people who are displaced because of disparities of health, wealth and so on.

We have to figure out a way to breach those barriers that we call “social determinants of health” today. It’s the message we deliver in an inner-city, underserved population in the South Bronx, like we’re working with in Canyon Ranch Institute, versus where we would deliver a message in Beverly Hills, California.

It’s the same science, but you’re delivering a different message to the population because different populations will resonate based on how you deliver that message. It’s being sensitive to their culture.

Sometimes it works best if you work in an underserved community through the opinion leaders in that community. It might be a priest, rabbi or mullah.

Helen Osborne: It could be a hairdresser.

Dr. Carmona: Barbershops and hairdressers are great for information. It’s a great public health model. In a Hispanic community, they use promotoras, young men and women who are not health professionals but are trained in a particular area. It might be for asthma prevention or mitigation. It may be for maternal/child health.

All of those are extraordinarily important, but we have to use every aspect of society, get them involved, and be better public health practitioners. Every citizen needs to become a health literate public health practitioner.

Helen Osborne: Thank you. That’s wonderful to be able to hear. I also know from your work that is very much based in evidence-based medicine. This is not just the person at the drugstore or barbershop deciding on a health message. We’re giving science-based, accurate health information. Is that correct?

Dr. Carmona: Absolutely. As you see in our meeting with Wisconsin Literacy and others, some of the thought leaders in our world are right here who have studied this for years. My colleague, Dr. Andrew Pleasant at the Canyon Ranch Institute, is a prolific researcher and writer of textbooks.

So there is a very strong science behind health literacy but incorporating that and being able to translate it is what’s important.

Anybody can do this. It’s not that difficult. It’s not rocket science, as they say. It’s paying attention, being culturally sensitive and learning how to deliver these resonate messages to communities that need this information.

Helen Osborne: Thank you. You’re a wonderful advocate. What would surprise most of us about the work you’ve discovered in health literacy? What about your work would really make someone think, “I didn’t think of that”?

Dr. Carmona: I’ll give you a perfect example that may be concrete. At our Canyon Ranch Institute, we’ve embedded ourselves in the South Bronx in a federally qualified health center where there are 40,000 of the poorest Hispanic immigrants in the country. There are many barriers, like language and culture. We have the highest rates of obesity, type 2 diabetes, hyperlipidemia and depression.

We have measureable indices that we look at. In the two years we’ve been there, we’ve gradually been able to change all of those indices in a health literate model. It’s figuring out how to communicate with this population in a resonant fashion where they see us now as friends, not foreigners. We’ve become part of their family. They trust us.

The proof is in the pudding. All of those metrics I measured are changing. Diabetes is going away. Weight loss is happening. People are becoming more socially and physically active. They’re developing new social networks. The interesting thing is that it’s very simple principles of health literacy that have done it.

Health Osborne: Thank you for that. That’s at the local, individual level. It’s really making a difference to people, communities and health literacy advocates everywhere. I thank you so much for sharing that with listeners of Health Literacy Out Loud.

Dr. Carmona: It’s my privilege. Thank you for the opportunity to be with you today.

Health Osborne: I learned so much from talking to Dr. Carmona, and I hope that you did too.

Health literacy isn’t always easy. For help clearly communicating your health message, please visit my health literacy consulting website at www.HealthLiteracy.com. While you are there, sign up for the free e-newsletter, What’s New in Health Literacy Consulting.

New Health Literacy Out Loud podcasts come out every few weeks. Subscribe for free to hear them all. You can find us on iTunes as well as the Health Literacy Out Loud website,www.HealthLiteracyOutLoud.com.

Did you like this podcast?

Dr. Carmona: I loved it. It was fun.

Helen Osborne: Did you learn something new?

Dr. Carmona: I did.

Helen Osborne: Tell your colleagues. Tell your friends. Together, let’s tell the whole world why health literacy matters. Until next time, I’m Helen Osborne.

Health Literacy Out Loud #58: From the Tooth’s Point of View: Communicating Serious Health Messages with Wit and Whimsy

Helen Osborne — Tue, 10 May 2011 06:00:13 +0000

Jeanette Courtad DDS is a practicing dentist. She has worked with patients of all ages—from outreach programs at primary schools to now being the dentist at the Colorado School of Mines Student Health Center.

