BREAKING NEWS
Cloud Server Hosting For Online Businesses
Inexpensive SEO Services
Benefits of Wanting to play Free Online Slot machines
Health literacy

Summary

Health literacy is the ability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment.[1] There are multiple definitions of health literacy,[2] in part, because health literacy involves both the context (or setting) in which health literacy demands are made (e.g., health care, media, internet or fitness facility) and the skills that people bring to that situation.[3]

The ability to read and understand medication instructions is a form of health literacy.

Since health literacy is a primary contributing factor to health disparities, it is a continued and increasing concern for health professionals.[4] The 2003 National Assessment of Adult Literacy (NAAL) conducted by the US Department of Education found that 36% of participants scored as either "basic" or "below basic" in terms of their health literacy and concluded that approximately 80 million Americans have limited health literacy.[5] These individuals have difficulty with common health tasks including reading the label of a prescribed drug.[6] Several factors may influence health literacy. However, the following factors have been shown to strongly increase this risk: age (especially patients 65 years and older), limited English language proficiency or English as a second language, chronic conditions, less education, and lower socioeconomic status.[7] Patients with low health literacy understand less about their medical conditions and treatments and overall report worse health status.[8]

Various interventions, such as simplifying information and illustrations, avoiding jargon, using "teach-back" methods, and encouraging patients' questions, have improved health behaviors in persons with low health literacy.[9] The proportion of adults aged 18 and over in the U.S., in the year 2010, who reported that their health care providers always explained things so they could understand them was about 60.6%.[10] This number increased 1% from 2007 to 2010.[10] The Healthy People 2020 initiative of the United States Department of Health and Human Services (HHS) has included health literacy as a pressing new topic, with objectives for improving it in the decade to come.[11]

In planning for Healthy People 2030 (the fifth edition of Healthy People), HHS[12] issued a "Solicitation for Written Comments on an Updated Health Literacy Definition for Healthy People." Several proposals address the fact that "health literacy is multidimensional",[13] being the result of a concerted effort that involves the individual seeking care or information, providers and caregivers, the complexity and demands of the system, and the use of plain language for communication.

Characteristics edit

 
A poster about airborne disease transmission encouraging the use of a handkerchief to prevent the spread.

Factors that contribute to health literacy edit

Many factors determine the health literacy level of health education materials or interventions: readability of the text, the patient's current state of health, language barriers between the clinician and patient, cultural appropriateness of the materials, format and style, sentence structure, use of illustrations, and numerous other factors.[14][15]

A study of 69,000 patients conducted in 1995 by two US hospitals found that between 26% and 60% of patients could not understand medication directions, a standard informed consent form, or materials about scheduling an appointment.[16] The 2003 National Assessment of Adult Literacy (NAAL) conducted by the US Department of Education found that 36% of participants scored as either "basic" or "below basic" in terms of their health literacy and concluded that approximately 80 million Americans have limited health literacy.[5]

Results of a systematic review of the literature found that when limited English proficient (LEP) patients receive care from physicians who are fluent in the patients' preferred language, referred to as having language concordance, generally improves outcomes. These outcomes are consistent across patient-reported measures, such as patient satisfaction, and also more such as blood pressure for patients with diabetes.[17]

Plain language edit

Plain language refers to the use of writing strategies that help readers find, understand, and apply information to fulfill their needs.[18] It has a vital role to play in improving health literacy. In conjunction with readers education, provider cultural training, and system design, plain language helps people make more informed health choices.[19]

Plain language is not, however, a one-size-fits-all approach. Some strategies can be used to improve communication among medical professionals, while others will improve communication with patients and caregivers. It is in this area of provider-patient communication that health literacy efforts have been strongest. Patients and consumers in general need to understand concepts that professionals often refer to in technical terms. Health professionals must know their audience in order to better serve their patients and general readers or listeners.[citation needed]

Plain language is defined by the International Plain Language Federation as writing whose "wording, structure, and design are so clear that the intended readers can easily find what they need, understand what they find, and use that information."[20]

Some key elements of plain language include:[21]

  • Organizing information so most important points come first
  • Breaking complex information into understandable chunks
  • Using simple language or language familiar to the reader
  • Defining technical terms and acronyms
  • Using active voice in subject-verb-object (SVO) sentences when subject/agent/topic coincide
  • Varying sentence length and structure to avoid monotony
  • Using lists and tables to make complex material easier to understand

The National Institute of Health (NIH) recommends that patient education materials be written at a 6th–7th grade reading level; further recommendations provided by the NIH Office of Communications and Public Liaison are published in their "Clear Communication" Initiative.[22] The UK's National Institute for Health and Care Research (NIHR) recommends involving patients and non-academic members of the public in writing plain language summaries of research articles. This can ensure that the language used will be appropriate for the intended audience.[23][24]

Assessment edit

There are several tests, which have verified reliability in the academic literature that can be administered in order to test one's health literacy. Some of these tests include the Medical Term Recognition Test (METER), which was developed in the United States (2 minute administration time) for the clinical setting.[25] The METER includes many words from the Rapid Estimate of Adult Literacy in Medicine (REALM) test.[25] The Short Assessment of Health Literacy in Spanish and English populations (SAHL-S&E) uses word recognition and multiple choice questions to test a person's comprehension.[25] The CHC-Test measures Critical Health Competencies and consists of 72 items designed to test a person's understanding of medical concepts, literature searching, basic statistics, and design of experiments and samples.[25]

Standardized measures of health literacy are the Newest Vital Sign (NVS), which asks people about a nutrition label,[26] and the Test of Functional Health Literacy (TOFHLA), which asks test-takers to fill in 36 blanks in patient instructions for X-rays and a Medicaid application, from multiple choices, and 4 numbers in medicine dosage forms.[27][28][29]

