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Workshop Ground Rules Turn cell phones off or to vibrate/silentRelax, be comfortable, be interactive Share experiences, thoughts and ideasPractice common conversational courtesyOne person talking at a time Respect different ideas and view points

Avoid rabbit trails and editorializing

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Workshop Outline Introductory sharing – “Know your audience”Preliminary information – “Connect the dots” Justification/need for the projectOverall goal and objectives Experimental design & process evaluationObservations & preliminary findings Summary

Know the Audience

Name and position/work areaHow many years in current position/work

area?Where you grew up?What states you have lived in as an adult?What you hope to get out of this workshop?

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Connect the DotsConference Theme “Leveraging Partnerships to Improve the Health

of the Nation”Creating Healthy Communities CoP Goal “Provide resource support to improve

community health”Workshop focus area “Promoting Health Literacy with Inmates”

Connect the Dots LiteracyHealth Literacy IncarcerationRecidivism - “a return to prison and/or jail as a

result of either a new conviction or a violation of terms of supervision”; Recidivism rates vary nationally: 1 out of 2 (50%) 2 out of 3 (66%) 4 out of 5 (80%)

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Connect the DotsHealth Literacy is the capacity/ability to obtain

(find), process (understand) and use (act on) basic health information and services in order to make appropriate health decisions.

Health Literacy is the #1 predictor of health outcomes – ahead of age, race, income, education, and employment

Connecting More Dots Statement: “The true health of a community

is determined by how it treats its weakest and most vulnerable members”

Who are the vulnerable members? (NN/LM) Elderly (age 65+)Minority and immigrant populations Low income People with chronic mental and/or physical

health conditions

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Education, Income & Health“Low education rates and inadequate income contribute to premature death, chronic disease, and spending on medical care. Prioritizing education and economic opportunity is an important strategy to save lives, improve health, and reduce spending on avoidable illnesses.” April 3, 2012

2012 County Health RankingsRobert Wood Johnson Foundation – Public Health

http://www.rwjf.org/publichealth/product.jsp?id=74148

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Justification/NeedHealth literacy is the #1 predictor of health

outcomesPoor health literacy is associated with poor self

care management, high health care costs, and low use of preventive services

Inmates have low health literacy skills and high incidence of chronic illnesses (80-90% vs 50% for all US)

Chronic illnesses account for 75% of all health care expenditures and 70% of all deaths

Goal of the Project

To improve the health literacy, self-care management skills and personal health care decision-making of inmates incarcerated in the county jail

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Objectives of the Project To enhance the capacity of inmates in their

understanding of locating, evaluating and using basic health information

To motivate inmates to take more responsibility for their own health care

To increase the inmate’s understanding of the importance in seeking assistance from local librarians after release

Experimental DesignAnnouncing the project to inmates Signing Informed Consent forms Filling out Pre-Survey QuestionnairesDistributing the following handouts:My Health Companion © Staying Healthy Student Resource Book Coping with Stress Student Book

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Experimental Design (con’t)Receiving the following handouts (con’t): Talking with Your Doctor Seeking Drug Abuse Treatment: Know What to

Ask the List – Community Resources for Gallatin

County Attending formal classes 2.5 hrs/day – M, W, FAttending informal classes 2 hrs/day – T & Th

Experimental Design (con’t) Filling out Post-Survey Questionnaires one week

after completion of 11.5 hours of classesModifying project protocol as neededDecreased class size from 12 to seven Changed laptops to desktops with headphones Reduced class time from two weeks to one week Promoted self-guided learning Maintained goal to reach 60-70 inmates with pilot

project

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Experimental Design (con’t)Health Information Literacy Offline System

(HILOS) – “internet-in-a-box”MedlinePlusUnderstanding Medical Words: A Tutorial from

the National Library of MedicineUSDA SuperTracker Plain Language Medical Dictionary 12 Power Point Presentations 42 Videos

Experimental Design (con’t) Topics of 12 Module PPTs Computer BasicsWhat is Health Literacy?My Health Companion © and Other Resources Advocacy and Self-Care Prevention and Screening Sexually Transmitted and Infectious Diseases

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Experimental Design (con’t) Topics of 12 Module PPTs (con’t)

Tobacco EpidemicMental Illness The Science of AddictionNutritionOral Health Library Resources

Observations - Target PopulationAddictive behaviors/substance abuse Mental illnessesHistory of unhealthy relationshipsComplex and chronic health conditions School dropouts/low literacy Sex offenders & violent offendersMinorities

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Observations - Classes Fragile population with frequent dropouts,

stop-outs and bail-outsBroad range of literacy, learning and

computer skillsBroad range of interest and motivation Scheduling conflictsMany positive comments

Preliminary Findings

“The health literacy class has already aided me in helping my parents with their medical issues.”

“I know more about STDs and what I need to do in order to maintain my health.”

“Thank you for all the time the volunteers gave to help us.”

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Summary – Key Components Pre- and post- questionnairesAccess to desktop computers with 12

module PPTs and internet-in-a-box (offline) system

Handout materialsMy Health Companion © Staying Healthy Student Resource Book Coping with Stress Student Book

Summary - Key CollaboratorsGallatin County Detention Center (County Jail)Montana State University (Extension, College

of Nursing, & Library)Gallatin City-County Health DepartmentGallatin Mental Health CenterBozeman Public LibraryHealthy Roads Media

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Summary – Health LiteracyAffordable Care Act (ACA) - March 2010

National Action Plan to Improve Health Literacy - May 2010

Healthy People 2020 - Dec 2010

National Prevention Strategy - June 2011 Healthy and Safe Community Environments Clinical and Community Preventive Services Empowered People Elimination of Health Disparities

Improve the Health of the Nation Improve self-care management and health

care decision-making of inmates upon release Improve community public health Improve public safetyReduce health care costsReduce recidivismReduce health disparities

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Improve the Health of the Nation

Prisoner reentry is a: Public safety issue Public health issueHousing and employment issue Family and community issue Education issueMinority and special needs issue

AcknowledgementsNational Library of Medicine, NIH, DHHSMedlinePlusUnderstanding Medical Words

United States Department of Agriculture SuperTracker

Taubman Health Sciences Library, University of Michigan Plain Language Medical Dictionary

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Acknowledgements (con’t)Healthy Roads Media, Bozeman, MT 39 videos

Extension IT Specialist, Montana State University ‘Internet-in-a-box offline system’

National Network of Libraries of Medicine, Pacific Northwest Region, University of Washington, Seattle, Washington

Contact Information

David YoungExtension/College of NursingP.O. Box 172230Bozeman, MT 50717-172230E-mail: dyoung@montana.eduPhone: (406) 994-5552

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Medical Library Association Health Literacy Consulting