Dr. Courtad is also an artist with a lifetime of experience painting, dancing, and sculpting. She combines her artistic talents with a passion for educating children about the need for better oral hygiene in her new book, Toothful Tales: How We Survived the Sweet Attack.

In this podcast, she talks with Helen Osborne about:

Why preventive health messages are often difficult to communicate.
Ways to draw attention to your message with empathy, wit, and whimsy.
Strategies that work with children, young adults, and even parents.

More Ways to Learn:

Toothful Tales, at http://www.toothfultales.com/
American Dental Association, at http://www.ada.org
Power of Sour on Your Teeth, Minnesota Dental Association. Available at http://www.mndental.org/public_home/educational_activities/the_power_of_sour_on_your_teeth

Health Literacy Out Loud #57: Texting Important Health Messages

Helen Osborne — Tue, 26 Apr 2011 06:00:07 +0000

Julie Gazmararian PhD is Associate Professor of Epidemiology at the Rollins School of Public Health at Emory University in Atlanta, Georgia. She has over 25 years of experience conducting public health research in both the public and private sector. Her research focuses on a range of topics including reproductive health, children’s health, health promotion, and health literacy.

Dr. Gazmararian has published many articles on health literacy topics including medication refill adherence and use of preventive services. Now she is evaluating an innovative project called “Text4Baby” that brings together text messaging with prenatal/newborn care.

In this podcast, she talks with Helen Osborne about:

How “Text4Baby” is being used to teach about prenatal and newborn care.
Why text messaging is a communication tool to consider now.
What researchers are learning early in the evaluation process.
Recommendations for using text messaging in your practice.

More Ways to Learn:

Text4Baby. Available for free at http://text4baby.org
Osborne H. “In Other Words…Using text messages to improve medication adherence,” On Call magazine. September 18, 2008. Available athttp://www.healthliteracy.com/article.asp?PageID=7987
Archer N, Cocosila M, Haynes RB, Yuan Y. “Can wireless text messaging improve adherence to preventive activities? Results of a randomised controlled trial.” International Journal of Medical Informatics. (2009). PubMed. Web. 28 Dec. 2009.
Balas EA, Boren SA, Krishna S. “Healthcare via cell phones: a systematic review.” Journal of the American Telemedicine Association. (2009). PubMed. Web. 28 Dec. 2009.
Chen WS, Leong KC, bLeong KW, Mastura I, Mimi O, Ng CJ, Phua KL, Sheikh MA, Teng CL, Zailinawati AH. “The use of text messaging to improve attendance in primary care: a randomized controlled trial.” Family Practice. (2006). PubMed. Web. 30 Dec. 2009.
Fry JP, Neff RA. “Periodic prompts and reminders in health promotion and health behavior interventions: systematic review.” Journal of Medical Internet Research. (2009). PubMed. Web. 28 Dec. 2009.
Haller DM, Patton GC, Sanci LA, Sawyer SM. “Text message communication in primary care research: a randomized controlled trial.” Family Practice. (2009). PubMed. Web. 30 Dec. 2009.

Health Literacy Out Loud #56: Helping Others Understand Health Messages

Helen Osborne — Tue, 05 Apr 2011 06:00:06 +0000

Lisa M. Schwartz, MD, M.S., and Steven Woloshin, MD, MS, are general internists at the White River Junction Veterans Administration Medical Center in Vermont. They also are professors of medicine, and community and family medicine, at Dartmouth Medical School in New Hampshire.

Together, they are working to address two important barriers to health communication: 1) many patients and providers are limited in their ability to interpret medical data, and 2) health messages are often exaggerated or incomplete. Dr. Schwartz and Dr. Woloshin have written extensively on this topic and are co-authors of several books including Know Your Chances: Understanding Health Statistics and Overdiagnosed.

In this podcast, they talk with Helen Osborne about:

Health statistics, health messages, and health claims. Helping people make sense of what they hear on the news, see on TV, and read in the ads.
Three questions to help others better understand health messages.
Ways to communicate complicated health messages more simply and clearly.