Patient safety and outcomes edit

Low health literacy negatively affects the treatment outcome and safety of care delivery.[30] The lack of health literacy affects all segments of the population. However, it is disproportionate in certain demographic groups, such as the elderly, ethnic minorities, recent immigrants, individuals facing homelessness,[31] and persons with low general literacy.[32] These populations have a higher risk of hospitalization, longer hospital stays, are less likely to comply with treatment, are more likely to make errors with medication,[33] and are more ill when they initially seek medical care.[34][35]

The mismatch between a clinician's communication of content and a patient's ability to understand that content can lead to medication errors and adverse medical outcomes. Health literacy skills are not only a problem in the general population. Health care professionals (doctors, nurses, public health workers) can also have poor health literacy skills, such as a reduced ability to clearly explain health issues to patients and the public.[36][37] In addition to tailoring the content of what health professionals communicate to their patients, a well arranged layout, pertinent illustrations, and intuitive format of written materials can improve the usability of health care literature. This in turn can help in effective communication between healthcare providers and their patients.[38]

Outcomes of low levels of health literacy also include relative expenditures on health services. Because individuals with low health literacy are more likely to have adverse health statuses, their use of health services is also increased.[39] This trend is compounded by other risk factors of low health literacy, including poverty.[40] Homelessness and housing insecurity can hinder good health and recovery in attempts to better health circumstances, causing the exacerbation of poor health conditions.[41] In these cases, a variety of health services may be used repeatedly as health issues are prolonged.[42] Thus overall expenditures on health services is greater among populations with low health literacy and poor health.[43] These costs may be left to individuals and families to pay which may further burden health conditions, or the costs may be left to a variety of institutions which in turn has broader implications for government funding and health care systems.

Low levels of health literacy is responsible for 3–5% of healthcare cost—approximately $143 to 7,798 per individual within the healthcare system.[44]

Risk identification edit

Identifying a patient as having low health literacy is essential for a healthcare professional to conform their health intervention in a way that the patient will understand. When patients with low health literacy receive care that is tailored to their more limited medical knowledge base, results have shown that health behaviors drastically improve. This has been seen with: correct medication use and dosage, utilizing health screenings, as well as increased exercise and smoking cessation. Effective visual aids have shown to help supplement the information communicated by the doctor in the office. In particular, easily readable brochures and videos have shown to be very effective.[45] Healthcare professionals can use many methods to attain patients' health literacy. A multitude of tests used during research studies and three minute assessments commonly used in doctors offices are examples of the variety of tests healthcare professionals can use to better understand their patients' health literacy.[35][46][47]

Asking simple single-item questions, such as "How confident are you in filling out medical forms by yourself?", is a very effective and direct way to understand from a patient's point of view how they feel about interacting with their healthcare provider and understanding their health condition.[48]

Homelessness edit

Individuals facing homelessness constitute a population that holds intersectional identities, is highly mobile, and is often out of the public eye.[49] Thus the difficulty of conducting research on this group has resulted in little information regarding homelessness as a condition that has increased risk of low health literacy levels among individuals.[41] Nonetheless, studies that do exist indicate that homeless individuals experience increased prevalence of low health literacy and poor health—both physical and mental—due to vulnerabilities brought on by the insecurity of basic needs among homeless individuals.[50][41] The combination of poor health and homelessness has been found to increase the risk for further decline in health status and increased housing insecurity, all of which is highly affected by low levels of health literacy.[42]

Intervention edit

In order to be understood by patients with insufficient health literacy, health professionals must intervene to provide clear and concise information that can be more easily understood. Avoidance of medical jargon, illustrations of important concepts, and confirming information by a "teach back" method have shown to be effective tools to communicating essential health topics with health illiterate patients.[46] A program called "Ask Me 3"[47] is designed to bring public and physician attention to this issue, by letting patients know that they should ask three questions each time they talk to a doctor, nurse, or pharmacist:

  • What is my main problem?
  • What do I need to do?
  • Why is it important for me to do this?

There have also been large-scale efforts to improve health literacy. For example, a public information program by the US Department of Health and Human Services encourages patients to improve healthcare quality and avoid errors by asking questions about health conditions and treatment.[48] Additionally, the IROHLA (Intervention Research on Health Literacy of the Ageing population) project, funded by the European Union (EU), seeks to develop evidence-based guidelines for policy and practice to improve health literacy of the ageing population in EU member states.[51] The project has developed a framework and identified and validated interventions which together constitute a comprehensive approach of addressing health literacy needs of the elderly. The UK's National Institute for Health and Care Research (NIHR) has published review of research on health literacy, focusing on how to help people understand health information, and which groups of the population may need extra support.[52] It covers research on using plain language, finding the focus, online information, and using alternative formats (e.g. visuals).

