Why Health Literacy Matters: A Podcast with Many Voices (HLOL #23)

October is Health Literacy Month. This is the 11th year that advocates everywhere are raising awareness about health literacy and ways to improve understanding. This year, we decided to focus on stories – stories about why health literacy matters to healthcare providers, policy makers, researchers, educators, students, patients, families, and all others who care about health.

In this special edition podcast, you will hear five people share their stories about why health literacy matters. I recorded these in May 2009 when I was giving a workshop at the Institute for Healthcare Advancement’s (or IHA) 8th Annual Health Literacy Conference.

This is the first of two Health Literacy Month podcasts. In this one, you will hear from:

  • Michael Villaire, Institute for Healthcare Advancement (IHA)
  • Cindy Brach, AHRQ (Agency for Healthcare Research and Quality)
  • Michael Wolf PhD, Northwestern University
  • Beccah Rothschild, Health Research to Action at UC Berkeley
  • Jutta Ulrich, Health Guide America

More ways to learn:

  • Health Literacy Month website. Thanks to a team of remarkable volunteers and amazing authors, each day in October there are one or more health literacy stories posted at www.healthliteracymonth.org.
  • Health Literacy Out Loud. Hear interviews with those in-the-know about health literacy by going to www.healthliteracymonth.org
  • Health Literacy Consulting. Find out more about Helen Osborne’s work and background by going to www.healthliteracy.com
  • Institute for Healthcare Advancement. Find out about this organization and its upcoming health literacy conference by going to www.iha4health.org

Writing Health Information That Caregivers Can Understand and Providers Will Accept (HLOL #22)

Carol Levine

Carol Levine works at the United Hospital Fund in New York City. There, she directs the Families and Health Care Project which focuses on developing partnerships between health care professionals and family caregivers, especially during transitions in health care settings. You can see this project online at www.nextstepincare.org.

Levine has won numerous awards for her work on health and social policy issues. In 1993, she was awarded a MacArthur Foundation Fellowship for her work in AIDS policy and ethics. In 2007, she was named a WebMD Health Hero.

In this podcast she talks with Helen Osborne about “Writing health information that caregivers can understand and providers will accept.” Topics include:

  • The growing interest in transitions of care
  • Writing information in ways caregivers can understand
  • Getting buy-in from a cross-section of providers
  • Successes, lessons learned, and recommendations

Age-Related Vision Loss (HLOL #21)

Cynthia StuenCynthia Stuen, PhD/DSW is Senior Vice President for Policy and Evaluation at Lighthouse International, headquartered in New York City. She advocates for policy at the national, state and local level while maintaining involvement in international efforts to preserve sight and prevent excess disability resulting from vision impairment.

Dr. Stuen’s entire career has been in the field of aging and she currently is Chair of the American Society on Aging. She is the author of numerous publications on topics that include age-related sensory loss, access to environments for older adults with impaired vision, and contributions older adults and their family and friends can make to program planning and service delivery.

In this podcast Dr. Stuen talks with Helen Osborne about age-related vision loss. Topics include:

  • The continuum of vision as people age
  • How to know when someone has vision loss (but doesn’t say so)
  • Ways to communicate effectively in print and on the web

More Ways to Learn:

  • Lighthouse International is a leading non-profit organization dedicated to fighting vision loss through prevention, treatment and empowerment. Available at http://lighthouse.org
  • Making Text Legible: Designing for People with Partial Sight. Includes guidelines and examples of effective legibility choices for anyone. Available by the Lighthouse International at www.lighthouse.org/accessibility/legible
  • Effective Color Contrast: Designing for People with Partial Sight and Color Deficiencies. Guidelines and specific examples of effective color contrast. Available from Lighthouse International at www.lighthouse.org/accessibility/effective-color-contrast
  • Making Your Web Site Senior Friendly is an informative checklist Web designers can use while creating online material for older adults. Published by the National Institute on Aging and the National Library of Medicine, it is available at www.nlm.nih.gov/pubs/checklist.pdf
  • Making Web Sites More Accessible for Users Who Are Older and/or Have a Disability. Sponsored by the U.S. Administration on aging, this website includes background information on visual disabilities and offers strategies for improving accessibility. Available at www.adrc-tae.org/tiki-index.php?page=TAEIssueBriefs
  • LowBrowseTM is a free add-on extension to the Mozilla Firefox web browser to help people with low vision access the web.  www.lowbrowse.org or email lowbrowse@lighthouse.org.
  • Osborne, H. On Call Magazine, 2000. “In Other Words…When Vision Is an Issue…Communicating With Patients Who Are Visually Impaired” Offers practical tips for designing materials for people with visual challenges. Available at www.healthliteracy.com/article.asp?PageID=3774
  • Worldwide Web Consortium. Available at http://www.w3.org