More Ways to Learn:

Woloshin S, Schwartz LM, Welch HG, Know Your Chances: Understanding Health Statistics. University of California Press, 2008. (The book can be downloaded for free from http://www.jameslindlibrary.org/testing-treatments.html
Welch HG, Schwartz LM, Woloshin, Overdiagnosed. Beacon Press, 2011.
S Woloshin, LM Schwartz, BS Kramer. “Promoting health skepticism in the news: Helping journalists get it right,” J Natl Cancer Institute 101(23): 1596–1599.
“Healthy Skepticism,” White River Junction Outcomes Group. Available at http://www.vaoutcomes.org/washpost.php
Osborne H, “In Other Words…Working With Numbers,” On Call magazine, June/July 2004. Available at http://healthliteracy.com/article.asp?PageID=3745

Health Literacy Out Loud #55: Health Literacy Milestones and Opportunities

Helen Osborne — Tue, 22 Mar 2011 06:00:28 +0000

Dr. Ruth Parker is Professor of Medicine and Public Health at Emory University in Atlanta, Georgia. She is nationally recognized for her efforts in health literacy research, education, and health policy.

Dr. Parker’s accomplishments are many, including helping to develop the TOFHLA (Test of Functional Health Literacy in Adults) and co-writing the health literacy definition included in many publications and initiatives including the U.S. Patient Protection and Affordable Care Act (otherwise known as “Health Care Reform”).

In this podcast, Dr. Parker talks with Helen Osborne about:

Why health literacy matters so much to her, and everyone else.
Health literacy milestones, especially in the past ten years.
Health literacy opportunities ahead in this era of health care reform.

More Ways to Learn:

HealthCare.gov, “Understanding the Affordable Care Act.” Available at http://www.healthcare.gov/law/introduction/index.html
HealthyPeople 2020, http://www.healthypeople.gov/2020/default.aspx
Institute of Medicine: Roundtable on Health Literacy. Learn more at http://www.iom.edu/Activities/PublicHealth/HealthLiteracy.aspx
Nielsen-Bohlman L, Panzer AM, Kindig DA (ed) 2004. Health Literacy: A Prescription to End Confusion. The National Academies Press: Washington, DC.
Osborne H (host), Baur C (guest). Health Literacy Out Loud Podcast #39: National Action Plan to Improve Health Literacy. June 8, 2010. Available athttp://www.healthliteracyoutloud.com/2010/06/08/hlol-39-national-action-plan-to-improve-health-literacy/
Osborne H (host), Clancy C (guest) Health Literacy Out Loud Podcast #27: CAHPS Health Literacy Item Set: An Interview with Dr. Carolyn Clancy.November 9, 2009. Available at http://www.healthliteracyoutloud.com/2009/11/09/hlol-27-cahps-health-literacy-item-set-an-interview-with-dr-carolyn-clancy/
Parker R, Ratzan SC, “Health Literacy: A Second Decade of Distinction for Americans.” Journal of Health Communication, 2010;15 Suppl 2:20-33.
Somers SA, Mahadevan R, “Health Literacy Implications of the Affordable Care Act,” Center for Health Care Strategies, November 2010. Available at http://www.chcs.org/publications3960/publications_show.htm?doc_id=1261193

Click here for a transcript of the episode.

Transcript:

Helen Osborne: Welcome to Health Literacy Out Loud. I’m Helen Osborne, President of Health Literacy Consulting, founder of Health Literacy Month and your host of Health Literacy Out Loud.

In these podcasts, you get to listen on my conversations with some pretty amazing people. You will hear what health literacy is, why it matters and ways we all can help improve health understanding.

Today I’m talking with Dr. Ruth Parker who is professor of medicine in the department of medicine at Emory University School of Medicine. Dr. Parker is nationally recognized for her health literacy research, teaching and advocacy.

Dr. Parker’s accomplishments are many, including helping to develop the TOFHLA, or Test of the Functional Health Literacy in Adults, and co-writing the widely used health literacy definition that is in many prominent publications and nationwide initiatives, including the US Patient Protection and Affordable Care Act, otherwise known as Healthcare Reform.

Dr. Parker servers on numerous health literacy panels and advisory boards and has won many awards for her health literacy work. If all of this doesn’t keep her busy enough, Dr. Parker is a marathon runner and an advocate for women athletes of all ages.

Welcome, Dr.Parker.

Dr. Ruth Parker: It’s nice to speak with you Helen.

Helen Osborne: You’re speaking with me, and we have listeners from everywhere listening in on our conversation. I’m so glad to have this opportunity to talk with you. You do so much work in health literacy and have for so long. Why is it so important to you?

Dr. Ruth Parker: It started as kind of a little, lonely endeavor. There were a few folks out there that you know well. Terry Davis and Barry Weiss were certainly out there thinking about how many things are written so much above the level of the patients that we’re trying to help their ability to understand and act on them.