Impact on specific conditions edit

Diabetes edit

Low health literacy is associated with poorer knowledge of diabetes and leads to a lower quality self-management of the condition.[53]

eHealth literacy edit

eHealth literacy describes an individual's ability to search for, access, comprehend, and appraise desired health information from electronic sources and to then use such information to attempt to address a particular health problem.[54] It has become an important topic of research due to the increasing use of the internet for health information seeking and health information distribution. Stellefson (2011) states, "8 out of 10 Internet users report that they have at least once looked online for health information, making it the third most popular Web activity next to checking email and using search engines in terms of activities that almost everybody has done."[55] Though in recent years, individuals may have gained access to a multitude of health information via the Internet, access alone does not ensure that proper search skills and techniques are being used to find the most relevant online and electronic resources. As the line between a reputable medical source and an amateur opinion can often be blurred, the ability to differentiate between the two is important.[56]

Health literacy requires a combination of several different literacy skills in order to facilitate eHealth promotion and care. Six core skills are delineated by an eHealth literacy model referred to as the Lily model. The Lily Model's six literacies are organized into two central types: analytic and context-specific. Analytic type literacies are those skills that can be applied to a broad range of sources, regardless of topic or content (i.e., skills that can also be applied to shopping or researching a term paper in addition to health) whereas context-specific skills are those that are contextualized within a specific problem domain (can solely be applied to health). The six literacies are listed below, the first three of the analytic type and the latter three of the context-specific:

  • Traditional literacy
  • Media literacy
  • Information literacy
  • Computer literacy
  • Scientific literacy
  • Health literacy

According to Norman (2006), both analytical and context-specific literacy skills are "required to fully engage with electronic health resources." As the World Wide Web and technological innovations are more and more becoming a part of the healthcare environment, it is important for information technology to be properly utilized to promote health and deliver health care effectively.The utilization of digital health information resources and the integration of digital interactions with healthcare providers offer significant advantages, with the potential to enhance healthcare system efficiency, quality, and accessibility, all while empowering patients.[57]

It has also been suggested that the move towards patient-centered care and the greater use of technology for self-care and self-management requires higher health literacy on the part of the patient.[58] This has been noted in several research studies, for example among adolescent patients with obesity.[59]

Improvement edit

Incorporate information through the university level edit

The United States Department of Health and Human Services created a National Action Plan to Improve Health Literacy.[60] One of the goals of the National Action Plan is to incorporate health and science information in childcare and education through the university level. The target is to educate people at an early stage; that way individuals are raised with health literacy and will have a better quality of life. The earlier an individual is exposed to health literacy skills the better for the person and the community.[citation needed]

Programs such as Head Start[61] and Women, Infants, and Children (WIC)[62] have impacted society, especially the low-income population. Head Start provides low-income children and their families early childhood education, nutrition, and health screenings. Health literacy is integrated in the program for both children and parents through the education given to the individuals. WIC serves low-income pregnant women and new mothers by supplying them with food, health care referrals, and nutrition education. Programs like these help improve the health literacy of both the parent and the child, creating a more knowledgeable community with health education.

Although programs like Head Start and WIC have been working with the health literacy of a specific population, much more can be done with the education of children and young adults. Now, more and more adolescents are getting involved with their health care. It is crucial to educate these individuals in order for them to make informed decisions.

Many schools in the country incorporate a health class in their curriculum. These classes provided an excellent opportunity to facilitate and develop health literacy in today's children and adolescents. The skills of how to read food labels, the meaning of common medical terms, the structure of the human body, and education on the most prevalent diseases in the United States should be taught in both private and public schools. This way new generations will grow with health literacy and would hopefully make knowledgeable health decisions.

Framework and potential intervention points edit

The National Library of Medicine defines health literacy as:[63]

"The degree to which individuals have the capacity to obtain, process, and understand basic health literacy information and services needed to make appropriate health decisions."

Based on this clinical definition, health literacy gives individuals the skills that they need to both understand and effectively communicate information and concerns. Bridging that gap between literacy skills and the ability of the individual in health contexts, the health literacy framework highlights the health outcomes and costs associated with health contexts including cognitive abilities, social skills, emotional state, and physical conditions such as visual and auditory contributions.[citation needed]

Potential intervention points are illustrated in reflection of the health literacy framework. While these potential intervention points include interactions such as those of individuals and the education systems that they are engaged with, their health systems, and societal factors as they relate to health literacy, these points are not components of a causal model. The three potential intervention points are culture and society, the health system, and the education system. Health outcomes and costs are the products of the health literacy developed during diversity of exposure to these three potential intervention points.

Referring to shared ideas, meanings, and values that influence an individual's beliefs and attitudes, cultural and societal influences are a significant intervention point for health literacy development. As interactions with healthcare systems often first occur at the family level, deeply rooted beliefs and values can shape the significance of the experience. Included components that reflect the development of health literacy both culturally and societally are native language, socioeconomic status, gender, race, and ethnicity, as well as mass media exposure. These are pathways to understanding American life paralleling conquests for a health-literate America.

The health system is an intervention point in the health literacy framework. For the purposes of this framework, health literacy refers to an individual's interaction with people performing health-related activities in settings such as hospitals, clinics, physician's offices, home health care, public health agencies, and insurers.

In the United States, the education system consists of K–12 curricula. In addition to this standard educational setting, adult education programs are also environments in which individuals can develop traditional literacy skills founded in comprehension and real-world application of knowledge via reading and writing. Tools for educational development provided by these systems impact an individual's capacity to obtain specific knowledge regarding health. Reflecting components of traditional literacy such as cultural and conceptual knowledge, oral literacy (listening and speaking), print literacy (reading and writing), and numeracy, education systems are also potential intervention points for health literacy development.

Development of a health literacy program edit

A successful health literacy program will have many goals that all work together to improve health literacy. Many people assume these goals should communicate health information to the general public; however, in order to be successful, the goals should not only communicate with people but also take into account social and environmental factors that influence lifestyle choices.[64] A good example of this is the movement to end smoking. When a health literacy program is put into place where only the negative side effects of smoking are told to the general public it is doomed to fail. However, when there is a larger program put in – one that includes strategies outlining how to quit smoking, raises tobacco prices, reduces access to tobacco by minors, and reflects the social unacceptability of smoking – it will be much more effective.[64]

The U.S. Department of Health and Human Services suggests a National Action Plan to implement a comprehensive Health Literacy Program. They include seven goals:[65]

  1. Develop and disseminate health and safety information that is accurate, accessible, and actionable
  2. Promote changes in the health care system that improve health information, communication, informed decision making, and access to health services
  3. Incorporate accurate, standards-based, and developmentally appropriate health and science information and curricula in child care and education through the university level
  4. Support and expand local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community
  5. Build partnerships, develop guidance, and change policies
  6. Increase basic research and the development, implementation, and evaluation of practices and interventions to improve health literacy
  7. Increase the dissemination and use of evidence-based health literacy practices and interventions

These goals should be taken into account when implementing a health literacy program.

