PREPARE For Your Care: An Online Tool to Make Medical Decision Making Easier for Patients and Caregivers (HLOL #192)

Rebecca Sudore MD is a geriatrician, palliative medicine physician, and health services researcher. She also is Professor of Medicine in the Division of Geriatrics at UCSF (University of California San Francisco). In addition, Dr. Sudore directs the Vulnerable Populations for Aging Research Core of the UCSF Older Adults Independence (Pepper) Center and co-directs the Innovation and Implementation Center in Aging & Palliative Care. Her research is focused on ways to improve advance care planning and medical decision-making for diverse, vulnerable older adults.

Dr. Rebecca Sudore and her team created PrepareForYourCare.org — an interactive, online advance care planning program to help with this process. In this podcast, she and Helen Osborne talk about:

  • Advance care planning. A process meant to support people at any age or stage of health in understanding their own values and preferences regarding current and future medical care.
  • Examples of problems that often occur along with ways to help patients, caregivers, and families feel more empowered and better able to advocate for themselves and others.
  • prepareforyourcare.orgA free easy-to-read and easy-to-use online tool to help clinicians, community organizations, patients, and caregivers engage in the process of advance care planning. 

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 12 (Forms, and Other Reading-To-Do Documents, and 18 (Know Your Audience: Culture and Language).

Read the transcript of this podcast.

Communicating Clearly Takes More Than Simple Words (HLOL #181)

Lauren McCormack PhD, MPSH is Vice President of RTI International’s Public Health Research Division and Adjunct Associate Professor in the UNC Gillings School of Global Public Health. McCormack’s research bridges the fields of health communication and health policy. It involves developing, testing, and evaluating interventions to promote patient-centered care, patient engagement, and informed decision-making.  An overarching goal is to improve the public’s understanding and use of medical evidence.

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

  • Helping patients and the public make decisions based on information and evidence. 
  • Targeting, narratives, tailoring, framing, expressing uncertainty, and other communication strategies.
  • Tips for using these strategies in your health related materials. 

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: 6, 8, 11, 16, 21, 28.

Read the transcript of this podcast. 

Making Lab Test Results More Meaningful (HLOL #175)

Brian J. Zikmund-Fisher, Ph.D.is Associate Professor of Health Behavior and Health Education and Research Associate Professor of Internal Medicine at the University of Michigan in Ann Arbor. He also is Associate Director of University of Michigan’s Center for Bioethics and Social Sciences in Medicine. Trained in decision psychology and behavioral economics, Dr. Zikmund-Fisher designs and evaluates novel communication methods to make health data more intuitively meaningful, studies the effects of poor numeracy on the public’s use of health data, and explores the power of narratives in health communications. He developed and teaches graduate courses in health risk communication and designing memorable (“sticky”) health messages.

In this podcast, Brian J. Zikmund-Fisher talk with Helen Osborne about:

  • Why it is important that patients understand lab test results. And why this is so hard for many people to do.
  • How visual cues such as number lines, ranges of relevant values, colors, and harm anchors (with simple words) can help patients not only understand lab results but also figure out what, if any, actions to take.
  • Takeaways from this research that clinicians can use in everyday practice.

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: 6, 8, 9, 12, 26, 37, 38

Read the transcript of this podcast.

Wellness, Women, and Health Literacy (HLOL #170)

Ruth Parker MD, MACP is Professor of Medicine, Pediatrics and Public Health at Emory University in Atlanta, Georgia.  For over two decades, her work has focused on research, education, and policy efforts to advance our nation’s health literacy. Ruth Parker’s health literacy accomplishments are many including being an author of the Test of Functional Health Literacy in Adults (TOFHLA) and the widely used definition of health literacy included in numerous scholarly articles and national health policies. She is also a life-long athlete and has completed more than 25 marathons using the RunWalkRun® method. (Pictured in photo on the left)

Carmen Patrick Mohan MD FACP is an internal medicine physician, urban homesteader, and marathon runner who prescribes food and exercise as medicine. She works to foster change in healthcare delivery through internet technology, improved patient communication, and information access. Carmen Patrick Mohan specializes in cardiometabolic risk factor reduction with a focus on women. She is also a competitive runner and on a quest to complete marathons in 50 states and on 7 continents. (In photo on the right)

Dr. Ruth Parker and Dr. Carmen Patrick Mohan talk with Helen Osborne about:

  • The book they co-authored with Jeff Galloway, The Women’s Guide to Health: Run Walk Run, Eat Right, and Feel Better. What this book is about and why it was important to write.
  • How their practice as physicians, experience as marathon runners, and commitment to health literacy help women of all abilities achieve fundamental health.
  • Tips and strategies for podcast listeners–of all professions, genders, ages, and levels of activity—to help others and themselves become more fit and healthy.