I came into this probably 20 years ago when I was actually involved in working on something totally unrelated with a colleague of mine. He was looking at waiting times in the emergency rooms and how long it took to get cared for in a big, urban public health hospital setting.

What we noticed in a little survey we were giving folks was how quickly they would come back to us and how there just wasn’t time for patients to be able to read them and understand them.

I turned to a hospital administrator, and I remember saying, “Gosh, can our patients read?” He turned back to me and said, “Yes, most of them can.” I said, “What is most?” He said, “I don’t know, two-thirds or so.”

It really just struck me that I had gone all the way through medical school and residency and was practicing and teaching internal medicine as a faculty member, and I had never stopped to think about whether or not people can understand all of the information and all it takes to be a patient.

Helen Osborne: That was your aha moment.

Dr. Ruth Parker: It was an aha moment. I turned to some people who knew a whole lot about it. There certainly are a lot of people that this is no secret to. They’ve been thinking about it and working in it.

The people I turned to were actually from Georgia State University down the street. I learned from those who live in the world of literacy and all that is known about how many people really do not understand what they need to be able to understand to act and that literacy is functional. It is context and setting specific.

Over the next several years we worked on developing a tool for measuring it and then measuring it. Then we worked with others to look at associations. Over the last five, seven to 10 years, we’ve been trying to figure out what in the heck we are going to do about it.

It’s been a long haul with a lot of great accomplishments, but there’s still a lot more to do.

Helen Osborne: There is. I appreciate hearing your story from the beginning. I can resonate with that as well. About 15 years ago, I was in practice myself, and I got bitten by that health literacy bug. It was maybe building on work that you had already started.

This was after reading an article that I found in JAMA, Journal of the American Medical Association, by Williams et al, saying that about half the adults in this country struggle to understand printed information. I looked at the patient population I was treating at a community hospital in Boston and said, “What can I do about it?”

Dr. Ruth Parker: Many of us in the early phases were really trying to figure out how we could quantitate the problem and put reliable numbers as to just how big a problem it was, defining it, putting some words around it, and identifying the prevalence and how common it was.

There were people out there who knew it was real, but we needed the data to back that up. Then we needed to put some studies beside it to say, “What does this mean? How is this related to what we’re seeing about peoples’ understanding of chronic diseases, self-management and outcomes of various sorts?”

I think there was a good decade of work to really amass that information, but it was pretty exciting with the IOM report that came out.

Helen Osborne: The Institute of Medicine report.

Dr. Ruth Parker: Right, and also a lot of other people were coming to the table with various backgrounds saying, “This looks real, but what are we going to do about it?”

It’s pretty exciting to take it from something that’s now recognized as real to saying, “What do we do with that and how do we begin to go after something that is this big of an issue for so many people?”

Putting the mirror on ourselves, those of us who are involved in providing health information, health services, medical care and public healthcare, what can we do to make ourselves more health literate and more understandable?

Helen Osborne: That’s something I think about a lot, the fact that it takes all of us together. Some people bring the research, some people bring the policy, and some people bring the programmatic parts of it.

There is an article of yours that you co-wrote with Scott Ratzan that came out recently. It’s called “Health Literacy: A Second Decade of Distinction for Americans.” It was published in the Journal of Health Communication in 2010. I just think that this is a brilliant overview of what’s been happening in health literacy in the last 10 years.

There’s a sentence in there that particularly resonates with me, and that is, “Health literacy has grown from an under-recognized silent epidemic to an issue of health policy and reform.” I wonder if you could help walk us through exactly how that has happened.

When I look at this wonderful chart you have in there of all that’s happened in the last decade of health literacy, what are some of our milestones?

Dr. Ruth Parker: Helen, you’ve certainly been there at the table and heard a lot of this as it unrolled, but it was probably back in the year 2000 that Scott and I put out the definition for the National Library of Medicine. It went in their current bibliography.

Helen Osborne: You put out the definition of health literacy?

Dr. Ruth Parker: Correct. It was important to have a definition even though there is always going to be discussion and room for improvement, but we needed to put something together that people could come around.

That definition went forward in Healthy People 2010 and was picked up and used by the NIH and the Institute of Medicine for the report that our committee was working on. We had this definition and we started moving forward around that.

Very central to this was the inclusion in Healthy People 2010 early on of a couple of objectives that specifically were around health literacy.