There are also goals for the outcomes of a Health Literacy Program.

Health-related goals:[63]

  • Promoting and protect health and prevent disease
  • Understand, interpret, and analyze health information
  • Apply health information over a variety of life events and situations
  • Navigate the healthcare system
  • Actively participate in encounters with healthcare professionals and workers
  • Understand and give consent
  • Understand and advocate for rights

In the creation of a program aimed to improve health literacy, it is also important to ensure that all parties involved in health contexts are on the same page. To do this, programs may choose to include the training of case managers, health advocates, and even doctors and nurses.[66][67][68] Due to the common overestimations of health literacy levels of patients, the education of health literacy topics and training in the identification of low health literacy in patients may be able to create significant positive change in the understanding of health messages.[69] The health belief model has been used in the training of health professionals in order to share insight on the knowledge that it has been shown to most likely change health perceptions and behaviors of their patients.[66] The use of the health belief model can provide basis for which patient health literacy may grow. The training of health workers may be seen as a "work around intervention" but is still a viable option and opportunity for mediating the negative outcomes of low health literacy.[67] Effective health literacy programs are created with cultural competency, and individuals working within health institutions can support individuals with low health literacy by being culturally competent themselves.[70]

In working to improve the health literacy of individuals, a multitude of approaches may be taken. Systematic reviews of studied interventions reveal that one works to improve health literacy in one patient may not work for another patient.[71] In fact, some interventions were found to worse health literacy in individuals.[71] Nonetheless, studies have illuminated general approaches that help individuals understand health messages. A review of 26 studies concluded that "intensive mixed-strategy interventions focusing on self-management" and "theory basis, pilot testing, emphasis on skill building, and delivery by a health professional" do aid in increasing levels of health literacy among patients.[71] Another study revealed that programs aimed at targeting more than one behavior through increased health literacy are no less successful than programs with a single focus.[72] The importance of dignity and respect is emphasized when creating programs for increasing health literacy of vulnerable individuals.[71] In intervention programs created for homeless individuals in specific, it has been found that "successful intervention programs use aggressive outreach to bring comprehensive social and health services to sites where homeless people congregate and allow clients to set the limits and pace of engagement".[73] A social justice model is recommended for homeless individuals which is based on shared support of the community and their health literacy needs by those who provide services for this underserved group as well as the professionals who create and implement health literacy interventions.[41]

Role of libraries edit

Libraries have increasingly recognized that they can play a role in health literacy since the 2000s, influenced by the Medical Library Association. Library initiatives have included running education programs, fostering partnerships with health organizations, and using outreach efforts.[74] Pan American Health Organization contributed greatly through their libraries network.[75] Various medical library associations have made an effort to introduce health literacy programs by attempting to define the concept to include the librarian's role as including a set of abilities needed to recognize a health information need, identify likely information sources and use them to retrieve relevant information, and assess the quality of the information and its applicability to a specific health situation.[76] The Network of the National Library of Medicine (NNLM) twice yearly hosts the #citeNLM Wikipedia Edit-a-thon initiative to "improve the credibility and content of medical and health-related articles on Wikipedia by adding citations and information from National Library of Medicine (NLM) sources."[77]

Alternative approaches edit

A study published in the American Journal of Obstetrics and Gynecology in 2018 suggested an alternative method of addressing health knowledge deficits due to low health literacy. This alternative method is the use of "culturally-related/accepted" music and singing amongst low-literacy populations. In the example of this study, the music with locally written song lyrics of health messages was shown to increase maternal health knowledge, and more specifically, antenatal care.[78]

History edit

The young and multidisciplinary field of health literacy emerged from two groups of experts: physicians, health providers such as nurses[79] and health educators; and Adult Basic Education (ABE) and English as a second language (ESL) practitioners in the field of education. Physicians and nurses are a source of patient comprehension and compliance studies. Adult Basic Education / English for Speakers of Languages Other Than English (ABE/ESOL) specialists study and design interventions to help people develop reading, writing, and conversation skills and increasingly infuse curricula with health information to promote better health literacy. A range of approaches to adult education brings health literacy skills to people in traditional classroom settings, as well as where they work and live.[citation needed]

Biomedical approach edit

The biomedical approach to health literacy that became dominant in the United States during the 1980s and 1990s often depicted individuals as lacking health literacy or "suffering" from low health literacy. This approach assumed that recipients are passive in their possession and reception of health literacy and believed that models of literacy and health literacy are politically neutral and universally applicable. This approach is found lacking when placed in the context of broader ecological, critical, and cultural approaches to health. This approach has produced, and continues to reproduce, numerous correlational studies.[80]

Level of health literacy is considered adequate when the population has sufficient knowledge, skills, and confidence to guide their own health, and people are able to stay healthy, recover from illness, and/or live with disability or disease.[81]

Health literacy is important in a community because it addresses health inequalities. It is no coincidence that individuals with lower levels of health literacy live, disproportionately, in communities with lower socio-economic standing. A barrier to achieving adequate health literacy for these individuals is a lack of awareness, or understanding of, information and resources relevant to improving their health. This knowledge gap arises from both patients being unable to understand information presented to them and hospitals' inadequate efforts and materials to address these literacy gaps.[81]

A more robust view of health literacy includes the ability to understand scientific concepts, content, and health research; skills in spoken, written, and online communication; critical interpretation of mass media messages; navigating complex systems of health care and governance; knowledge and use of community capital and resources; and using cultural and indigenous knowledge in health decision making.[82][83][84] This integrative view sees health literacy as a social determinant of health that offers a powerful opportunity to reduce inequities in health.

