Health Literacy from a Literacy Perspective (HLOL #41)

John Comings EdD is Principal International Technical Advisor at the Education Development Center in Newton, MA. Prior to this, he was Director of the National Center for the Study of Adult Learning and Literacy (NCSALL) and a member of the faculty of the Harvard Graduate School of Education.

Dr. Comings’s research and writing focuses on the impact of adult literacy programs and factors that predict persistence of adult education students in the U.S. and Third World countries. In this podcast, he talks with Helen Osborne about:

  • The literacy part of health literacy, including components of reading skills
  • The health part of health literacy, including functional skills within health contexts
  • Practical literacy strategies that health professionals can use today
  • Ways the health system can collaborate with the adult literacy system

More Ways to Learn:

Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Second Edition (Updated 2018), by Helen Osborne. Relevant chapters include: 1, 21, 27.

Assessing Readability in the European Union (HLOL #40)

Mark Gibson MA is a Consumer Information Specialist based in Leeds, England. He is a linguist, translator, and journalist who now focuses on readability testing and information design. Building on his research in patient communication, Mark designs information that is appropriate for diverse audiences – including those with limited English proficiency, low literacy skills, and sight loss.

In this podcast he compares and contrasts ways to assess readability in the European Union (EU) and the United States. Topics include:

  • Assessing readability: How does the system used in the EU compare to that in the United States?
  • EU process of assessing readability: What works well and what does not?
  • Lessons learned and resources that listeners can use right away.

More Ways to Learn:

Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Second Edition (Updated 2018), by Helen Osborne. Relevant chapters include: 4, 6, 9, 18, 27, 30.

National Action Plan to Improve Health Literacy (HLOL #39)

Cynthia Baur, Ph.D., is the Senior Advisor for Health Literacy at the Centers for Disease Control and Prevention (CDC), a division of the U.S. Department of Health and Human Services (HHS). She co-chairs several federal health literacy initiatives, including the workgroup for Healthy People 2020 Health Communication and Health Information Technology.

Dr. Baur is the lead author for the National Action Plan to Improve Health Literacy and helped develop CDC’s online health literacy training for health professionals. In this podcast, she talks with Helen Osborne about the National Plan to Improve Health LiteracyTopics include:

  • How the National Action Plan to Improve Health Literacy was developed with input from researchers, practitioners, and community members.
  • Ways individuals and organizations can use this health literacy action plan.
  • A national and international perspective about health literacy.

More Ways to Learn:

Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Second Edition (Updated 2018), by Helen Osborne. Relevant chapters include: 1, 27.

Talking about Interactive Health Literacy & Oral Communication (HLOL #35)

Donald Rubin, PhD is Emeritus Professor of Speech Communication, of Language & Literacy Education, and of Linguistics at the University of Georgia. He is also senior researcher at that institution’s Center for Health and Risk Communication.

Much of Dr. Rubin’s work focuses on assessment, training, and analysis of oral communication, including listenability. His current research looks at 1) health literacy and health communication message design, 2) public health workforce development in communication to reduce health disparities, and 3) assessment of language proficiency among non-native speakers of English.

In this podcast, Dr. Rubin talks with Helen Osborne about:

  • Interactive health literacy. How do written and spoken communication differ?
  • The communication environment. How physical and linguistic aspects affect communication.
  • Older adults. A research study about their distinct communication needs.
  • Practical strategies. How all health professionals can invite patients/consumers to participate verbally in their health care encounters.

More ways to learn:

Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Second Edition (Updated 2018), by Helen Osborne. Relevant chapters include: 1, 24, 27, 32, 41.

Read a transcript of this podcast. 

A Participatory Approach for Communicating with Diverse Audiences (HLOL #31)

Linda Neuhauser, DrPH, is Clinical Professor of Community Health and Human Development at the University of California, Berkeley School of Public Health. Her work focuses on translating research into improved health interventions and mass communication. Dr. Neuhauser is especially interested in participatory approaches that meet the literacy, linguistic, and cultural needs of diverse audiences. She is Co-Principal Investigator of the UC Berkeley Health Research for Action Center that uses participatory design to create, implement and evaluate communication initiatives that have now reached over 30 million people.

In this podcast, she talks with Helen Osborne about participatory and user-centered approaches to health communication.