Selina Maphorogo Talks About Community Health Education in South Africa (HLOL #20)

Selina Maphorogo has been a community health worker in Northern South Africa for many years. She recently retired from the Elim Care Group Project where she worked with health professionals, volunteers, and community leaders to help eradicate the blinding eye disease trachoma.

Selina is recognized for her outstanding work. In 1996, she received the Community Builder of the Year award. In 1997, she was a finalist for the Nelson Mandela Award for Health and Human Rights.

I first learned about Selina when reading the book, The Community Is My University: A Voice from the Grass Roots on Rural Health and Development. On a recent trip to South Africa, I had the privilege of speaking with her and recording this podcast.

In this podcast she talks with Helen Osborne about:

  • What trachoma is and how it is passed from one person to another.
  • Strategies to educate a community about disease prevention.
  • Using song, dance, role-play and other ways to teach about health.

 

More Ways to Learn:

Read a transcript of this podcast.

Communicating Clearly on the Web (HLOL #19)

Janice (Ginny) Redish, Ph.D. is president of Redish & Associates, Inc. based in Bethesda, Maryland. In this work, Ginny helps government agencies and private companies create successful web sites through training and consultation on plain language and usability. Among her many accomplishments, Ginny helped develop the federal website www.usability.gov – a guide for developing usable and useful websites.

Ginny has won many awards for her work and is the author of numerous publications on usability, task analysis, accessibility, document design, plain language, and writing for the web. Her latest is the widely-acclaimed book, Letting Go of the Words – Writing Web Content that Works.

In this podcast she talks with Helen Osborne about ways to communicate clearly on the Web. Topics include:

  • Writing for print or the web. What’s the difference? How are they the same?
  • Appreciating that every web use is a conversation started by the site visitor.
  • Understanding your web visitors by thinking of “personas.”
  • Applying principles of plain language to health websites.
  • Using usability testing to measure how well your website works.

More Ways to Learn

About plain language: www.plainlanguage.gov & www.centerforplainlanguage.org

About usability: www.usability.gov & www.usabilityprofessionals.org

Developing Healthcare Materials With and For Village Health Workers (HLOL #18)

Curt Wands-Bourdoiseau is a physician assistant who has worked in free and community clinics across the United States. He has also trained village health workers in rural, isolated and conflict zones in Southern Mexico, Guatemala, Honduras and Colombia. Curt now works at the Hesperian Foundation in Berkeley, CA – serving as the project manager for the first major rewrite of the internationally renowned village health worker training book, Where There Is No Doctor.

In this podcast, he talks with Helen Osborne about developing healthcare materials with and for village health workers. Topics include:

  • Overview about the Hesperian Foundation
  • About Hesperian’s books, including Where There Is No Doctor
  • Materials development process using the participatory model
  • Lessons learned and shared with the health literacy community

Ways to Learn More:

Hesperian Foundation (English): http://www.hesperian.org
Hesperian Foundation (Spanish): http://espanol.hesperian.org

Dr. Arthur Culbert Talks About Statewide Health Literacy Initiatives (HLOL #17)

Arthur Culbert, Ph.D., M.S. is the Interim Executive Director, Health Literacy Missouri and serves as the Senior Advisor to the Missouri Foundation for Health in St. Louis, Missouri.  In this capacity, Dr. Culbert chairs the coordinating council and facilitates the collaboration of the development of Health Literacy Missouri, a state wide health literacy center.

Prior to moving to St. Louis, Dr. Culbert spent 31 years as a faculty member and a dean at the Boston University schools of medicine and public health. He has over 25 years of teaching experience in the fields of public health, medical sociology, and medical education. Throughout his career Dr. Culbert has been a pioneer, an innovator, and a leader in the fields of public health and medical education.