This perspective defines health literacy as the wide range of skills, and competencies that people develop over their lifetimes to seek out, comprehend, evaluate, and use health information and concepts to make informed choices, reduce health risks, and increase quality of life.[85] While various definitions vary in wording, they all fall within this conceptual framework.

Defining health literacy in that manner builds the foundation for a multi-dimensional model of health literacy built around four central domains:[85]

  • fundamental literacy,
  • scientific literacy,
  • civic literacy, and
  • cultural literacy.

See also edit

Citations edit

  1. ^ Roundtable on Health Literacy; Board on Population Health and Public Health Practice; Institute of the Medicine (10 February 2012). Facilitating State Health Exchange Communication Through the Use of Health Literate Practices: Workshop Summary. National Academies Press. p. 1. ISBN 978-0-309-22029-3.
  2. ^ A. Pleasant; J. McKinney (2011). "Coming to consensus on health literacy measurement: An online discussion and consensus-gauging process". Nursing Outlook. 59 (2): 95–106.e1. doi:10.1016/j.outlook.2010.12.006. PMID 21402205.
  3. ^ Atkinson, Richard C.; Jackson, Gregg B. (1992-01-01). Research and Education Reform. doi:10.17226/1973. ISBN 978-0-309-04729-6.
  4. ^ İlgün, Gülnur; Turaç, İlkay Sevinç; Orak, Sevilay (2015-02-12). "Health Literacy". Procedia - Social and Behavioral Sciences. International Conference on New Horizons in Education, INTE 2014, 25–27 June 2014, Paris, France. 174: 2629–2633. doi:10.1016/j.sbspro.2015.01.944. ISSN 1877-0428.
  5. ^ a b Kutner, MA; Greenberg, E; Jin, Y; Paulson, C (2006). The Health Literacy of America's Adults: Results From the 2003 National Assessment of Adult Literacy. Washington, DC: National Center for Education Statistics.
  6. ^ "America's Health Literacy: Why We Need Accessible Health Information". health.gov. Retrieved 2015-11-20.
  7. ^ Hickey, Kathleen (February 27, 2019). "Low Health Literacy". The Nurse Practitioner. 43 (8): 49–55. doi:10.1097/01.NPR.0000541468.54290.49. PMC 6391993. PMID 30028773.
  8. ^ "Health literacy: report of the Council on Scientific Affairs. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association". JAMA. 281 (6): 552–557. 1999-02-10. doi:10.1001/jama.281.6.552. ISSN 0098-7484. PMID 10022112.
  9. ^ Yin, H. Shonna; Jay, Melanie; Maness, Leslie; Zabar, Sondra; Kalet, Adina (15 July 2015). "Health Literacy: An Educationally Sensitive Patient Outcome". Journal of General Internal Medicine. 30 (9): 1363–1368. doi:10.1007/s11606-015-3329-z. ISSN 0884-8734. PMC 4539338. PMID 26173523.
  10. ^ a b "Health Communication and Health Information Technology - Healthy People 2020".
  11. ^ "Health Communication and Health Information Technology - Healthy People 2020".
  12. ^ "Solicitation for Written Comments on an Updated Health Literacy Definition for Healthy People 2030". Federal Register. 2019-06-04. Retrieved 2020-09-22.
  13. ^ Sparano, Romina Marazzato (2020-02-26). "Health Literacy is Multidimensional". Language Compass. Retrieved April 13, 2022.
  14. ^ "Health Literacy". National Institutes of Health (NIH). 2015-05-08. Retrieved 2020-04-30.
  15. ^ "Health Literacy". Official web site of the U.S. Health Resources & Services Administration. 2017-03-31. Retrieved 2020-04-30.
  16. ^ M. V. Williams; et al. (1995). "Inadequate functional health literacy among patients at two public hospitals". JAMA. 274 (21): 677–82. doi:10.1001/jama.274.21.1677. PMID 7474271. Retrieved 2006-06-30.
  17. ^ Diamond, Lisa; Izquierdo, Karen; Canfield, Dana; Matsoukas, Konstantina; Gany, Francesca (2019). "A Systematic Review of the Impact of Patient–Physician Non-English Language Concordance on Quality of Care and Outcomes". Journal of General Internal Medicine. 34 (8): 1591–1606. doi:10.1007/s11606-019-04847-5. ISSN 0884-8734. PMC 6667611. PMID 31147980.
  18. ^ "Plain Language". National Institutes of Health (NIH). Retrieved 2020-04-30.
  19. ^ CDC (2023-09-20). "Plain Language Materials & Resources". Centers for Disease Control and Prevention. Retrieved 2023-10-23.
  20. ^ "Plain Language Definitions". International Plain Language Federation/. 28 June 2019. Retrieved 2020-02-25.
  21. ^ "Federal Plain Language Guidelines: Table of Contents". www.plainlanguage.gov. Retrieved 2016-03-30.
  22. ^ "Clear Communication". National Institutes of Health (NIH). Retrieved 2018-11-04.
  23. ^ "Plain English summaries". National Institute for Health Research. Retrieved 2022-01-05.
  24. ^ "Plain language summary". NIHR Journals Library. Retrieved 2024-04-09.
  25. ^ a b c d Altin, Sibel; Finke, Isabelle; Kautz-Freimuth, Sibylle; Stock, Stephanie (2014). "The evolution of health literacy assessment tools: a systematic review". BMC Public Health. 14 (1): 1207. doi:10.1186/1471-2458-14-1207. PMC 4289240. PMID 25418011.
  26. ^ Weiss, Barry D.; Mays, Mary Z.; Martz, William; Castro, Kelley Merriam; DeWalt, Darren A.; Pignone, Michael P.; Mockbee, Joy; Hale, Frank A. (November 2005). "Quick Assessment of Literacy in Primary Care: The Newest Vital Sign". Annals of Family Medicine. 3 (6): 514–522. doi:10.1370/afm.405. ISSN 1544-1709. PMC 1466931. PMID 16338915.
  27. ^ Gazmararian, Julie; Daker, David; Parker, Ruth; Blazer, Dan G (November 27, 2000). "A multivariate analysis of factors associated with depression: evaluating the role of health literacy as a potential contributor" (PDF). Arch Intern Med. 160 (21): 3307–3314. doi:10.1001/archinte.160.21.3307. PMID 11088094. S2CID 27673368. Retrieved April 13, 2022.
