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In It Together:
Improving Health
Literacy for Black MSM Training of Trainers
Module 4: Written Communication
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
Recap of Module 3
General strategies for clear communication
Ask Me 3 Approach
Teach-back Method
2
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
Training goal
Trainers will increase their
awareness of strategies to
improve delivery of written
information
3
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
4
Objectives
By the end of this training, you will be able to:
Explain how written material can be used to address
health literacy
Identify at least 3 factors to consider when developing or
selecting written material
Identify at least 2 strategies that make prescriptions
instructions easier to understand
Understand the components of eHealth literacy
Describe 3 strategies to improve online communications
0 II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
What is written material?
5
life's a game, and with treatment, I'm winning it day by day." Christopher Washington, DC l 1'+' 1nq w1lh IIIV ••nni 191/,
I wa only 16 yPan. 11 whm Id overed th.lt
I w.n born w11h HIV My mother pil 1-d 11W 1y trom the hs but until g tttnq t ted at a commu, ly hrahh f,111: I Ii.Id no dt• thal I 10(1
was l1w,g w,1h HIV W1th1n a •ew Tionths of my
cha 00\LS I <J ton Ir tlnt"nt •o rol my vu I
lo.xf Smee then, I w- tayOO on t~atnw!nt and
m, ood health. tf'ttmq h ted saved my hf
•nc:tlW'iJ :-dmy Xpt"fttnt1 toh lp uth tun
about HIV prf"WflllOI\ ll' llng nd f,qtrtHlCJ
ugmn l 1Y I l'"f0Y fnend fanuly nnd hv1nq
I h U 1 HIV
Get in care. Stay in care. Live well.
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
What is written material?
6
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
7
Materials development poll
How many of your organizations:
a. Create your own materials?
b. Purchase or download material that is already created?
c. Both?
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
Traditional information exchange
In person from a health care provider
By talking to family and friends
Through newspapers, magazines, books, radio, and
television programs
8
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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Value of written material
Written information can:
Improve understanding
and recall of medical
information
Provide more information
about medical conditions,
treatments, or desired
outcomes
Facilitate adherence to
medical advice or
treatment
Reinforce information
provided by the health
professional
Support visual learners
Improve treatment
adherence
Facilitate discussions
about client concerns
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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Promising practices
for written material
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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Formatting Immediately appealing
Has a clear and obvious
path for the eye to follow
Uses headings and
subheadings (chunk)
Maintains consistent style
and structure
Uses bolding to
emphasize important
points
Uses easy-to-read font in
12 point or larger
Times New Roman
Arial
Calibri
Remember: I may read your handout with my smartphone.
Left-justify text
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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Word choice
Simple words with 1 or 2 syllables
Short sentences with 10 to 15 words
Strong, vivid words, including verbs
Words or phrases familiar to the audience
At a 6th grade reading level
Use culturally appropriate words
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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Content
Focus on the patient’s experience of the condition
Clearly state:
What the client needs to do
Why the client needs to do it
When the client can expect results
What warning signs the client needs to watch for
What to do if a problem occurs
Who to contact with questions
HIV CAN BE TRANS ITTED THROUGH ...
Sexual Pregn ncy, Ch ldb rth Injection Contact & Breast Feeding Drug Use
• 'I' .. tt
Occupational Exposure
' Blood Transfusion/Organ Transplant
14
literacy
Content (continued): Images and
pictographs
Use images and pictographs
Infographics and pictographs
promote recall
Ensure images are reflective of
target population
36% of American adults
have limited health
AS EARLY AS 2-4 WEEKS AFTER EXPOSURE TO HIV PEOPLE CAN EXPERIENCE ARS,
OFTEN DESCRIBED AS "THE WORST FLU EVER"
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
Images
What does this image communicate?
