Cynthia Baur, Ph.D. Senior Advisor, Health Literacy August 23, 2011 The National Action Plan to...

Cynthia Baur, Ph.D. Senior Advisor, Health Literacy

August 23, 2011

The National Action Plan

to Improve Health Literacy

Office of the Director

Office of the Associate Director for Communication

Key Messages

Government agencies, foundations, and research universities should prioritize funding for qualitative and quantitative studies related to health literacy improvement.

Goal 6, National Action Plan

Funders play a critical role in the dissemination and use of research findings.

Goal 7, National Action Plan

What is the Gap?

Health Literacy: Hearing the voices of people on the receiving end of our communication

What is a 2 times greater risk for pneumonia if I don’t get a flu shot?

Greater than what?

What do these survival rates mean for me?

80% 8 of 10 women?

80 of 100? .8?

Is one better than the other?

What is Health Literacy? Obtain Process Understand Decide

Sources: National Library of Medicine, Healthy People

Health Information and Services

How is Health Literacy Different

from General Literacy?

Builds on literacy skills BUT ALSO

Cultural and contextual factors

Beliefs, experience and preferencesTopic area and conceptual knowledge,

such as knowledge of the body and how it works terms for specific health conditions scientific results and risk

Institute of Medicine Report

on Health Literacy• Limited health literacy is a major public

health issue• Interaction of individual skills and social

complexity creates health literacy problems• Professionals need health literacy training

Health Literacy Dynamic

Literacy in AmericaNational Assessment of Adult Literacy

(NAAL)

National sample survey conducted in 1992 and 2003

Performed by U.S. Department of Education,National Center for Health Statistics

In-person interviews with Americans age 16 and older (N~19,000) Tested in English or alternate short test in Spanish

Over sampling of Blacks and Hispanics

http://nces.ed.gov/naal/

NAAL Domains Emphasized the use of printed everyday

materials (newspapers, prescriptions, bills) needed to function

153 items that assessed prose, document, or quantitative literacy

Most items required searching text for specific information, short written responses

http://nces.ed.gov/naal/

Prose Document Quantitative

Categories and Sample Health Tasks

Proficient Proficient – Calculate employee’s share of health insurance costs for a year

IntermediateIntermediate – Determine healthy weight range; medication timing

BasicBasic – Explain why it is difficult to know if they have a specific chronic condition

Below BasicBelow Basic – Identify what is permissible to drink before a medical test

http://nces.ed.gov/naal/

Results from the NAAL

Kutner et al. National Assessment of Adult Literacy, 2006

Intermediate

Basic

Below Basic

Proficient

13%

12%

53%

22%

77 Million Adults have Basic or Below Basic Health Literacy

Health Literacy by Age

Kutner et al. National Assessment of Adult Literacy, 2006

59%

Health Literacy by Race/Ethnicity

Kutner et al. National Assessment of Adult Literacy, 2006

28%

66%

58%

Health Literacy by Education

Kutner et al. National Assessment of Adult Literacy, 2006

76%

44%

13%

11%

Outcomes Associated with Limited Health Literacy

Health outcomes Taking medications appropriately Interpreting labels and health messages Seniors’ health status and quality of life Mortality

Health services Hospitalization Emergency care visit Flu immunization

Knowledge and comprehension

Berkman et al 2011 Health Literacy Interventions and Outcomes :An Updated Systematic Review

Why A National Action Plan?

What is the Plan?

Seven Goal Areas

Health information creation and dissemination

Healthcare services

Early childhood-university education

Community-based services

Partnership and collaboration

Research and evaluation

Dissemination of evidence-based practice

HHS Health Literacy Research

NIH/AHRQ Understanding and Promoting Health Literacy Program Announcement (PAR-10-133) R01, R03 and R21 NIH: 85 grants totaling $67 million (2004-2011) http://obssr.od.nih.gov/scientific_areas/

social_culture_factors_in_health/health_literacy/index.aspx Additional research under other Funding

Opportunity Announcements and contracts NIH/AHRQ support of annual research

conference http://www.bumc.bu.edu/healthliteracyconference/

Ideas for research and intervention topics

NIH/AHRQ Program Announcement National Action Plan Goals Research presented at annual conference AHRQ systematic review

http://www.ahrq.gov/clinic/tp/lituptp.htm Evaluation of tools

Organizational audits Universal precautions in clear communication Clear communication training Standards

Call to Action

The National Action Plan to Improve Health

Literacy challenges individuals, organizations

and communities to fulfill their responsibility

to make

health information and services

ACCURATE, ACCESSIBLE AND ACTIONABLE

A Challenge Is your foundation using its resources to

improve health literacy OR perpetuate and create health literacy

barriers?

For more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: cdcinfo@cdc.gov Web: www.cdc.gov

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

What questions do you have?

www.cdc.gov/healthliteracyhttp://blogs.cdc.gov/healthliteracy/

Office of the Director

Office of the Associate Director for Communication