Focusing on those most in need…
 

 

Top 10 (or 12) Tips for
Health Literacy Programs

Andrew Pleasant, Ph.D.
– Rutgers University
August 2007

1. Involve participants early
and often.

2. Language – a primary
tool – use with caution and
don’t reinvent the wheel.

3. Provide a path to action.

4. Know what you mean by
“health”.

5. Do no harm!

6. Respect Culture.

7. Do not ignore or fear
science.

8. Health literacy is not
a ‘deficit’ issue; it is a
communication issue.

9. Health literacy is
generative.

9.1. Know your audience.

9.2. Know your stuff.

10. Evaluation begins at the
beginning.

 

MomsFirst is a city of Cleveland program that offers case management and home visiting services to pregnant women and new moms until their babies reach age one.
 
The Sisters of Charity Foundation of Cleveland has helped support the program. 

Women who participate get information and education on prenatal care, breast feeding and other topics. MomsFirst want to reduce the number of babies who die before they are a year old. The program helps the moms get a medical home, health insurance and even help in getting to doctors' appointments.
 
Moms who participate in the program also get a copy of  Baby Basics, a book that helps moms-to-be understand what's happening to their bodies, how to take care of themselves during the pregnancy, including exercising and eating right.
 
The book, which is a good example of improving health literacy for pregnant moms, also gives information for after the baby is born.
 
Health Literacy
Nearly half of all American adults - 90 million people - have difficulty understanding and using health information, and there is a higher rate of hospitalization and use of emergency services among patients with limited health literacy, according to a report by the Institute of Medicine titled Health Literacy: A Prescription to End Confusion. 
 
Limited health literacy may lead to billions of dollars in avoidable heatlh care costs. 

Health literacy encompasses an individual’s ability to find, understand, evaluate, and use health information, to engage the services needed to make appropriate health decisions and navigate the health care system. More than just reading, for example, health literacy addresses the capacity to comprehend prescriptions, appointment slips, hospital admission policies, health insurance and financial eligibility information. Health literacy also focuses on how those abilities influence individual health care decision-making.

Community organizations and literacy coalitions in greater Cleveland are addressing the area’s low rates of basic literacy:

  • 2004 report prepared for The Greater Cleveland Literacy Collaborative revealed that: “seven out of 10 in Cleveland lack the minimum literacy skills needed to effectively function in today’s society (five of 10 in Cuyahoga County)”.
  • “In 2000, about nine percent of youth ages 16-19 in Cuyahoga County, and 17% of youth ages 16-19 in Cleveland, were neither employed nor in school,” according to a 2003 study by the Center for Community Solutions and United Way of Greater Cleveland.

For too many area residents, reading a bus schedule, understanding work benefits, or calculating the cost of menu items are anything but routine tasks. Low health literacy has a myriad of consequences to both patients and the health care system, including poor health outcomes, medication errors, preventable emergency room visits and hospitalizations.

In fact, almost half (47%) of adults in the U.S. read below an 8th grade level. When statistical adjustments are made for education and other socio-demographic co-variables, a person’s literacy level is the strongest factor impacting health knowledge and disease management skills. In fact, health literacy is a better predictor of one’s health status than age, income, employment, ethnicity, or education level.

The Health Literacy Initiative

The Foundation has developed a Health Literacy Initiative that envisions an integrated approach to literacy and health in Cuyahoga County in which multiple stakeholders – patients, health care providers and insurers, schools, libraries, media, the business community, government agencies and other community organizations – play a role.

The Foundation seeks to build support for a community-wide effort to advance health literacy and link with various efforts sprouting throughout the Midwest and nationally. Our objectives are:

  • To increase the health literacy and capacity of individuals and providers to reduce health disparities, and
  • To enhance the capacity of organizations to implement or adapt effective programs within the field of health literacy.

The Health Literacy Initiative began in June 2007 with the release of an RFP and an Educational Forum & Pre-Application Workshop showcasing some of America’s “best practice” programs. The pioneering program was shaped with input from regional and national experts, including Rutgers University Associate Professor Andrew Pleasant, Ph.D.

In recognition of the importance of health literacy to the development of healthy communities, The Cleveland Foundation has joined with the Sisters of Charity Foundation to act as a co-funder of the Health Literacy initiative.

A variety of strategies will be tested with the goal of:

  • encouraging better health decisions and healthy behaviors,
  • promoting health literacy education and training for health professionals, and
  • enhancing communication between consumers and care providers.
For More Information
Find out about research findings and research in progress on health literacy at the the Agency for Healthcare Research and Quality.
 
The Health Literacy Wiki is sponsored by the Adult Literacy Education Wiki and is moderated by Julie McKinney, the Health Literacy topic area leader. Ms. McKinney may be reached at jmckinney@worlded.org.
 

 

Health Literacy Grants (Awarded November 2007)

HEALTH DISPARITIES: HEALTH LITERACY INITIATIVE $375,959.00
Demonstration Grants $235,200.00
Cleveland Department of Public Health – MomsFirst Cleveland Baby Basics Assessment & Feasibility Project $47,775.00
Cleveland Department of Public Health – Steps to a Healthier Cleveland Cleveland Health Promotion Through Health Literacy Funded by The Cleveland Foundation $50,000.00
Cuyahoga Community College Foundation  Cleveland Community Health Literacy Alliance Funded by The Cleveland Foundation $30,000.00
The Free Medical Clinic of Greater Cleveland  Cleveland Patient Advocate Program Funded by The Cleveland Foundation $42,000.00
Project:LEARN  Cleveland Reading Health $40,425.00
Rainbow Pediatric Practice Clinic at Rainbow Babies & Children’s Hospital of University Hospitals  Cleveland Parental Peer-Coaching for Self-Efficacy Support Group Funded by The Cleveland Foundation $25,000.00
Planning Grants $140,759.00
Diabetes Association of Greater Cleveland Cleveland Diabetes Health Literacy Coalition $10,000.00
Environmental Health Watch Cleveland Practicalities of Family Management of Childhood Asthma $22,870.00
Greater Cleveland Neighborhood Centers Association Cleveland Improving Health Literacy Through Cleveland’s Neighborhood Centers $25,000.00
Kidz Health 2020, Cleveland  Cleveland Mt. Pleasant Asthma Consortium $6,000.00
PM Foundation, Inc. dba Urban Community School Cleveland UCS Health Emissaries – Children Leading the Way $16,913.00
Senior Outreach Services, Inc. Cleveland SOS Elder Health Literacy Collaborative $18,976.00
St. Vincent Charity Hospital Cleveland Health Literacy Train-the-Trainer Workshop $25,000.00
West Side Ecumenical Ministry Cleveland Health Literacy Initiative $16,000.00