In this podcast, he talks with Helen Osborne about statewide health literacy initiatives. Topics include:

  • Statewide health literacy initiatives: What Missouri and other states are doing
  • Synergy and collaboration among statewide health literacy initiatives
  • Stakeholders and other necessary partners in these initiatives
  • Economic considerations and essential resources to get started

More Ways to Learn:

Terry Davis Talks About “Baby Steps,” Action Planning (HLOL #16)

Terry C. Davis, Ph.D is a pioneer in the field of health literacy. She is Professor of Medicine and Pediatrics at Louisiana State University Health Sciences Center in Shreveport, LA (LSUHSC-S), where she also heads the Behavioral Science Unit of the Feist-Weiller Cancer Center. She has won awards for her accomplishments and published more than ninety articles and book chapters related to health literacy, health communication, and preventive medicine.

Dr. Davis’s many health literacy accomplishments include: developing the Rapid Estimate of Adult Literacy in Medicine (REALM); chairing Louisiana’s statewide Health Literacy Task Force; serving as master faculty of the AMA’s Train-the-Trainer Health Literacy Curriculum; and participating as a member of the Healthy People 2010 Health Literacy/Health Communication Section, and the FDA’s Drug Safety and Risk Management Advisory Committee.

In this podcast, she talks with Helen Osborne about helping patients take “baby steps” (action planning). Topics include:

  • What baby steps are and why they are needed in healthcare today
  • How baby steps help in the management of chronic disease
  • Ways to build baby steps into your healthcare practice


Ready, Set, Action Plan
Lorig, Bodenheimer

More ways to learn:

  • American College of Physicians (ACP) Foundation, Living with Diabetes: An Everyday Guide for You and Your Family. To learn more and order copies, go to http://foundation.acponline.org/hl/diabguide.htm
  • Bodenheimer T. “Coordinating care–a perilous journey through the health care system.” N Engl J Med 2008;358(10):1064-71.
  • Bodenheimer T, Davis C, Holman H. “Helping patients adopt healthier behaviors.” Clinical Diabetes 2007;25(2):66-70.
  • DeWalt DA, Davis TC, Wallace AS, Seligman HK, Bryant-Shilliday B, Arnold CL, Freburger J, Schillinger D. “Goal setting in diabetes self-management: taking the baby steps to success.” Patient Education and Counseling, April 7, 2009, PMID: 19359123.
  • Handley M, MacGregor K, Schillinger D, Sharifi C, Wong S, Bodenheimer T. “Using Action Plans to Help Primary Care Patients Adopt Healthy Behaviors: A Descriptive Study.” J Am Board Fam Med 2006;19(3):224-31.
  • Lorig K. “Action Planning: A Call To Action.” J Am Board Fam Med 2006;19(3):324-5.
  • Lorig, Bodenheimer. Ready, Set, Action Plan. 5 minute instructional video for providers and health educators.  The video demonstrates an easy, brief method for helping 3 patients create small achievable action plans. http://foundation.acponline.org/images/diabetes_dvd.wmv
  • MacGregor K, Wong S, Sharifi C, Handley M, Bodenheimer T. “The action plan project: discussing behavior change in the primary care visit.” Ann Fam Med 2005;3 Suppl 2:S39-40.
  • MacGregor K, Handley M, Wong S, et al. “Behavior-Change Action Plans in Primary Care: A Feasibility Study of Clinicians.” J Am Board Fam Med 2006;19(3):215-23.
  • Osborne H, “In other words…How to help patients manage their action planning.” On Call magazine, June 26, 2007. Available online at http://www.healthliteracy.com/article.asp?PageID=6111
  • Seligman HK, Wallace AS, DeWalt DA, et al. “Developing low-literacy patient educational materials to facilitate behavior change.” American Journal of Health Behavior 2007;31(Suppl 1):S69-78.
  • Seligman HK, Wallace AS, DeWalt DA, Schillinger D, Arnold CL, Shilliday BB, Wallace AS, Seligman HK, Davis TC, Schillinger D, Arnold CL, Bryant-Shilliday B, Freburger JK, DeWalt DA. “Literacy appropriate educational materials and brief counseling improves diabetes self-management.” Patient Education and Counseling. 2009.
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Dr. Rima Rudd Talks About the Health Literacy Burden in Healthcare (HLOL #15)

Dr. Rima Rudd is Senior Lecturer on Society, Human Development, and Health at the Harvard School of Public Health. Her work centers on health communication and the design and evaluation of public health programs. She teaches courses on innovative strategies in health education, program planning and evaluation, and health literacy.

