November 22, 2010
Health Literacy: What Family Leaders and Advocates Can Do
by Wendy Jones, Director, Children and Youth with Special Health Care Needs, National Center for Cultural Competence; Secretary, Family Voices Board of Directors
Health literacy is defined as “the degree to which individuals have the capacity to obtain, process and understand basic health information needed to make appropriate health decisions and access services needed to prevent or treat illness.1 Research tells us that nearly 9 out of 10 adults may not have the skills needed to manage the health of their children or themselves and to prevent disease.2 Low health literacy can affect a person or family’s ability to:
- Locate health care providers
- Find their way to and through hospitals and clinics
- Measure and take medicine correctly
- Follow treatment or discharge plans
- Keep records of their own or their child’s health appointments, medications, symptoms or side effects
- Understand and use their health care coverage appropriately
- Fill out forms and share medical or health information
- And much, much more.
Anyone can have low health literacy. It is seen more often in older adults, underserved populations, people with lower socioeconomic status, and individuals whose first language is not English. Having an awareness and understanding of the impact of health literacy is essential to family leaders who advocate with and on behalf of families. Family leaders are in a key position to educate, support, assist, and link families to strategies and approaches that will enhance their ability to understand health information and to make informed decisions.
Two important approaches to addressing health literacy are Ask Me Three and the Teach Back Method. Ask Me Three is a communication strategy to encourage patients/family members at every encounter to ask three basic questions of a provider. The three questions are:
- What is my main problem?
- What do I need to do?
- Why is it important for me to do this?
Research has shown that about 40-80 percent of the health information patients and families receive is forgotten almost immediately3 and that about half of the information that patients and families do remember is often incorrect.4 The Teach Back Method (also called “show me” and “closing the loop”) is a way to confirm that patients and families have understood information received from a provider by having them “teach” or explain what they understood back to the provider.
Family leaders can share these important strategies with families and providers alike to help improve health communication and understanding. See resources that follow.
1 U.S. Department of Health and Human Services, HRSA Health Literacy
2 Kirsch IS, Jungeblut A, Jenkins L, Kolstad A. 1993. Adult Literacy in America: A First Look at the Results of the National Adult Literacy Survey (NALS). Washington, DC: National Center for Education Statistics, U.S. Department of Education
3 Kessels RP. Patients' memory for medical information. J R Soc Med. May 2003;96(5):219-22.
4 Anderson JL, Dodman S, Kopelman M, Fleming A. Patient information recall in a rheumatology clinic. Rheumatology. 1979;18(1):18-22.
Here’s a smorgasbord of health literacy web sites and other resources for families, family organizations, and professionals:
- HRSA Health Literacy Courses
- Ask Me Three information
- The Teach Back Method Information and Video
- North Carolina Program on Health Literacy
- Take a Quiz—How much do you know about Health Literacy?
- “Creating Material” from the Harvard School of Public Health
- “Health Literacy Online: A Guide to Writing and Designing Easy-to-Use Health Web Sites” from the Office of Disease Prevention and Health Promotion
- “Family Health and Literacy: A Guide to Easy-to-Read Health Education Materials and Web Sites for Families” from World Education and the National Institute for Literacy
- “Toolkit for Making Written Material Clear and Effective” from the Centers for Medicare and Medicaid Services
- Health Literacy Now sample easy-to-read health forms
- “Health Communicator’s Social Media Toolkit” from the CDC is “a guide to using social media [blogs, Facebook, podcasts, etc.] to improve reach of health messages, increase access to your content, further participation with audiences, and advance transparency to improve health communication efforts”
Family Leadership in the States:
Congratulations to Family Voices of Ohio—Consumer Assistance Grant Recipient!
Thanks to the US Department of Health and Human Services—and the Patient Protection and Affordable Care Act—Family Voices of Ohio and three other non-profit organization are recipients of a Consumer Assistance Grant. This $1.1 million grant is designed to:
- Help consumers enroll in health coverage
- Help consumers file complaints and appeals against health plans
- Educate consumers about their rights and empower them to take action
- Track consumer complaints to help identify problems and strengthen enforcement
The expertise and community connections of Family Voices of Ohio and the F2F HIC make them key community partners--“critical” to achieving the grant objectives. Family Voices of Ohio President Cindy Leffel is quoted in the press release, “Family Voices of Ohio is pleased to be a part of the Consumer Assistance Grant, and working with Ohio Department of Insurance and consumer organizations for families in Ohio . . . to help families who have children with special health care needs work together with professionals and learn to navigate through various health care systems.”
