A medical educator recently gave me some feedback from her students on a talk I’d given:
“They thought you had many great points about communicating with patients, and liked the point you made about cell phones.”
As a literacy researcher and educator, I have spent years talking with folks about health literacy. My emphasis is on helping providers get the outcomes they want with the work they are already doing. This involves knowing how to be more efficient and effective in communication and education.
That’s where health literacy comes in, as I see it.
I thought I’d share with you what I’d said about cell phones and health literacy.
And I’ll end with two things you can do to help your patients, regardless of their health literacy levels.
Connecting health literacy to patient communication
Physicians repeatedly tell me that one of the biggest hurdles to patient communication is the time constraint around patient interaction. The field of health literacy has addressed patient communication using some concepts and tools from literacy research, mostly related to written materials and to patients’ reading levels.
Attending to the quality and nature of health information given by providers is one means of supporting patients’ autonomous health decisions. There’s still more we need to know about how patients engage with language around their health, how they learn to navigate the health care system, and how best to support them in these processes.
However, the physicians I have worked with agree that, in the immediacy of the face to face patient encounter, they seek to help patients understand and take action on an important health matter.
A few words about literacy
Health literacy is about much more than reading, but reading does get the majority of the attention.
That may be because when we hear literacy, many of us think ‘reading.’ Literacy is actually much more complex. We all have a range of skills and processes for creating and interpreting the information we encounter each day.
There is literacy all around us. Think of all the common, everyday tasks that involve literacy, which your patient might engage in:
- keeping bank accounts
- making or using shopping lists
- calculating prices
- reading recipes
- using the internet
- reading signs
- reading/annotating/reciting sacred texts
A more robust idea of what literacy is can help us appreciate the many ways literacy is connected to everyday life.
At the end, I’ll show you how this can also be helpful during the patient encounter–especially when you’re trying to motivate an action, and you’re unsure of someone’s comfort with health literacy.
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Here’s the bit about cell phones
I’ve often mentioned cell phones when I’m talking about health literacy. This is because they illustrate very well how we all use language every day in complex ways.
Smartphones tend to cut across income levels and cultures. Through them, we both consume and produce complex materials. Consider:
- text messages are read and written
- images are created and shared
- products and services are located and sometime purchased
- videos are created and shared
- websites are interacted with
- social media is scanned and updated
Smartphones are incredibly demanding, in terms of the reading, writing, and numeracy skills we need in order to operate them!
A few words about ‘illiteracy’
“Illiteracy” has been used a threatening and pejorative term for decades.
“Illiterate” can quickly take on connotations of being unintelligent, uninformed, backward, or somehow lacking in what’s really necessary to live in the modern world.
Sometimes, writings or policies can get scarily close to implying that people with low literacy lack a kind of logic or higher thought process that other folks have. This is clearly untrue, but people who are repeatedly told they are illiterate come to believe these things about themselves.
Many studies prove that people who are labelled as illiterate by one measure or another have multiple sophisticated ways of reading a text or image, keeping track of items, measuring and weighing, estimating and calculating. They access information in multiple ways, and learn by and from their families, peers, and communities. Patients with literacy difficulties draw on a broad range of strategies and skills when confronted with complex health-related experiences.
What you can do
So what can you do as a provider, when you’re concerned about getting messages across to your patients, and you’re unsure of their health literacy? Oh, and you only have a tiny slice of time together?
Everyday literacy
Consider the most common kinds of information you want to gather or get across. Think about which of the everyday tasks I mentioned about have similar demands.
- Talk to your patients with this in mind. “If you can follow a recipe, you can do this.”
- Consider which everyday literacy tasks would make an apt metaphor or analogy. “Think of this like keeping track of the cost of the groceries in your basket…”
The point is that you are attaching your recommendation to the patient’s already existing skills.
Cell phones
If someone can use a smart phone, they have some level of literacy and numeracy. And there is a very good chance that your patient uses a cell phone, and it’s probably a smart phone.
- Ask your patients if they use a cell phone or smart phone, and if so, what they do with it. (Refer to that bulleted list above)
- Relate these actions to what you want them to do and know. “Next time you get on your phone, check out this video on this website. Here’s the link…”
When you wish to encourage an action, don’t start from scratch. Show people that they are already capable of, and doing things related to, that action.
Reaching people through language
Thinking about health literacy in the ways I’m suggesting here requires—and rewards–more attention to the patients’ own social and material worlds.
As a bonus, such communication can not only increase your effectiveness as an educator, but also intermediate outcomes associated with improved health, including trust, mutual understanding, and self-efficacy.
You and I are both trying to reach people through language.
Part of my job, as I see it, is to get you thinking in slightly different ways about your own practice, including some things you might take for granted about language. This is so that you can begin to see opportunities and possibilities you hadn’t noticed before, in order to make the impact you seek.
Effective Patient Education Audiobook Bundle
This bundle of audiobook, eBook, and supplementary materials will help make your life easier. And it might change the way you think about patient education, no matter your specialization or patient population. You get practical, culturally and linguistically relevant advice and research-based tools, in an unfussy, conversational format. All sales support this podcast series.
$19.99
Buy Now
