When Communicating Risk, Consider What Patients Need and Want to Know (HLOL #102)

BZF Donaghue headshotBrian J. Zikmund-Fisher, PhD is an Assistant Professor in the Department of Health Behavior and Health Education at University of Michigan’s School of Public Health. He also is a Research Assistant Professor in their Internal Medicine Department and affiliated with several other University of Michigan’s programs. With a background in decision psychology and behavioral economics, Dr. Zikmund-Fisher teaches, researches, and writes about meaningful ways to communicate risk and other number-based health messages.

In this podcast, Dr. Zikmund-Fisher talks with Helen Osborne about:

  • How all risk communications are not the same.
  • The responsibility of the communicator to consider the spectrum of patient’s needs before deciding what to provide.
  • How to align the format of risk information to its purpose. In other words, how to know when we want numbers and when we might not.
  • The pros and cons of different formats for discussing risk including icon arrays and other visual ways of showing probabilities, labels that group numbers into categories, and narratives that recount lived experience but ignore probability.
  • Thoughts about the history and future of risk communication.

More Ways to Learn:

  • Zikmund-Fisher BJ, “The Right Tool is What They Need, Not What We Have: A Taxonomy of Appropriate Levels of Precision in Patient Risk Communication,” Medical Care Research and Review. Published online September 6, 2012. Full text available at http://hdl.handle.net/2027.42/98434
  • Icon Array, a free online tool to communicate your risk information in a matrix, http://www.iconarray.com

Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Second Edition (Updated 2018), by Helen Osborne. Relevant chapters include: 8, 9, 11, 13, 26, 38.

Read a transcript of this podcast.

Poetry and Other Artful Ways to Communicate Health Messages (HLOL #99)

EM Authors LiveElspeth Murray is a Scottish poet whose background is in cultural anthropology, health promotion, public health policy and patient involvement in cancer care. She also works with the Puppet State Theatre Company on their award-winning puppetry and storytelling production, “The Man Who Planted Trees” that has toured internationally for many years.

In this podcast, Elspeth Murray talks with Helen Osborne about:

  • “This is Bad Enough.” Murray reads her poem about why health communication is hard, along with ways to make it easier.
  • Using the arts to engage, entertain, and educate audiences.
  • Creating compelling health messages with poetry, whiteboard animation, videos, storytelling, and other artful ways.

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: 11, 28, 32, 40, 41.

Read a transcript of this podcast.

Communicating Results of Mammograms and Other Screening Tests (HLOL #97)

Erin Marcus, M.D. Internal MedicineErin N. Marcus, MD, MPH, is a general internist at the University of Miami Miller School of Medicine. In 2009, she was one of three physicians nationally to receive an American Cancer Society Cancer Control Career Development Award for Primary Care Physicians. Her research focused on the communication of mammogram results. Before medical school, Dr. Marcus worked as a newspaper reporter. Even now as a practicing physician, she sometimes writes about health for The New York Times, The Washington Post, The Miami Herald, and The Huffington Post.

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

  • Challenges when communicating test results by mail or online.
  • Strategies to make this information more understandable.
  • Ways to help patients be more activated when learning about health.

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, 9, 11, 26, 27, 30.

Read a transcript of this podcast.

 

How Visual Cues Help Readers Read (HLOL #95)

JosiahFiskAugust2012Josiah Fisk is founder and president of More Carrot, a firm that combines plain language with information design to create simplified, user-centric documents. While Fisk often works on consumer financial products, he also has experience with healthcare providers, software companies, and the IRS. More Carrot is a global company with offices in Boston and Luxembourg.

In this podcast, Josiah Fisk talks with Helen Osborne about:

  • How information design improves readability and navigation.
  • Ways that visual cues make it easier for readers to complete forms and other business or informational documents.
  • Suggestions about using photos, spacing, sub-headings, and other design elements in healthcare documents.

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: 9, 12, 30.

Read a transcript of this podcast.

Talking About Jargon (HLOL #94)

Dean's photoDean Schillinger MD is Professor of Medicine in Residence at the University of California San Francisco and Chief of the UCSF Division of General Internal Medicine at San Francisco General Hospital. Among his many responsibilities, Dr. Schillinger treats patients, teaches in the primary care residency program, and conducts research about healthcare for vulnerable populations. Dr. Schillinger is a well-published researcher, winner of many awards, and widely recognized as an expert in health literacy, health communication, and chronic disease prevention and management.

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

  • What jargon is and why it is often a problem in health communication.
  • A study showing that patients often do not understand jargon, even when jargon is clarified.
  • Recommendations about ways to more clearly communicate about health, along with a suggestion for more research.