Topics include:

  • Communication challenges for both givers and receivers of information
  • A structured approach to participatory, user-centered design
  • Overcoming objections of limited time, money, or other resources

More Ways to Learn:

  • Neuhauser L, Rothschild R, Graham C, et al. “Participatory Design of Mass Health Communication in Three Languages for Seniors and People With Disabilities on Medicaid,” American Journal of Public Health. 2009;99 (12).
  • Neuhauser L, Constantine WI, Constantine NA, et al. “Promoting Prenatal and Early Childhood Health: Evaluation of a Statewide Materials-based intervention for Parents. American Journal of Public Health. 2007;97(10):1813-1819.
  • Health Literacy Out Loud Podcast #13: Len & Ceci Doak Discuss Health Literacy’s Past, Present, and Future (includes a discussion of the SAM materials assessment tool), Available at http://www.healthliteracyoutloud.com/2009/03/23/hlol-13-len-ceci-doak-discuss-health-literacy’s-past-present-and-future/

Read a transcript of this podcast 

Making a Business Case to Move Health Literacy Forward (HLOL #30)

David Walsh is a principal in the consulting firm, SmartLaunch based in Havertown, PA. With expertise in strategic and business planning, marketing and financial management, Walsh helps non-profit and for-profit businesses manage change, maximize opportunities, and launch new ventures.

Walsh recently helped develop a business case for Health Literacy Missouri and worked to launch them as a new, independent non-profit business entity. In this podcast, he talks with Helen Osborne about the importance of using proven business principles to move health literacy forward. Topics include:

  • Knowing why you need to make a business case for health literacy
  • Using the language of business (key terms and acronyms)
  • Creating a workable and measurable business plan
  • Understanding business drivers, goals, and the importance of focus

More Ways to Learn:

Read a transcript of this podcast.

Applying Adult Education Principles to Medicine & Public Health (HLOL #28)

Dr. Winston Lawrence Winston Lawrence knows a lot about adult literacy education and community health. He works at the Literacy Assistance Center (LAC), a non-profit adult literacy organization providing professional development and technical assistance to the adult literacy community throughout New York City.

In this work, Dr. Lawrence oversees the city-wide implementation of LAC’s Health Literacy Initiative. He trains teachers and health professionals about health literacy principles and strategies. He also facilitates partnerships between literacy agencies and health care institutions.

In this podcast he talks with Helen Osborne about ways to apply adult literacy principles to medicine and public health. Topics include:

  • Why and how a literacy organization got involved with health literacy
  • How teaching practical health literacy skills helps teachers and students alike
  • Ways health literacy partnerships benefit both literacy and health programs
  • Resources to start building health literacy partnerships near you

More Ways to Learn:

CAHPS Health Literacy Item Set: An Interview with Dr. Carolyn Clancy (HLOL #27)

Clancy, CarolynCarolyn M. Clancy, M.D., is a general internist, health services researcher and director of the U. S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) in Rockville, Maryland. Throughout her career, Dr. Clancy has been an advocate for improving the health care system. Her major research interests include improving health care quality and patient safety, and reducing disparities in care associated with patients’ race, ethnicity, gender, income, and education.

In 2009, Dr. Clancy was chosen as the most powerful physician-executive by the readers of Modern Healthcare and Modern Physician magazines. She was also awarded the 2009 William B. Graham Prize for Health Services Research.

In this podcast she talks with Helen Osborne about AHRQ’s new CAHPS Health Literacy Item Set. Topics include:

  • Health literacy and how it relates to quality, safety, and patient care
  • CAHPS Health Literacy Item Set: A way to measure patients’ experience of care and communication
  • Vision for the future with health literacy as part of every practice

More Ways to Learn:

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

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.

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. 
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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:

Andrew Krueger MD talks about health literacy and management of chronic disease (HLOL #7)

Andrew Krueger, M.D. is the Medical Director for Accordant Health Services (a division of CVS Caremark Corporation). His responsibilities include directing and supporting Health Management Medical Affairs, providing medical leadership to numerous projects and committees, and serving as the senior clinician providing guidance for Accordant’s disease management programs.

In this podcast, he talks with Helen Osborne about health literacy and management of chronic disease. Topics include:

  • What disease management programs are and why health literacy matters
  • Ways to communicate with patients including by telephone, mail, and the Web
  • How helping patients understand their conditions can improve health outcomes

More ways to learn:

Lee Joesten Talks About Generating Hospital-Wide Interest & Activity About Health Literacy (HLOL #6)

Leroy (Lee) B. Joesten is Vice President of Mission and Spiritual Care at Lutheran General Hospital, part of Advocate Health Care in the Chicagoland area. He is an ordained Lutheran minister and certified hospital chaplain. Chaplain Joesten has developed ministries for the bereaved and those facing life threatening and terminal illnesses. He also has chaired Lutheran General’s Health Literacy Task Force since 2003.

In this podcast, he talks with Helen Osborne about generating hospital-wide interest and activity about health literacy. Topics include:

  • Why health literacy is important to address hospital-wide
  • Health literacy strategies, initiatives, and lessons learned
  • Wishes and vision for the future in terms of health literacy

More ways to learn:

Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Second Edition (Updated 2018), by Helen Osborne. Relevant chapters include: 4, 11, 27, 41.

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