15
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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Avoid
ALL CAPITAL LETTERS
Italicized text
Underlined text
Acronyms and contractions
Technical words or jargon
Passive voice
Passive voice: The results of your lab work will be sent to you
Active voice: We will send you your lab results
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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Medication instructions,
intake forms, consent
documents, and websites
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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Medication instructions
Use actionable language
Be specific
Do not group medication
instructions
Use numerals
Provide visual
descriptions or images
(sun/moon, image of pill)
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
19
Intake and consent forms
Test forms with intended users
Revise as needed based on what you learn from users
Provide plain language forms to all clients (in multiple
languages if appropriate)
Train staff to answer client questions and help clients
complete forms
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
20
Assessments and tools
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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How to assess written material
Clinical assessment
Educational assessment
Technical assessment
Appeal assessment
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
22
Reading level assessment tools
Write at or below a 6th grade
reading level
Use readability assessments to
measure the complexity text
Flesch Reading Ease
Fry Graph Readability Formula
The SMOG Readability Formula
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
Clear language tools
Clear Communication Index (Centers for Disease
Control and Prevention)
Toolkit for Making Written Material Clear and Effective
(Centers for Medicare and Medicaid Services)
Patient Education Materials Assessment Tool (Agency
for Healthcare Research and Quality)
23
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
Group exercise: materials review Clinical assessment Accurate Current Sufficient
Appeal assessment Positive tone
Avoids stereotyping Avoids commercial product promotions
Technical assessment Illustrations are simple and easy to
understand Illustrations enhance the text Uses headings Main points are easy to find and understand Sentences are 10-15 words or less Paragraphs are 2-3 sentences Uses lists
Uses white space
Educational assessment Holds interest and attention of
reader Information is well-organized Avoids or defines all acr onyms Written at or below a 6th grade reading level Avoids unnecessary information
24
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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How to use written material
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
When to use written material
Use print material during clinical encounter
Use during or when approaching pivotal care points
Reinforce specific, important points about care and treatment
Refer to printed material in future visits and during
follow-up phone calls
26
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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How to use written material
Emphasize important information by circling or
highlighting it
Personalize the materials
Confirm client understanding of the material
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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Where to offer print material
Waiting rooms
In private areas
Exam rooms or meeting spaces
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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The digital age
and e-health
literacy
'
30
Changing landscape for health
information Web 2.0 Web 1.0
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
31
Changing health technology
landscape: Opportunities Increased availability and access to health information
Learning opportunities that are multisensory and
interactive
Access to and management of their own health care
information
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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Changing health technology
landscape: Challenges Reading level
Information overload
Cost
Time
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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How online health information is
used Find information on topics that are uncomfortable to
discuss in person
Supplement to traditional supports
Use smartphones and tablets to search
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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e-Health literacy
The ability to seek, find,
understand, and assess
health information from
electronic sources and
apply the knowledge gained
to address or solve a health
problem
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
Components of e-health literacy Traditional Literacy
Health Literacy Computer Literacy
Media Literacy Information Literacy Scientific Literacy
35
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
36
Developing digital content for
people with limited health literacy Use plain and clear language
Put the most important information first
Write actionable content
Ensure content is relevant to your audience
Use clear, consistent formatting
Design for compatibility with mobile devices
Ensure that content is accessible to people with
disabilities
You ~
Tube
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
Types of social media
37
H!Y,J g~
DIGITAL TOOLS
HIV BASICS FEDERAL RESPONSE DIGITAL TOOLS EVENTS BLOG P O ;:,::u,t ~
P1onrung ond Mono1;;ement
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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How health organizations can use
social media Go to HIV.gov to learn more about social
Patient outreach media tools and strategy. and engagement
To engage with
Black gay, bisexual,
and same-gender-
loving men
Promote your health
literacy efforts
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
39
Wrap up Today we learned:
How written material can be used to
promote health literacy
Why, how, when and where to introduce
patient material
How to select effective written material
Tips to use to create effective patient
material
Strategies that make prescription
instructions, intake forms and informed
consent documents easier to understand
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
Next steps
Creating Health
Literate Materials
40
II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM
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If you have questions… Email: hivhealthliteracy@jsi.com
Phone: 404-460-4803
This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and
Human Services (HHS) under grant number U69HA30143: Building Ryan White HIV/AIDS Program Recipient Capacity to Engage
People Living with HIV in Health Care Access. This information or content and conclusions are those of the author and should not be
construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.
The persons shown in photographs on this website/tool/resource are models and are being used for illustrative purposes only.
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