More Ways to Learn:

  • Castro CM, Wilson D, Wang F, Schillinger D, “Babel Babble: Physicians’ Use of Unclarified Medical Jargon with Patients.” Am J Health Behavior, 2007;31(suppl 1):S85-S95.
  • Osborne H, “In Other Words…Abbreviations, Acronyms, and Other Healthcare Shorthand.” On Call magazine, April 10, 2008. Available at http://healthliteracy.com/abbreviations-acronyms

Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Second Edition (Updated 2018), by Helen Osborne. Relevant chapters include: 16, 25.

Read a transcript of this podcast.

Numeracy, Chronic Disease, and Repeat Emergency Room Visits or Hospitalizations (HLOL #92)

PastedGraphic-1Candace McNaugton MD, MPH, is an emergency medicine physician at Vanderbilt University Medical Center and a fellow in the Vanderbilt Emergency Medicine Research Training Program. Dr. McNaughton also completed a VA Quality Scholar Fellowship, focusing on issues of quality and patient safety. Her research looks at patients with heart failure, hypertension and other chronic diseases who seek care in the emergency department.

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

  • Numeracy and chronic disease. Number-based tasks that patients must do to care for themselves at home.
  • Return ER visits and hospitalizations. Patients with low numeracy skills appear to be at more risk for acute exacerbation of heart failure symptoms.
  • What can all of us do to help? Recommendations for clinicians, patients, and healthcare systems.

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, 5, 7, 26.

Read a transcript of this podcast.

Making Research Consent Forms Easier for Patients to Understand (HLOL #86)

Kristofer (Kris) Griffith is Manager of Human Research Regulations at The University of Texas MD Anderson Cancer Center. Among his many responsibilities, Griffith manages regulatory aspects of human subjects research as submitted through their Office of Protocol Research, edits the Human Subjects Research Bulletin and, along with an editorial staff, maintains MD Anderson’s Adverse Events Database.

In this podcast, Kris Griffith talks with Helen Osborne about:

  • Why research consent forms are so very difficult to write. And understand.
  • Strategies to help, including: listing side effects, using consistent and clear wording, formatting pages, and writing short summaries.
  • Useful tools, resources, and ways to learn more.

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: 8, 12, 27, 30.

Read the transcript for this podcast.

Clearly Communicating Scientific Information (HLOL #83)

David Nelson MD, MPH is Director of the Cancer Prevention Fellowship Program at the National Cancer Institute. Prior to this position, Dr. Nelson worked as an epidemiologist and health communication scientist at the Centers for Disease Control and Prevention (CDC). He is the author, co-author, or lead author of numerous books and over 100 peer-reviewed scientific articles.

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

  • Why it can be hard to communicate scientific information to lay audiences.
  • Ways to communicate clearly–beginning with an understanding of your audience, their beliefs, and communication goals.
  • How to tell a scientific story using data, metaphor, visuals, and examples.
  • What to consider when weighing the “ethics of simplicity.”

More ways to learn:

  • Nelson DE, Hesse BW, Croyle RT (2009). Making Data Talk: Communicating Public Health Data to the Public, Policy Makers, and the Press. Oxford University Press.
  • National Cancer Institute, US Department of Health and Human Services (2011). Making Data Talk: A Workbook. At http://www.cancer.gov/cancertopics/cancerlibrary/MDT-Workbook.pdf
  • Parvanta C, Nelson DE, Parvanta SA, Harner RN (2010). Essentials of Public Health Communication. Jones and Bartlett Learning.
  • Remington PL, Nelson DE, Parvanta C (2002). Communicating Public Health Information Effectively: A Guide for Practitioners. American Public Health Association.
  • Osborne H (2004). “In Other Words…The Ethics of Simplicity,” On Call magazine. Available at www.healthliteracy.com/ethics-of-simplicity
  • Rosling, Hans (2010). “The Joy of Stats,” Wingspan Productions for BBC. At http://www.gapminder.org/videos/the-joy-of-stats/

Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Second Edition (Updated 2018), by Helen Osborne. Relevant chapters include: 9, 11, 26, 28, 30.

Read a transcript of this podcast.

 

Plain Writing Act of 2010 (HLOL #73)

Annetta Cheek Ph.D. is an ongoing champion of plain language. With a background in anthropology and many years experience as a federal employee, Cheek helped lead the way to convincing the U.S. Congress to pass the Plain Writing Act of 2010. Now she and others are supporting new legislation to streamline government regulations.

Annetta Cheek’s commitment to plain language is long-standing. Among her many accomplishments, she served as an expert for Vice President Gore’s plain language initiative. More recently, she helped found the non-profit organization, the Center for Plain Language.

In this podcast, Annetta Cheek talks with Helen Osborne about:

  • Plain language: What it is and why it is needed for all types of documents.
  • Plain language legislation: How government communications affect everyone.
  • Practical ways to help overcome a “culture of complex communication.”

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: 3, 4, 6, 27, 28, 30.