Helen Osborne: Can you give an example?

Dr. Ruth Parker: The main one probably had to do with improving the health literacy of persons with inadequate or marginal literacy skills. That was a specifically mentioned objective. That, of course, helped set some of the policy agenda for federal agencies that are working under the guidance of Healthy People 2010 and what it does for setting a public health agenda for our country.

There were some other very important initiatives that started happening as well. Health and Human Services created and began to have a work group across agencies.

The IOM came out with a report in 2003 that was also really important. It linked health literacy with self-management as a crosscutting priority for the country for transforming healthcare quality to the 21^st century.

This was really important because it meant not only is taking care of and self-managing your health a priority but you have to understand what it is you need to do.

These were crosscutting across all the priorities for transforming the quality of healthcare, with quality obviously being one of the main policy goals for health in our country.

That came out in 2003 before we had the health literacy Institute of Medicine report which was published in 2004, “A Prescription to End Confusion.” Like I mentioned, that did use the definition that Scott and I had put out back in 2000 for the National Library of Medicine.

That report went a long way to lay out specific recommendations and was just a sentinel event in helping to frame health literacy for the country as well as lay out some concrete recommendations.

Helen Osborne: As I look back on my journey with health literacy, I see that Institute of Medicine report as a real turning point. It’s a time when it went from, “What is health literacy?” which is the response I got from others, to “Health literacy: What are we going to do about it?” It’s interesting to see how all of this has been leading up to that. What happened after 2004 to take us to now?

Dr. Ruth Parker: The IOM report in 2004 requested more research. We were fortunate to have the National Institute of Health and the Agency for Healthcare Research and Quality issue a program announcement with review. This stimulated the beginning of some federal funding specific to it.

That was so important to stimulate the work of many to try to advance what it is we can do about the problem. That was first issued in 2004 and was reissued in 2007 and again in 2010. With that, we saw more and more people coming to the table and being involved.

The Institute of Medicine continued their good work of pulling together stakeholders by creating a roundtable. Since 2006 they have met at least twice a year, bringing together people around all kinds of issues related to what we know, what we need to learn more about, who the stakeholders are and what we can do.

They’ve also published a series of workshop summaries that have helped to raise awareness and educate. They have looked at specific issues like quality of care and prescription medication labels.

Helen Osborne: I have been to some of those, and they are really impressive. They are very fast-paced. Every 15 minutes somebody different is presenting. I just go to listen in and sit on the sidelines. It’s very impressive.

Dr. Ruth Parker: It has drawn a lot of people from different constituencies. One of the last ones we had had to do with a state-based approach. It was held out in California. It’s a wonderful venue. We’ve got another one that has become very active on health reform, looking at what the opportunities are and what we could do with that.

It’s a wonderful opportunity to bring together stakeholders from multiple constituencies who are vested in doing something to address the issue and to continue to make this a part of the public health agenda for the country. I’m always incredibly grateful to the IOM for their convening and continuing to support the efforts of all types of people who see this as a real issue for us to be engaged in.

Helen Osborne: I’m looking at your article now. There are so many more landmarks and milestones along the way. I also want to get to what the opportunities are ahead. You talked about the Affordable Care Act, otherwise called Healthcare Reform in the US. Where does health literacy fit in in that?

Dr. Ruth Parker: It was certainly wonderful to see the definition of health literacy actually written into the Affordable Care Act, the ACA as many call it, and to have that definition included. It’s very extensive legislation and there is a whole lot in it. I think most people are still trying to digest what all is in it and what does it mean for me?

We did have a recent Institute of Medicine roundtable workshop where we focused very specifically on health literacy implications of the Affordable Care Act.

In addition to noting that the definition was in there, we were able to identify through a white paper that was presented at that workshop where there is direct mention of health literacy relating to research and the dissemination of research in order to get information out to the people that it can help and who might benefit from it.

It went into shared decision making and what it means to share information between providers and patients as consumers of health and healthcare. It also covered medication labels, which patients need to be able to pick up and understand on an everyday basis as they self-manage all types of conditions.

In workforce development, for those of us who are involved in providing health and healthcare, what is it that we need in order to be confident as health literacy providers? There again, the emphasis has more recently been on those of us who are involved in the delivery of health and health information. How health literate are we?