More Ways to Learn:

The Women’s Guide to Health: Run Walk Run, Eat Right, and Feel Better, by Jeff Galloway, Ruth Parker, Carmen Patrick Mohan. Published by Meyer & Meyer Sport, 2018. Available on Amazon at https://www.amazon.com/Womens-Guide-Health-Right-Better/dp/1782551239

Author websites:

Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Second Edition (Updated 2018), by Helen Osborne. Relevant chapters include: 1, 13, 27

Read the written transcript.

Advance Care Planning: Communicating Clearly Before There Is a Crisis (HLOL #168)

Aretha Delight Davis MD, JD, and Angelo Volandes MD, MPH, are an amazing team. They not only are married to each another but also created, run, research, and otherwise make possible ACP Decisions — an ever-growing collection of video support tools designed to help patients and families make informed decisions about advance care planning and end-of-life care. They both are physicians. Dr. Davis is also a lawyer. Their accomplishments are many and build on a deep and unwavering commitment to empowering patients.

In this podcast Dr. Davis and Dr. Volandes talk with Helen Osborne about:

  • Advance Care Planning (ACP). What it includes and why this topic is important to patients, caregivers, and healthcare professionals.
  • “Death illiteracy” and other reasons it can be hard to discuss advance care planning.
  • Tips, strategies, and tools to help make advance care planning conversations easier. These include using videos and excellent consumer-facing websites.

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: 5, 8, 13, 22, 30, 41

Read the transcript of this podcast.

Best Case/Worst Case: A Strategy to Manage Uncertainty in Shared Decision-Making (HLOL #164)

Gretchen Schwarze MD, MPP, is an Associate Professor in the Departments of Surgery and Medical History and Bioethics at the University of Wisconsin. Dr. Schwarze is a practicing vascular surgeon and health services researcher who also directs the clinical ethics curriculum for the UW School of Medicine and Public Health.  Her research interests are in patient-doctor decision making for high-risk operations and end-of-life care for surgical patients.

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

  • Best Case/Worst Case. A decision-making strategy that uses narrative, a graphic aid, and simplicity to communicate with families about complex treatment options.
  • Examples, stories, and research about using Best Case/Worst Case in practice.
  • Ways that patients and non-physicians can build on these lessons learned.

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: 5, 8, 12, 13, 19, 26, 32, 38, 41

Read a transcript of this podcast.

Health Literacy & Consumer Health Librarians (HLOL #161)

Amy Six-Means, MLIS, is on the librarian team at Children’s Health in Dallas, Texas. She worked at two other consumer health libraries prior to that. Six-Means started as an elementary school teacher, later going back to school for a degree in library science. Along the way, she discovered the connection between medical librarianship and health literacy and has been a passionate advocate ever since.

In this podcast, Amy Six-Means talks with Helen Osborne about:

  • What consumer health librarians do, where they work, and how they help patients, caregivers, and the public better understand about illness, treatment, and health.
  • How consumer health librarians can make a difference whether working in hospitals, communities, or healthcare systems.
  • Collaborating with consumer health librarians for better health literacy.

More Ways to Learn:

Examples of collaborative partnerships with medical/consumer health librarians and community members, public health initiatives, or health care organizations to further health literacy and support patients, loved ones, and the community.

Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Second Edition (Updated 2018), by Helen Osborne. Relevant chapters include: 1, 13, 27, 29, 32

Read the transcript of this podcast.

End of Life Education (HLOL #157)

1_dk_kkKathy Kastner is founder and curator of the only patient/consumer-perspective website for end of life education, BestEndings.com, and author of the eBook, Death Kills… and other things I’ve learned on the Internet. Kastner also shares this information by speaking at healthcare conferences, blogging on health websites, hosting tweetchats, and participating in invitation-only think tanks. Kathy Kastner has received numerous awards for her advocacy and work in end of life education.

In this podcast, Kathy Kastner talks with Helen Osborne about:

  • End of life. An emotionally fraught topic often prompted by a new diagnosis, change in health status, or even news reported in the media.
  • Examples of words, terms, and end of life concepts that are often misunderstood.
  • Ways professionals can help improve education and understanding about end of life. Ways patients, families, and the public can help in these conversations too.

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: 5, 8, 11, 13, 22, 41

Read the written transcript of this podcast. 

Research to Practice: How Much Patient Teaching is Enough? (HLOL #144)

Mike Pignone headshotMichael Pignone, MD, MPH, is professor of medicine at the University of North Carolina Department of Medicine and chief of the university’s Division of General Internal Medicine. In addition to his numerous clinical and teaching responsibilities, Dr. Pignone researches chronic disease prevention and treatment, physician-patient communication, and decision-making in primary care settings. Health literacy is a thread woven throughout all his work.