  28. ^ "Test of Functional Health Literacy in Adults". reginfo.gov. Retrieved 2021-02-18.
  29. ^ Morrison, Andrea K.; Schapira, Marilyn M.; Hoffmann, Raymond G.; Brousseau, David C. (November 2014). "Measuring Health Literacy in Caregivers of Children: A Comparison of the Newest Vital Sign and S-TOFHLA". Clinical Pediatrics. 53 (13): 1264–1270. doi:10.1177/0009922814541674. ISSN 0009-9228. PMC 4416472. PMID 25006116.
  30. ^ The Institute of Medicine: Health Literacy: A Prescription to End Confusion (2004)
  31. ^ McGonagle, Kristen. "Integrating Public Health Literacy into Homelessness Services" (PDF). Institute for Health Advancement.
  32. ^ 2003 National Assessment of Adult Literacy The Health Literacy of America's Adults Retrieved 9 September 2006
  33. ^ Terry C. Davis; Michael S. Wolf, MPH; Pat F. Bass III, MD; Jason A. Thompson, BA; Hugh H. Tilson, MD, DrPH; Marolee Neuberger, MS; and Ruth M. Parker, MD (2006). "Literacy and Misunderstanding Prescription Drug Labels". Annals of Internal Medicine. 145 (12): 887–94. doi:10.7326/0003-4819-145-12-200612190-00144. PMID 17135578.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  34. ^ U.S. Department of Health and Human Services: Quick Guide to Health Literacy Archived 2017-12-22 at the Wayback Machine
  35. ^ a b M. V. Williams; et al. (1995). "The test of functional health literacy in adults: a new instrument for measuring patients' literacy skills". J Gen Intern Med. 10 (1): 537–41. doi:10.1007/BF02599568. PMID 8576769. S2CID 29005114.
  36. ^ American Society of Anesthesiology abstracts (October 25, 2005), Aaron M. Fields, M.D., Kirk H. Shelley, M.D., Ph.D., Craig Freiberg, M.D. (Department of Anesthesiology, Yale University School of Medicine)Patients and Jargon: Are We Speaking the Same Language?, retrieved 2008-10-18
  37. ^ The Center for Advancement of Health (March 2003): Talking the Talk: Improving Patient-Provider Communication Archived 2008-10-06 at the Wayback Machine, retrieved 2008-10-18
  38. ^ Gill, P.S.; Gill, T.S.; Kamath, A.; whisnant, B. (2012). "Readability Assessment of Concussion and Traumatic Brain Injury Publications by Centers for Disease Control and Prevention". International Journal of General Medicine. 5: 923–933. doi:10.2147/IJGM.S37110. PMC 3508564. PMID 23204856.
  39. ^ McGonagle, Kristen. "Integrating Health Literacy into Homelessness Services" (PDF). Institute for Health Advancement. Retrieved 14 December 2018.
  40. ^ National Center for Education Statistics (September 2006). "The Health Literacy of America's Adults" (PDF). U.S. Department of Education – via NCES.
  41. ^ a b c d Fetter, Marilyn S. (November 2009). "Promoting Health Literacy with Vulnerable Behavioral Health Clients". Issues in Mental Health Nursing. 30 (12): 698–702. doi:10.3109/01612840902887725. PMID 19916815. S2CID 45393302.
  42. ^ a b Institute of Medicine (US) Committee on Health Care for Homeless People (1988). "Health Problems of Homeless People". Homelessness, Health, and Human Needs – via NCBI.
  43. ^ Kushel, Margot B. (May 2002). "Emergency Department Use Among the Homeless and Marginally Housed: Results From a Community-Based Study". American Journal of Public Health. 92 (5): 778–784. doi:10.2105/AJPH.92.5.778. PMC 1447161. PMID 11988447.
  44. ^ Eichler, K. (July 2009). "The costs of limited health literacy: a systematic review". International Journal of Public Health. 54 (5): 313–324. doi:10.1007/s00038-009-0058-2. PMC 3785182. PMID 19644651.
  45. ^ Agency for Healthcare Research and Quality: Evidence Report/Technology Assessment: Number 87 Literacy and Health Outcomes
  46. ^ a b "A Conversation on Cultural Competence With Cindy Brach, Senior Health Policy Researcher, AHRQ". Agency for Healthcare Research and Quality. 2013-04-17. Retrieved 2013-08-22.
  47. ^ a b "National Patient Safety Foundation". Archived from the original on 2008-03-08.
  48. ^ a b Agency for Healthcare Research and Quality: Questions Are the Answer, retrieved 2008-10-18
  49. ^ Institute of Medicine (US) Committee on Health Care for Homeless People (1988). "Who Are the Homeless?". Homelessness, Health, and Human Needs – via NCBI.
  50. ^ McGonagle, Kristen. "Integrating Health Literacy into Homelessness Services" (PDF). Institute for Health Advancement. Retrieved 14 December 2018.
  51. ^ "Home". Archived from the original on 2015-06-13. Retrieved 2015-06-11.
  52. ^ "Health information: are you getting your message across?". NIHR Evidence. 13 June 2022. doi:10.3310/nihrevidence_51109. S2CID 249946766.
  53. ^ Watts, Sharon A.; Stevenson, Carl; Adams, Margaret (January 2017). "Improving health literacy in patients with diabetes". Nursing. 47 (1): 24–31. doi:10.1097/01.NURSE.0000510739.60928.a9. ISSN 0360-4039.
  54. ^ Norman, Cameron D; Skinner, Harvey A (1 January 2006). "eHealth Literacy: Essential Skills for Consumer Health in a Networked World". Journal of Medical Internet Research. 8 (2): e9. doi:10.2196/jmir.8.2.e9. PMC 1550701. PMID 16867972.
  55. ^ Stellefson, Michael; Hanik, Bruce; Chaney, Beth; Chaney, Don; Tennant, Bethany; Chavarria, Enmanuel Antonio (1 January 2011). "eHealth Literacy Among College Students: A Systematic Review With Implications for eHealth Education". Journal of Medical Internet Research. 13 (4): e102. doi:10.2196/jmir.1703. PMC 3278088. PMID 22155629.
  56. ^ Norman, Cameron D.; Skinner, Harvey A. (2006-06-16). "eHealth Literacy: Essential Skills for Consumer Health in a Networked World". Journal of Medical Internet Research. 8 (2): e9. doi:10.2196/jmir.8.2.e9. ISSN 1438-8871. PMC 1550701. PMID 16867972.