We spent a lot of time early on defining the public and saying, “What do we know about the skills and the abilities of the public?” I think it’s very exciting that in the last five to seven years we’ve really been willing to turn it the other way.

We can say as we move toward interventions, “What is it that we can do to make ourselves health literate and understandable and to make sure that what we tell people is actionable and meets them with their abilities and skills to use the information?”

Helen Osborne: That’s how I am seeing the health literacy definition evolving. It’s as looking at the alignment between the needs of the system and the needs of the individuals.

Many people email me and ask, “How do I measure health literacy of my colleagues? I want to do some training. How do I figure that out before and after?” Under this workforce development part, do you have any ideas or recommendations for us?

Dr. Ruth Parker: I think that is still very much an evolving area. It’s on the horizon and we’re seeing it mentioned. We’re seeing people talk about it. Certainly awareness and understanding of the issue is a first phase.

Then you get into the nitty-gritty. What exactly does it mean? Helen, I think you would be a good one to say. You know it when you see it, but how do you measure it?

We also know that what gets measured gets done. That’s really true from an organization or a system level. If we want to see impact on something that’s as big a problem as health literacy in our country, we need to have ways to measure it and to gauge it.

Helen Osborne: I actually comment that the opposite way. I’m more on the practice side of what I do. Some things right now are hard to measure, and I see these standards where things need to be written at whatever low grade level they can come up with and it frustrates me time after time.

Just because you reduce the number of syllables doesn’t make something easy to understand, but it’s easy to measure. How would you go about balancing between the need to measure something, and I appreciate that, but finding the right things to measure?

Dr. Ruth Parker: I think you’re right, and I think ultimately the goal is to measure the alignment. How well does what you need to be able to do align with the skills and abilities of the people who need that information?

What we really need to know is how well aligned are we? How good a job are those of us who are putting out all this content doing at aligning that with what people need?

A very simple example I think, is to take a look at a pill bottle. You pick up a pill bottle, and very commonly you will see an instruction that would say, “Take one pill twice a day.”

What’s the reading grade level requirement of that? It’s very low, but then you and I could immediately say, “What is twice? Is twice in the morning? When is the morning? Is it morning and midday? When is midday? Is it 8:00 a.m. and 8:00 p.m.? Does it matter in terms of how the medication works and its safety or efficacy?”

If it matters, why doesn’t it specify that on a bottle that is given out so commonly, every day in our country and varies across state lines?

The question is how well are we as providers doing at offering to the people who need it something that is understandable, actionable and actually useful? We’re flunking.

How do you measure and capture that? You capture it when you don’t have a problem with the misalignment any more. How do we go about coming up with useful gauges and measures?

We’re struggling with that. I think this is doable, but I think it is all still part of being nescient and also being new to realizing what our ultimate goal is.

Helen Osborne: That’s what I was wondering about. What is this goal? You’re a marathon runner. You know that 26.2 miles, or whatever it is down the road, there’s a finish line. What is that finish line we’re all running toward?

Dr. Ruth Parker: The finish line is the alignment. When what you need to know to understand, know and do for your health meets you with your own skills and abilities across various skills and abilities, everybody gets it because it’s presented in multiple ways with reinforcing messages that mean the same thing. That’s the art and science of communication.

You would probably agree with me that we’re masters at putting out volumes of content. We do it more and more, but more is not always better. More is just more. What we really need to do is understand what the essential need to know to do is.

For example, with the pill bottle it’s the real meaning. It’s take one at 8:00 a.m. and at 4:00 p.m. If we know that, we can find a way to say it. “Take one twice a day” is not clear by its inherent nature, yet that’s what’s on the bottle. That’s a very simple example, but it’s so common.

Helen Osborne: It is so common. It’s everywhere. I see another problem ahead is that it seems to be a moving object, what it is that we as patients and family members need to understand, such as nutrition information. Some days it’s good to eat this kind of food. The other day don’t eat that kind of food. It’s constantly changing. Maybe that’s why we have so much information out there. It’s confusing.

Dr. Ruth Parker: It’s confusing, and what we do is put out lots of information. Just because it’s content doesn’t mean that it’s good. I think that many people just begin to ignore it because they don’t know what to believe, why to believe it, what is really valuable and what is really necessary

I think in general, people care about their health and are vested in it. They want to be healthy. We’ve said over and over that it really is hard to be a patient. It really is hard to know what to do.