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

  • Recognizing the challenge of treating patients who have chronic illnesses, complex medical regimens, and a range of interests and abilities.
  • Teaching in ways patients can learn. This starts with knowing each patient and continues with a team over time.
  • Valuing the intersection of research and practice to help patients reach their goals.

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, 6, 11, 27.

Read the written transcript of this podcast

Choosing Wisely: A Campaign Helping Patients Be Engaged Consumers (HLOL #104)

Rothschild HeadshotBeccah Rothschild, MPA, is the Senior Outreach Leader for the Choosing Wisely campaign at Consumer Reports. Beccah has over 15 years experience in the fields of adult literacy, health literacy, health communication, and outreach including direct service interventions, research, and policy. Her role at Consumer Reports focuses on patient engagement around the issues of overuse and misuse of medical tests, treatments, and procedures that provide little benefit and in some cases cause harm.

In this podcast, Beccah Rothschild talks with Helen Osborne about:

  • Choosing Wisely. How this campaign helps patients, consumers, and providers engage in important conversations about medical tests, treatments, and procedures.
  • Consumer-friendly teaching materials from Choosing Wisely. These materials not only are free and easy-to-read but also approved by national medical societies and organizations.
  • Health literacy, and its important role in the Choosing Wisely campaign.

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, 8, 13, 27.

Read a transcript of this podcast.

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.

Choosing A Health Plan: Ways to Make This Experience Easier and More Consumer-Friendly (HLOL #87)

Lynn Quincy is a senior health policy analyst for Consumers Union–the policy and advocacy division of Consumer Reports. Quincy works on a wide variety of health policy issues that often focus on consumer protections, consumers’ health insurance literacy, and health insurance reform at the federal and state levels.

In this podcast, Quincy talks with Helen Osborne about:

  • Choosing a health plan. Why this task is often so hard for consumers.
  • Ways to make this experience easier and more consumer-friendly.
  • Strategies to help, including: choice architecture, cognitive shortcuts, stories, visuals, and doing the math for consumers.

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, 13, 30, 36, 39.

Read the 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.

Mammograms: Clearly Communicating New Guidelines (HLOL #63)

Diana Zuckerman, Ph.D. is the President of the National Research Center for Women & Families–a nonpartisan, nonprofit research and education organization that works to evaluate and improve policies and programs that affect the health and safety of adults and children.

Dr. Zuckerman is a nationally respected expert on health and health policy, including the safety and effectiveness of medical treatments and the impact of violence on women and families. She has testified dozens of times before U.S. Congressional hearings and other federal and state agencies. Dr. Zuckerman is often interviewed or quoted on television, radio, and the national press.

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

  • Why and how national guidelines, policies, and recommendations change.
  • How to clearly communicate ever-changing, nuanced health messages.
  • Communication challenges ahead as science continues to evolve.

More Ways to Learn:

  • National Research Center for Women & Families, http://www.center4research.org/
  • Cancer Prevention and Treatment Fund, a new program of the National Research Center for Women & Families. Available at http://www.stopcancerfund.org
  • Osborne H (host). 2011, April 5. Health Literacy Out Loud #56: Helping Others Understand Health Messages. Available at http://healthliteracy.com/hlol-helping-others-understand
  • Schousboe JT, Kerlikowske K, Loh A, Cummings SR, “Personalizing Mammography by Breast Density and Other Risk Factors for Breast Cancer: Analysis of Health Benefits and Cost-Effectiveness,” Annals of Internal Medicine. July 5, 2011, 155:10-20.
  • Welch HG, Schwartz LM, Woloshin, Overdiagnosed. Beacon Press, 2011.
  • 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

Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Second Edition (Updated 2018), by Helen Osborne. Relevant chapters include: 11, 13, 27, 30.

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.

Decision Support for Patients Making Life-Changing Choices (HLOL #49)

Jeff Belkora PhD is a faculty member at the University of California, San Francisco (UCSF). There he runs the Medical Center’s Decision Services program, helping patients weigh the risks and benefits of their treatment options. Belkora also consults with outside organizations about decision support for patients making life-changing choices. In all this work, Belkora’s focus is on leadership, teamwork, and decision-making.

In this podcast, he talks with Helen Osborne about:

  • How decision support helps patients reflect critically on life-changing choices.
  • Strategies and systems to help patients understand decisions and communicate effectively.
  • Lessons learned that listeners can use in day-to-day practice.

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

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.
bestshoesmeme