As a result of the mid-term elections, the political landscape has changed substantially since the last issue of Friday’s Child. The new Congress (which convenes in January) will have a majority of Republicans in the House of Representatives. Therefore, all of the House committees will be chaired by Republicans and will have a majority of Republican members. This is significant because the Republican Party’s “Pledge to America” includes in its agenda the repeal of the health care reform law (Affordable Care Act or ACA).
So, will health care reform be repealed? Not likely -- at least not in the next two years -- since there are not likely sufficient votes to do so in the Senate. In any case, the President would veto repeal legislation and there would not be enough votes in Congress to override a veto. Nevertheless, the House majority will be able to make it more difficult for the administration to carry out the law by holding hearings that will divert the resources of the implementing agencies. See the article.
At the state level, a number of governors are attempting to block implementation of the health care reform law through lawsuits, the outcomes of which are yet to be determined. State lawmakers are also filing bills aimed at nullifying the law.
Of course, there are also a number of “ordinary citizens” who have serious misgivings about the health care reform law, and some of you may have encountered these concerns from families you serve. To the extent that they are worried about the individual mandate (to buy health insurance), you can explain that the protections afforded by the ACA (such as prohibitions against pre-existing condition exclusions) cannot work unless everyone gets health care coverage to spread the risk. Some resources to counter challenges to the ACA (although not particularly aimed at families) can be found on the website of Families USA.
More information about the ACA, and information about public and private health insurance options in every state, can be found at http://www.healthcare.gov*. Also see http://www.pcip.gov, which explains some upcoming changes to the federal high-risk insurance plan (Pre-existing Condition Insurance Plan), including a reduction in premiums and establishment of “child-only” policies. *The US Department of Health and Human Services (HHS) has created a companion site in Spanish for health care information, the first of its kind.
If you have questions, please contact the Public Policy Team -- Brooke Lehmann and Janis Guerney.
News from Family Voices
Have You Registered for the Family Voices National Conference and Gala Yet?
February 13-15, 2011 Omni Shoreham Hotel, Washington, DC
Click here for more information or to register.
Congratulations, Trish Thomas—Recipient of the MCHB Director’s Award! At the Maternal and Child Health Federal/State Partnership Meeting and the 75th Anniversary Celebration of Title V of the Social Security Act, individuals and organizations—pioneers and emerging leaders in Maternal and Child Health (MCH)—were recognized for their significant contributions to the field of MCH through innovative practices, partnerships, and research at the local, state, and national levels. Trish Thomas, National Family Voices TA/Partnership Coordinator, was awarded the Director’s Award in recognition of her contributions to improving the health of infants, mothers, children, adolescents, and children with special health care needs in the nation. Congratulations, Trish!
Bright Futures Family Matters October 2010 Issue: Health Literacy
Looking for a good resource to share with families on the importance of health literacy? Check out the latest issue of Bright Futures Family Matters
New KASA Publication
Paraprofessional Toolkit: Working With a One-on-One Aide in School written by youth, with sections for Students, Paras and School Administrators.
From Our National Partners
MCH 75th ANNIVERSARY
1200 people participated in the 75th Title V Anniversary Celebration on October 20 in Washington, DC. Get the flavor of the celebration through videos—both an official MCHB video, as well as YouTube submissions–and publications distributed at the meeting.
NEW F2F FUNDING
HHS Secretary Kathleen Sebelius announced $3.9 million to extend support for the F2F HICs through 2012. Read the press release.
MCH Library Knowledge Path: Children with Special Health Care Needs
Here’s the latest Knowledge Path revision from the MCH Library at Georgetown University, on CSHCN. As with other Knowledge Paths, you’ll find web sites, publications, databases, and social media for families and professionals.
The Flu Ends with U
Fall brings cooler temperatures and the start of the flu season! The Centers for Disease Control recommend three actions to take to prevent this year’s flu season from becoming as deadly as last year’s epidemic:
- Get vaccinated! Many businesses, health clinics, schools, churches, and other community locations are providing flu shots. See to find a location near you.
- Cut down the spread of the virus by frequent handwashing and covering your mouth when coughing or sneezing.
- If your health care provider recommends it, take flu antiviral medication if you get sick.
New Fact Sheets
The Association of Maternal and Child Health Programs has released three new publications to help state MCH programs understand and implement key Patient Protection and Affordable Care Act provisions:
President Barack Obama has declared November National Native American Heritage Month to “honor and celebrate their importance to our great Nation and our world.” Read the press release.
For more information on these vital members of health care teams, go to the National Family Caregivers Association website.
Thank you for your interest in Friday's Child. To subscribe to the e-newsletter version, please visit http://www.familyvoices.org/action/keep_informed. Should you have any questions about this newsletter, please email Peggy Curran.