MINNESOTA DEPARTMENT OF HEALTH
Addressing Health Literacy at State Health Departments
Presented by:Genelle Lamont, MPH
DHPE Fellow
September 25, 2013
MINNESOTA DEPARTMENT OF HEALTH
Objectives
1. Describe health literacy within a public health context.
2. Relay the importance of addressing health literacy in public health.
3. List strategies for starting a health literacy initiative at a state department of health.
MINNESOTA DEPARTMENT OF HEALTH
Health Literacy…
“is the degree to which individuals have the capacity to obtain, process, and understand basic information and services needed to make appropriate decisions regarding their health.”-National Academies of Sciences, Institute of Medicine (2004)
MINNESOTA DEPARTMENT OF HEALTH
The Calgary Charter
Find Understand Evaluate Communicate
Fundamental: reading, writing & numeracy Scientific: science and technology Cultural: customs and cultural beliefsCivic: enabling citizens to become involved
USEUSEHealth Literacy Domains (Zarcadoolas, 2005)
MINNESOTA DEPARTMENT OF HEALTH
Medicaid Letter
The law cited below [not included here] requires that all conditions of eligibility must be verified at each redetermination of eligibility unless the verification is pending from a third party and the recipient has cooperated in obtaining the verification. Since you have not provided the necessary verification or you have failed to cooperate in obtaining verification from a third party, your cash and/or medical assistance must be stopped.
MINNESOTA DEPARTMENT OF HEALTH
Antibiotic Resistance Print Ad
Source: United Health Foundation (2003) as seen on page 47 of Zarcadoolas C; Pleasant AF; and Greer DS (Eds). Advancing Health Literacy: A Framework for Understanding and Action. Jossey-Boss Publications; San Francisco, CA: 2006.
MINNESOTA DEPARTMENT OF HEALTH
…But what about examples that ARE health literate?
Contact: Don McCormick, Public Information Officer,Iowa Department of Public Health
www.idph.state.ia.us/PlainAndSimple/Default.aspx
MINNESOTA DEPARTMENT OF HEALTH
Barriers to Health Literacy
1. Complexity of written health information in print/web.
2. Lack of health information in languages other than English and inadequate translations.
3. Lack of cultural appropriateness of health information.
4. Inaccuracy or incompleteness of information in mass media.
5. Low-level reading abilities, especially among undereducated, elderly and some segments of ethnic minority populations.
6. Lack of empowering content that targets behavior change as well as direct information (social marketing strategies).
Source: Zarcadoolas, Pleasant and Greer (2006)
MINNESOTA DEPARTMENT OF HEALTH
U.S. Adult Health Literacy
88% of American adults do not have proficient health literacy skillsneeded to make important individual and family health choices.
Source: National Center for Education Statistics (2006). The Health Literacy of America’s Adults: Results from the 2003 National AssessmentOf Adult Literacy. Washington, DC: U.S. Department of Education.
MINNESOTA DEPARTMENT OF HEALTH
Risk Factors for Low Health Literacy
• Older adults (65+ years)
• Limited English Proficiency (LEP)
• Socioeconomically disadvantaged• Lower educational attainment• Lower income level• Higher percent minorities• Medicare/Medicaid recipients or uninsured
• Chronic and severe health conditions
MINNESOTA DEPARTMENT OF HEALTH
Health Literacy: A Social Determinant of Health
• “Adults with limited health literacy have less knowledge of disease management, report poorer health status, and are less likely to seek preventative care.” (IOM, 2004)
• “Low health literacy costs the U.S. healthcare industry $73 billion per year in misdirected or misunderstood healthcare services (Vernon, 2009; Friedland, 1998; Howard, 2005)
• Public health has ethical and legal obligation to promote health literacy (Gazmararian et al. 2005)
MINNESOTA DEPARTMENT OF HEALTH
2013 CHP Health Literacy Workshop
Purpose: Create a public health workforce at MDH fluent in health literacy principles and best practices.
MINNESOTA DEPARTMENT OF HEALTH
Methodology
• Conducted comprehensive literature review• Developed workshop learning objectives and content• Arranged guest speakers, facilitators and panelists• Arranged workshop venue and catering service• Advertisements and invitations sent via MDH
Intranet and MS Outlook Calendars • Assessed participant learning needs for break-out
group activity: CDC Training Module and Simply Put Checklist
• Created Participant Workshop and Resources Packet
MINNESOTA DEPARTMENT OF HEALTH
Resources
Participants received•Welcome letter•Agenda•Learning objectives•Speaker bios•Presentation slides•Directory of resources •MDH Communication policies/resources•Panel questions•Copies of pre-workshop assignment
MINNESOTA DEPARTMENT OF HEALTH
Agenda
• Health literacy overview• Using health behavior theory to target, design,
and evaluate health messages • Implementing health literacy in a state public
health department • Video Screening: Say It Visually! • Break-out group activity• Panel Discussion: communicating with a diverse
audience • Wrap-up
MINNESOTA DEPARTMENT OF HEALTH
Evaluation Results (51 of 85 attendees)
MINNESOTA DEPARTMENT OF HEALTH
Lessons Learned
1. Health literacy curriculum for health departments needs to include application of health literacy and numeracy principles and best practices.
2. Curriculum should also include related topics such as health equity and SDH, health behavior and marketing models, risk communication, and cultural competency.
3. Emphasize data collection on target audience, including demographic data, focus groups and work on previous programs.
MINNESOTA DEPARTMENT OF HEALTH
Lessons Learned (Contin…)
4. Utilizing internal and external resources (e.g. graphic designer, marketing consultants, website developer, communications department and community partners.5. Use of education design specialists, to apply adult learning theory to the curriculum.6. Evaluate curriculum.
MINNESOTA DEPARTMENT OF HEALTH
What State Health Departments Can Do
1. Identify leadership and staff with interest2. Become local experts in health literacy 3. Build and strengthen relationships with internal
and external partners4. Conduct an agency health literacy assessment 5. Create an agency health literacy plan6. Identify health literacy resources and guides for
staff7. Provide opportunities for staff to be trained in
health literacy principals and best practices8. Build health literacy into staff competencies and
performance measures9. Evaluation
MINNESOTA DEPARTMENT OF HEALTH
Acknowledgements
Directors of Health Promotion & Education•Steve Owens, Director of Health Equity•Karen Thompkins, Internship & Fellowship Manager•Liz Traore, Evaluation & Epidemiology Manager•Cheryl Welbeck, Executive AssistantMinnesota Department of Health•Mary Manning, Promotion & Chronic Disease (HPCD) Director•Jose Gonzalez, Office of Minority & Multicultural Health (OMMH) Director•Jim Peacock, Epidemiologist Senior Heart Disease & Stroke PreventionCenter for Health Promotion Leadership•Don Bishop, Director•Charity Kreider, Oral Health Program Coordinator•Mark Kinde, Injury & Violence Prevention Supervisor•Stan Shanedling, Heart Disease & Stroke Prevention Supervisor•Gretchen Taylor, Diabetes Program Supervisor•Merry Jo Thoele, Oral Health Program Supervisor
MINNESOTA DEPARTMENT OF HEALTH
Questions
MINNESOTA DEPARTMENT OF HEALTH
Genelle [email protected]@umn.edu
Charity [email protected]
www.health.state.mn.us/divs/hpcd/chp/
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