“The Shanghai Declaration positions health literacy as one of three key pillars to support the world to reach the Sustainable Development Goals. The Shanghai Declaration has very little detail on how to use health literacy in a practical way.” – Richard Osbourne
There are many reasons why it can feel like health literacy is hard to address on a practical level.
Health literacy research often relies on large data sets about groups or patient populations. This can make it difficult to drill down for meaningful suggestions at the small group or individual level.
But there are things you can do, actions you can take, wherever you are, whatever your role.
This month is health literacy month and I’m not messing around here. Let’s get down to it.
On your own
When health literacy burst on the scene, it brought some needed attention to the disconnects between medical language and people’s everyday language.
What’s more, conversationally speaking, the patient encounter is not a level playing field. There is an imbalance to be sure. You know this already, and the research bears it out.
Yet you can’t help but speak from your own position as a health professional. So, why not explore it? See what’s under the hood, so to speak, of the words you use with patients, clients, or students, everyday?
If ‘high’ health literacy is even a thing, health care professionals have it!
Reflect on your own professional language use. Question common practices, processes, even phrases or terminology. Examine the underlying assumptions about patients, and about what they know, do, and value, that are embedded within these words and phrases. (Click here if you want to get very good at doing this.)
That’s right: I’m inviting you to increase your awareness of your own health literacy–and what you’re doing with it.
With your patients or clients
Researchers are explicit about the fact that a health literacy assessment score is NOT a proxy for a patient’s education level. But it still gets talked about that way.
It can also be easy to focus on a person’s perceived weaknesses, based on what we think is or should be normal, basic, or fundamental. We (sometimes unconsciously) can think that the ways other people do things are problematic. Like, say, the ways patients understand their bodies and act upon health information.
So ditch the deficit perspective. Instead, take a resource perspective on your patients.
Start where they are, what they are already doing. An important health literacy approach is connecting whatever information you have, to what the person (or community) you are trying to reach already values.
The goal becomes expanding and extending what the patient is already doing, in order to help get his or her needs met. This might remind you of patient-centeredness, moving toward seeing the patient as more than a collection of needs and problems. In spite of all the pressures that can lead to seeing them that way.
Want more support in doing this? I have it here.
This is about interacting with a patient as a whole person, with a full life, and who uses language everyday in very sophisticated ways. It’s is about shifting your starting position.
With your organization (or with your students)
Have (or build) a list of websites and apps you trust.
Apps and websites tend to be graphics-heavy. They are also often interactive. Both of these traits are beneficial for learning. The small amount of information on the screen of an App can also be less intimidating than pages of solid prose.
It goes without saying—but here I am saying it—that you’re checking these digital health tools are communicating reliable and up-to-date information. The AMA is working on it (along with some friends, known as Xcertia). The NASEM is working on it (in virtual services). And so am I.
If you’re not already asking your patients if they use apps, and which ones, do it! Keep a list, both of the good and not-so-good ones. Be prepared to talk about which ones you don’t recommend and why. (This could be a great class activity too.) Bonus points for occasionally visiting a site or app together, side by side with a patient, and eliciting feedback.
Listen to my podcast! Here’s 4 episodes about health literacy and digital health tools. Each episode is only about 10 minutes. That’s just enough time to get a good discussion going.
With your written materials
Reduce literacy demands wherever possible. This means first getting clear on which parts of a patient visit or procedure require patients to read or write. Then, ask yourself:
- What reading and writing activities can be delayed? What can patients fill out or read at home with a friend?
- What reading and writing activities can be eliminated altogether? For example, is a patient being asked to provide information that has been provided before, or that is available on his/her EMR?
While we’re on the topic, how long has it been since you looked at the written materials you give to patients?
Make sure they are accompanied by images, and broken up into small paragraphs. Everyone finds this more manageable and memorable.
How you physically handle and talk about written materials matters. Handle a document with seriousness, and people will notice. So highlight or underline important passages, and talk about them or point to them.
I’m serious about health literacy
If you are too, contact me. Whether you’re a provider, administrator, educator, research, or developer. Because helping you with health literacy is what I do.