For a transcript of this podcast, please visit http://healthliteracy.com/transcript.asp?PageID=11098

Helping Others Understand Health Messages (HLOL #56)

Lisa M. Schwartz, MD, M.S., and Steven Woloshin, MD, MS, are general internists at the White River Junction Veterans Administration Medical Center in Vermont. They also are professors of medicine, and community and family medicine, at Dartmouth Medical School in New Hampshire.

Together, they are working to address two important barriers to health communication: 1) many patients and providers are limited in their ability to interpret medical data, and 2) health messages are often exaggerated or incomplete. Dr. Schwartz and Dr. Woloshin have written extensively on this topic and are co-authors of several books including Know Your Chances: Understanding Health Statistics and Overdiagnosed.

In this podcast, they talk with Helen Osborne about:

  • Health statistics, health messages, and health claims. Helping people make sense of what they hear on the news, see on TV, and read in the ads.
  • Three questions to help others better understand health messages.
  • Ways to communicate complicated health messages more simply and clearly.

More Ways to Learn:

  • Woloshin S, Schwartz LM, Welch HG, Know Your Chances: Understanding Health Statistics. University of California Press, 2008. (The book can be downloaded for free from http://www.jameslindlibrary.org/testing-treatments.html
  • Welch HG, Schwartz LM, Woloshin, Overdiagnosed. Beacon Press, 2011.
  • S Woloshin, LM Schwartz, BS Kramer. “Promoting health skepticism in the news: Helping journalists get it right,” J Natl Cancer Institute 101(23): 1596–1599.
  • “Healthy Skepticism,” White River Junction Outcomes Group. Available at http://www.vaoutcomes.org/washpost.php
  • Osborne H, “In Other Words…Working With Numbers,” On Call magazine, June/July 2004. Available at http://healthliteracy.com/article.asp?PageID=3745

Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Second Edition (Updated 2018), by Helen Osborne. Relevant chapters include: 8, 13, 26.

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.

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 

Using Design to Get Readers to Read and Keep Reading (HLOL #29)

Karen Karen SchriverSchriver, PhD is President of KSA Communication Design and Research, a consultancy located in Pittsburgh, Pennsylvania. She is former professor of rhetoric and information design at Carnegie Mellon University where she co-directed the graduate programs in professional writing and information design.

Dr. Schriver’s first book, Dynamics in Document Design: Creating Texts for Readers—now in its 9th printing—is regarded as an essential text in its field. Winner of ten national awards for her work, Schriver is writing two new books: the first on developing expertise in information design, and the second on visual and verbal design moves to engage readers online.

In this podcast, she talks with Helen Osborne about using good information design to get readers to read, and keep reading. Topics include:

  • Using good information design to help readers feel valued and respected
  • Being a visual detective, observing what works and what doesn’t
  • Engaging readers with contrast, consistency, grouping, and other design moves

More Ways to Learn:

Read a transcript of this podcast

 

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. 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.

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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Lisa Bernstein Talks about Patient-Centered Communication (HLOL #4)

Lisa Bernstein is Executive Director and Co-founder of the What to Expect Foundation based in New York City. This non-profit organization takes its name and leadership from the best selling pregnancy guide What to Expect When You’re Expecting. The Foundation helps low-income, at-risk parents expect healthier pregnancies, safer deliveries, and happier babies. One of Lisa’s many responsibilities is directing the “Baby Basics Prenatal Health Literacy Program.”

In this Health Literacy Out Loud Podcast, she talks with Helen Osborne about using patient-centered communication to reach communities. Topics include:

  • Baby Basics: Why this easy-to-read pregnancy guide was created and ways to use it in practice.
  • How lessons learned from Baby Basics apply to many health situations including teaching about diabetes, smoking cessation and hypertension.
  • Ways to evaluate and use simply-written materials in context of a person’s life and community.

More ways to learn:

  • What to Expect Foundation website includes information about the book Baby Basics. Available at http://www.whattoexpect.org. You can reach Lisa Bernstein by email at lisab@whattoexpect.org
  • Health Literacy Out Loud (audio CD). Helen Osborne talks with Lisa Bernstein about Creating and Using Excellent Written Materials. Available at http://www.healthliteracy.com/buy.asp?PageID=3672
  • Osborne, H. “In Other Words… Helping Patients Ask Questions.” On Call Magazine, November/December 2006. This article includes quotes from Lisa Bernstein. Available at http://www.healthliteracy.com/article.asp?PageID=5179
  • Osborne H, 2004. Health Literacy from A to Z: Practical Ways to Communicate Your Health Message. Sudbury, MA: Jones & Bartlett. To order, go to most online bookstores or the publisher’s website at http://www.jbpub.com/catalog/0763745502/
  • Zarcadoolas C, Pleasant AF, Greer DS, 2006. Advancing Health Literacy: A Framework for Understanding and Action. San Francisco, CA: Jossey-Bass.

Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Second Edition (Updated 2018), by Helen Osborne. Relevant chapters include: 24, 27, 28, 32, 41.

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