  57. ^ López, Maria del Pilar Arias; Ong, Bradley A.; Frigola, Xavier Borrat; Fernández, Ariel L.; Hicklent, Rachel S.; Obeles, Arianne J. T.; Rocimo, Aubrey M.; Celi, Leo A. (2023-10-12). "Digital literacy as a new determinant of health: A scoping review". PLOS Digital Health. 2 (10): e0000279. doi:10.1371/journal.pdig.0000279. ISSN 2767-3170. PMC 10569540. PMID 37824584.
  58. ^ Kim, Henna; Xie, Bo (January 2017). "Health literacy in the eHealth era: A systematic review of the literature". Patient Education and Counseling. 100 (6): 1073–1082. doi:10.1016/j.pec.2017.01.015. PMID 28174067.
  59. ^ Holmberg C., Berg C., Dahlgren J., Lissner L., Chaplin J. E. (2018). "Health literacy in a complex digital media landscape: Pediatric obesity patients' experiences with online weight, food, and health information". Health Informatics Journal. 25 (4): 1343–1357. doi:10.1177/1460458218759699. PMID 29499615. S2CID 3687773.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  60. ^ "National Action Plan to Improve Health Literacy" (PDF).
  61. ^ "Home - Office of Head Start - Administration for Children and Families".
  62. ^ "Women, Infants, and Children (WIC) - Food and Nutrition Service".
  63. ^ a b Nielsen-Bohlmn, Lynn (2004). "Health Literacy: A Prescription to End Confustion". Institute of Medicine.
  64. ^ a b Nutbeam, D. (2000-09-01). "Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century". Health Promotion International. 15 (3): 259–267. doi:10.1093/heapro/15.3.259. ISSN 0957-4824.
  65. ^ U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion (2010). "National Action Plan to Improve Health Literacy" (PDF).
  66. ^ a b McGonagle, Kristen. "Integrating Health Literacy into Homelessness Services" (PDF). Institute for Health Advancement. Retrieved 14 December 2018.
  67. ^ a b Berkman, Nancy D (March 2011). "Health Literacy Interventions and Outcomes: An Updated Systematic Review". Evidence Report/Technology Assessment. 199 (199): 1–941. PMC 4781058. PMID 23126607.
  68. ^ Schaefer, Cynthia T. (September 2008). "Integrated Review of Health Literacy Interventions". Orthopaedic Nursing. 27 (5): 302–317. doi:10.1097/01.NOR.0000337283.55670.75. PMID 18832992. S2CID 205412733 – via Ovid.
  69. ^ Dickens, Carolyn (October 2013). "Nurse Overestimation of Patients' Health Literacy". Journal of Health Communication: International Perspectives. 18 (Suppl 1): 62–69. doi:10.1080/10810730.2013.825670. PMC 3814908. PMID 24093346.
  70. ^ Andrulis, Dennis P. (September 2007). "Integrating Literacy, Culture, and Language to Improve Health Care Quality for Diverse Populations". American Journal of Health Behavior. 31 (Suppl 1): 122–133. doi:10.5993/AJHB.31.s1.16. PMC 5091931. PMID 17931131.
  71. ^ a b c d Sheridan, Stacey L. (September 2011). "Interventions for Individuals with Low Health Literacy: A Systematic Review". Journal of Health Communication: International Perspectives. 16: 30–54. doi:10.1080/10810730.2011.604391. PMID 21951242. S2CID 41491210.
  72. ^ Taggart, Jane (2012). "A systematic review of interventions in primary care to improve health literacy for chronic disease behavioral risk factors". BMC Family Practice. 13: 49. doi:10.1186/1471-2296-13-49. PMC 3444864. PMID 22656188.
  73. ^ Sharman, Cheryl (May 2006). "New York prepares to tackle homeless health". The Lancet. 365 (9524): 1719–1720. doi:10.1016/S0140-6736(06)68752-7. PMID 16755690. S2CID 31446441 – via Science Direct.
  74. ^ Barr-Walker, Jill (13 June 2016). "Health literacy and libraries: a literature review". Reference Services Review. 44 (2): 191–205. doi:10.1108/RSR-02-2016-0005.
  75. ^ Roundtable On Health, Literacy; Board on Population Health Public Health Practice; Institute Of, Medicine (2013-07-10). Health Literacy. doi:10.17226/18325. ISBN 978-0-309-28484-4. PMID 24872976.
  76. ^ "Health literacy and libraries: a literature review". escholarship.org. Retrieved 2021-04-10.
  77. ^ "Wikipedia Edit-a-thon | NNLM". nnlm.gov. Retrieved 2022-10-03.
  78. ^ Sharma, Binod Bindu; Loxton, Deborah Joanne; Murray, Henry; Angeli, Giavanna Louise; Oldmeadow, Christopher; Chiu, Simon; Smith, Roger (December 2018). "A first step to improving maternal mortality in a low-literacy setting; the successful use of singing to improve knowledge regarding antenatal care". American Journal of Obstetrics and Gynecology. 219 (6): 615.e1–615.e11. doi:10.1016/j.ajog.2018.09.038. ISSN 0002-9378. PMID 30291841. S2CID 52929097.
  79. ^ Dickens C., Piano MR. (2013). "Health literacy and nursing: an update". The American Journal of Nursing. 113 (6): 52–7. doi:10.1097/01.NAJ.0000431271.83277.2f. PMID 23702767. S2CID 573754.
  80. ^ Pleasant & Kuruvilla, 2008
  81. ^ a b Anne McMurray (2007). Community Health and Wellness: A Sociological Approach (3rd ed.). Brisbane: Elsevier. ISBN 978-0-7295-3788-9.
  82. ^ Nutbeam, D. (2000-09-01). "Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century". Health Promotion International. 15 (3): 259–267. doi:10.1093/heapro/15.3.259. ISSN 1460-2245.
  83. ^ Ratzan, S. C. (June 2001). "Health literacy: communication for the public good". Health Promotion International. 16 (2): 207–214. doi:10.1093/heapro/16.2.207. ISSN 0957-4824. PMID 11356759.
  84. ^ Li, Ang (2021). "Individual and organizational health literacies: moderating psychological distress for individuals with chronic conditions". Journal of Public Health. 44 (3): 651–662. doi:10.1093/pubmed/fdab133. PMID 33955477.
  85. ^ a b Zarcadoolas, Christina; Pleasant, Andrew; Greer, David S. (June 2005). "Understanding health literacy: an expanded model". Health Promotion International. 20 (2): 195–203. doi:10.1093/heapro/dah609. ISSN 0957-4824. PMID 15788526.