It’s so incredibly easy to make a mistake, mess up and lose trust in knowing what to believe and why, especially when information that you may need is not even accessible in terms of its navigability or understandability. The clearer those of us who care about this are about what the essential need to know to do is, the better.

It’s not only taking an entity like your diet, care for your diabetes, care to get to the optimum weight or the optimum approach to your own fitness. Once you know what you need to know, it’s understanding with clarity what that is, what that means and then finding a way to communicate that so its meaning is accessible to people of various literacy levels.

Helen Osborne: I wonder if you could help. For all of us who are advocates of health literacy, for our listeners who really are passionate about the topic and want to make a difference, how can we challenge people? What can we give them to do that maybe could make a difference tomorrow, not just way down the road?

Dr. Ruth Parker: I think for all of us who care, it comes down to figuring out who it is we’re trying to reach with whatever it is we’re doing. Are we looking to address individuals or an entire system that provides health information or health services?

We can take wherever we are and say, “What is it I’m trying to communicate? What is the evidence for it? Do I understand what the message is? Do I understand the real nitty-gritty of this?”

Take that and make sure that people across levels of understanding can understand it, and then find multiple channels that reinforce that. Use print, but beyond that, how do we reinforce evidence-based content and make it accessible across levels?

We have to do this up front. So much of what we do is try to retrofit and take content that’s out there and say “People didn’t understand this. How do we make it fit now?”

We’ve already lost a lot of our audience in that approach. If, on the front end, we work to make things understandable, actionable and accessible rather than trying to take volumes of content and retrofit it, we’re going to find it easier.

We’re still trying to figure out what that process really looks like. There are some people doing it and doing it effectively, but the real challenge is to make this seamless. This needs to become a part of what we do all the time.

Helen Osborne: Do you see us getting there?

Dr. Ruth Parker: I absolutely do. Look at the opportunity for enrollment of all the people who currently don’t have health services. Under the opportunities to reform, we could take the process of enrollment and make it on the front end a process that people understand, navigate and recognize.

We can make it process that’s not something that tries to do the same thing hundreds of different ways and becomes just inaccessible by its own design.

Helen Osborne: I thank you for all of that. You really are bringing that whole big picture and big vision. You’re working on policy and research at the highest level, but you’re also giving us that how-to information so we can make a difference wherever we enter this conversation. You’re making it very accessible for us to understand, follow and do.

Thank you so much for being a part of this podcast but also for helping champion the cause and lead the way for health literacy.

Dr. Ruth Parker: It is a pleasure, Helen. Thank you for getting the word out. There are wonderful people working on this, and it’s a lot of fun. We welcome others to the table. It’s a delight to chat with you about it.

Helen Osborne: We will be having some of the references that you mentioned on the Health Literacy Out Loud website. Thank you very much.

I learned a lot from Dr. Parker and hope that you did too. Health literacy isn’t always easy. For help in clearly communicating your health message, please visit my health literacy consulting website at www.HealthLiteracy.com. While you are there, feel free to sign up for the free e-newsletter, “What’s New in Health Literacy Consulting.”

Did you like this podcast? More importantly, did you learn something new? If so, tell your colleagues and friends. Together, let’s let the whole world know why health literacy matters. Until next time, I’m Helen Osborne.

Health Literacy Out Loud Podcast #54: Dr. David Blumenthal Talks About Health Information Technology

Helen Osborne — Tue, 01 Mar 2011 06:00:10 +0000

David Blumenthal MD, MPP serves as the National Coordinator for Health Information Technology (or Health IT) under President Barack Obama. Dr. Blumenthal is charged with building a secure nationwide health information system and supporting the widespread, meaningful use of Health IT.

Dr. Blumenthal’s credentials are extensive. He not only was a practicing primary care physician but also is a renowned researcher and national authority on health IT. Dr. Blumenthal serves on numerous national boards and has authored over 200 scholarly publications, including “Heart of Power: Health and Politics in the Oval Office,” which tells the history of U.S. Presidents’ involvement in health reform, from FDR through George W. Bush.

In this podcast, Dr. Blumenthal talks with Helen Osborne about:

What Health IT is and why it’s needed in healthcare today.
How Health IT benefits providers, researchers, and patients.
Concerns about Health IT and work being done to address them.
What an ideal Health IT world would look like 20 years from now.

More ways to learn:

U.S. Department of Health & Human Services: The Office of the National Coordinator for Health Information Technology. Available at http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__home/1204