Dr. Rudd is widely recognized as a leader in health literacy – helping to shape both the research and practice agenda in the US, Canada, and Europe. Dr. Rudd works closely with the adult education, public health, oral health, and medical sectors. Her current research looks at literacy-related disparities and literacy-related barriers to health programs, services, and care. Her Harvard website on health literacy serves scholars and practitioners.

In this podcast, she talks with Helen Osborne about the health literacy burden in healthcare. Topics include:

  • Literacy-related disparities and barriers as they relate to healthcare
  • Deconstructing healthcare language, instructions, and activities
  • Literacy demands in chronic disease management, prevention, and navigation
  • Why it’s time to reconsider the definition of health literacy

More Ways to Learn:

  • Harvard School of Public Health, Health Literacy Studies. www.hsph.harvard.edu/healthliteracy
  • Communicating Health: Priorities and Strategies for Progress (2003), US Department of Health and Human Services & Office of Disease Prevention and Health Promotion.  Dr. Rudd wrote the chapter about health literacy. Available at http://odphp.osophs.dhhs.gov/projects/healthcomm/
  • Literacy and Health in America (2004), Educational Testing Services. Dr. Rudd is one of the authors. Available at http://www.ets.org/Media/Research/pdf/PICHEATH.pdf
  • National Center for the Study of Adult Literacy and Learning (NCSALL), http://www.ncsall.net
  • Nielsen-Bohlman L, Panzer AM, Kindig DA, (ed), 2004. Health Literacy: A Prescription to End Confusion. The National Academies Press: Washington DC. Dr. Rudd was a member of the Institute of Medicine committee as well as writer/contributor to the book. Available at http://books.nap.edu

Read the transcript of this podcast.

Talking about the Economic Side of Health Literacy (HLOL #14)

George J. Isham, M.D., M.S. is Chief Health Officer and Plan Medical Director for HealthPartners Health Plan in Minneapolis, Minnesota. His many responsibilities include overseeing programs of health promotion and disease prevention, research, professional education, strategic planning, quality and utilization management.

Dr. Isham is active nationally, as well. He works with a wide range of associations including America’s Health Insurance Plans, Alliance of Community Health Plans, Accreditation Association for Ambulatory Health Care, and Bridges to Excellence. Dr. Isham chairs the Institute of Medicine’s (IOM) Roundtable on Health Literacy.   

In this podcast, he talks with Helen Osborne about economic side of health literacy. Topics include:

  • Framing health literacy economics in terms of effectiveness and efficiency
  • Looking at the relationship between health literacy and health outcomes
  • Making a compelling case for organizations to invest in health literacy

More ways to learn:

  • IOM Roundtable on Health Literacy, http://www.iom.edu/?id=32786
  • Isham G, Halvorson G, 2003. Epidemic of Care: A Call for Safer, Better, and More Accountable Health Care. Jossey-Bass: San Francisco, CA.
  • Nielsen-Bohlman L, Panzer AM, Kindig DA, (ed), 2004. Health Literacy: A Prescription to End Confusion. The National Academies Press: Washington DC.
  • Osborne, H. “In Other Words…Making a Bottom-Line Case for Health Literacy,” On Call magazine, Sept/Oct 2006. Available at http://www.healthliteracy.com/article.asp?PageID=4804

Len & Ceci Doak Discuss Health Literacy’s Past, Present and Future (HLOL #13)

Cecelia (Ceci) and Leonard (Len) Doak are a husband and wife team who, for over 30 years, helped lead the way to health literacy. Their book, workshops, and articles have inspired advocates everywhere to improve health understanding.

Ceci started as a commissioned officer in the US Public Health Service. During her more 20 years there, Ceci developed and led numerous health education programs. In fact, she received a commendation from the Surgeon General for her work educating the public about cancer.

Len comes to health literacy via adult education, volunteering for many years as a tutor of non-readers. Len’s first career was as a Navy engineer and among his many accomplishments he helped simplify instructions for crews working on ships and submarines.

Len & Ceci co-authored the award-winning book, Teaching Patients with Low Literacy Skills. In their non-profit business Patient Learning Associates, Inc., Len and Ceci have written guidelines for many important projects and analyzed the suitability of over 2,000 healthcare materials in virtually all formats. They have presented at more than 200 health literacy workshops, training thousands of health professionals in all disciplines.