Sources edit

  • Nutbeam D (2000). "Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century". Health Promotion International. 15 (3): 259–267. doi:10.1093/heapro/15.3.259.
  • Pleasant, A.; Kuruvilla, S. (2008), "A tale of two health literacies? Public health and clinical approaches to health literacy", Health Promot Int, 23 (2), Health Promotion International: 152–9, doi:10.1093/heapro/dan001, PMID 18223203, archived from the original on 2008-10-07, retrieved Feb 28, 2008
  • Ratzan S. C. (2001). "Health literacy: Communication for the public good". Health Promotion International. 16 (2): 207–214. doi:10.1093/heapro/16.2.207. PMID 11356759.
  • Rootman, I., & Wharf-Higgins, J. (2007), Literacy and Health: Implications for Active Living (PDF), WellSpring, p. 4{{citation}}: CS1 maint: multiple names: authors list (link)
  • "Health Literacy Improvement". health.gov. July 24, 2008.
  • Rudd, R., Moeykens, B. Colton, TC. (1999). Health and literacy: A review of medical and public health literature. In J. Comings, B. Garners, & C. Smith, eds. Annual Review of Adult Learning and Literacy, Volume I. New York, NY: Jossey-Bass.
  • Zarcadoolas C., Pleasant A., Greer D. (2005). "Understanding health literacy: An expanded model". Health Promotion International. 20 (2): 195–203. doi:10.1093/heapro/dah609. PMID 15788526.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  • Zarcadoolas, C., Pleasant, A., & Greer, D. (2006). Advancing health literacy: A framework for understanding and action. Jossey-Bass: San Francisco, CA.

External links edit

  • Teaching Patients with Low Literacy Skills by Doak, Doak, and Root free download of entire book
  • Health literacy course and materials based at Harvard University led by Rima Rudd
  • Health Literacy Discussion List
  • Health and Literacy Special Collection Archived 2017-09-04 at the Wayback Machine
  • "A Selection of Health Literacy Articles and Research" published by Partnership for Clear Health Communication
  • Health Literacy Consulting. Includes the full-text of many health literacy articles as well as links to numerous resources.
  • Using social media for improving health literacy. In: THE SOLID FACTS - Health Literacy: Enabling healthier decisions in the 21st century. Copenhagen, Denmark: World Health Organization Regional Office for Europe, due Oct 2012 (in press)
  • Health information: are you getting your message across?
  • Health Literacy Improvement Tools from Agency for healthcare Research and Quality
  • Health.Gov's Health Literacy Resources
  • Centers for Disease Control and Prevention (CDC)'s Health Literacy Page

By using this platform, you agree to the Terms of Use ©2020 Knowpia