In this Health Literacy Out Loud podcast, they talk with Helen Osborne about the past, present, and future of health literacy. Topics include:

  • How health literacy began more than 30 years ago
  • Why health literacy was important then and is even more so today
  • Strategies to improve communication and assess if messages are understood
  • Ceci & Len Doak’s vision for health literacy in the future

More ways to learn:

  • Doak, Doak, & Root, Teaching Patients with Low Literacy Skills, Second Edition. 1996. Available for free at Harvard University School of Public Health’s Health Literacy Studies website, http://www.hsph.harvard.edu/healthliteracy/resources/doak-book/
  • Houts, Doak, Doak, Lascalzo. “The role of pictures in improving health communication:  A review of research on the benefits of pictures on attention, comprehension, recall, and adherence.”  Patient Education and Counseling, 61 (2006) 173-190, 2005 Elsevier Ireland Ltd.
  • Osborne, H. “In Other Words…Can They Understand? Testing Patient Education Materials With Intended Readers,” On Call Magazine, Nov 2001. Available at http://www.healthliteracy.com/article.asp?PageID=3811

Read a transcript of this podcast. 
[Read more…]

Talking Health to Men (HLOL #12)

Joe Zoske, MS, MSW is the Administrative Coordinator of the BSW Social Work Program at Siena College in Loudonville, NY. He incorporates his interests in communication, literacy, and men’s health in his teaching of Health Care Communication Skills and Gender Health courses. Zoske promotes a “whole man model of male wellness,” communicating health information in ways that are male-compassionate and male-affirming.

In this podcast, he talks with Helen Osborne about communication strategies for talking health to men. Topics include:

  • Gender as it relates to cultural competence and health disparities
  • How and why men receive health messages differently than women
  • Strategies providers can use to teach men about illness and well-being

More ways to learn:

  • Men’s Health Network, PO Box 770   Washington, D.C. 20044. http://www.menshealthnetwork.org. This is the lobbying organization for men’s health in the U.S. which also promotes National Men’s Health Week.
  • Osborne, H. “In Other Words… What’s the Difference? . . . Does Gender Matter When Communicating About Health?” On Call magazine, December 2004. Available at http://www.healthliteracy.com/article.asp?PageID=3787
  • Senay, E & Waters, R. (2004). From Boys to Men: A Women’s Guide to the Health of Husbands, Partners, Sons, Fathers, and Brothers. Scribner: NY
  • Zaman, F. and Underwood, C. (March 2003). The Gender Guide for Health Communication Programs. Center Publication No. 102. Baltimore: Johns Hopkins Bloomberg School of Public Health / Center for Communication Programs. Available at http://www.jhuccp.org/pubs/cp/102/102.pdf
  • Zoske, J. Men’s Health & Wellness: 50 Health Promotion Ideas for Educators, Planners, and Practitioners. 1998. Contact Zoske directly at: Siena College, Social Work House, 515 Loudon Rd, Loudonville NY 12211.

Pauline Hamel Talks About Intergenerational Health Communication (HLOL #11)

Pauline C. Hamel, Ed.D, PT, teaches in Boston University’s online Master of Science in Health Communication program and Northeastern University’s Health Sciences program. She is a physical therapist, educator, former healthcare administrator, geriatric specialist, and now consultant. Her interests include interdisciplinary research, teaching, writing, and consulting in the areas of health communication, health literacy, public health, professional development, intergenerational service learning, and health promotion in older adults. You can reach Pauline Hamel at phamel@bu.edu.

In the podcast, she talks with Helen Osborne about intergenerational health communication. Topics include:

  • How college students and older adults are often more alike than different
  • Ways different generations can learn from, and teach, one another
  • Why service learning matters and ways you can get involved

More ways to learn about intergenerational teaching and learning:

Julie McKinney Talks About An Online Health Literacy Community (HLOL #10)

Julie McKinney moderates the “Health & Literacy Discussion List” (“List”) for the National Institute for Literacy. She also consults on a wide variety of health literacy projects in her work with World Education, Inc., the National Institute for Literacy, and others. McKinney helps build collaborations between the fields of adult literacy and health education.

In this podcast, she talks with Helen Osborne about an online health literacy community. Topics include:

  • What the “Health & Literacy Discussion List” is and ways to participate
  • How this List creates a sense of community and collaboration
  • Examples of projects, actions, and advocacy that arose from this List

More ways to learn:

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