Improve Health Literacy Skills

OVERVIEW

It is important that everyone is able to obtain, process, and understand basic health information. This information may then be used to make appropriate and necessary health decisions. Ideally, teens and young adults have at least one parent or other family member to assist with health literacy. But, sometimes, teens and young adults must travel this route by themselves or with the assistance of a nonadult friend. While maintaining a healthy lifestyle may not be easy for many teens and young adults, those who have better health literacy skills may find the process a little easier.

Health literacy requires some degree of mathematical skills. These are needed to calculate such figures as cholesterol and blood sugar levels, measure medications, and understand nutrition labels. Mathematical skills also help with calculating premiums and determining amounts of copays and deductibles. On the other hand, analytical skills may be used to select a health plan or compare prescription drug coverage. 1

People with limited health literacy skills have an increased risk of making health care mistakes. To make better health care decisions, it is important to take steps to improve one’s health literacy.

WHAT THE EXPERTS SAY

Curriculums May Be Designed to Improve Health Literacy

In an article published in 2016 in the journal Health Education & Behavior, researchers from Boston and Somerville, Massachusetts, wanted to learn more about how a biology curriculum that focused on infectious diseases improved health literacy. The curriculum was implemented between 2010 and 2013 in elective Biology II classes in three public high schools in Massachusetts, one public high school in Ohio, and a private school in Virginia. The 273 student participants were compared to an age-matched nonparticipant peer group of 125 students from the same schools. The participants in each of the school settings demonstrated increases in conceptual content knowledge and an improved ability to apply scientific principles to health claim evaluation and risk assessment. In addition, the school participants had greater knowledge about infectious diseases, and they shared their information with their social networks. As a result of their findings, the researchers suggested that high school biology classes were a “viable setting” to foster health literacy skills to diverse populations, and these classes “should be used more extensively.” 2

It Is Important to Use Credible Online Health Sources 3

Low Health Literacy Is Associated with Poorer Health Outcomes

In a systematic review published in 2011 in the journal Annals of Internal Medicine, researchers based in Durham, North Carolina, examined research articles on the association between low health literacy and health outcomes. After identifying close to 4,000 studies published from 2003 to May 2010, the researchers selected 96 studies in 111 articles, which they rated as having good or fair quality. The researchers found that low health literacy was consistently associated with more hospitalization, greater use of emergency care, lower use of mammography screening, lower use of influenza vaccine, poorer compliance with medications, less ability to understand labels and messages, and, among the elderly, poorer health status and higher mortality. The researchers concluded that “low health literacy is associated with poorer health outcomes and poorer use of health care services.” 4

Teens from Less Advantaged Environments May Improve Their Health Literacy 5

BARRIERS AND PROBLEMS

Everyone Does Not Have Sufficient Health Literacy. Health Materials Need to Be Designed to Direct Readers to the Most Important Information

In a study published in 2013 in the Journal of Health Communication, researchers from Texas and Arizona wanted to learn more about how people with different levels of health literacy visualize health related information. The researchers recruited 25 university administrative staff members, whom they assumed would have adequate health literacy skills, and 25 adults enrolled in an adult literacy program, whom they assumed would have limited health literacy skills. During the trial, each subject participated in a health literacy assessment that involved answering questions about an ice cream nutrition label while viewing the label. Two of the questions involved finding information and four required numerical calculations. The researchers found that the subjects with less health literacy spent more time looking at information that was not relevant to the question asked. In fact, those with lower levels of health literacy looked at one spot, even if it was irrelevant, for longer amounts of time than those with high levels of health literacy. As a result of their findings the researchers concluded that health information for patients “should be designed to help them better distinguish important from unimportant information.” 6

Teens with Low Levels of Health Literacy Appear to Have Fewer Healthful Nutritional Behaviors 7

Nurses Tend to Overestimate the Health Literacy of Their Patients

In a trial published in 2013 in the Journal of Health Communication, researchers from Chicago noted that it is very important for nurses to be aware of their patients’ level of health literacy. It is “integral to patient care, safety, education, and counseling.” The researchers wanted to learn if inpatient nurses were properly assessing levels of health literacy. The cohort consisted of 65 patients and 30 nurses from two inpatient cardiac units; the study was conducted over a six-month period of time. The patients were primarily female African Americans who had heart failure as their diagnosis. The researchers found that the nurses incorrectly identified patients with low health literacy. Overestimates outnumbered underestimates by six to one. The researchers commented that “the overestimation of a patient’s health literacy by nursing personnel may contribute to the widespread problem of poor health outcomes and hospital readmission rates.” Apparently, there is a need for providing nurses with more training in health literacy. Unfortunately, “while some nursing schools now include HL [health literacy] education in their curriculum, most nurses do not receive this education.” 8

NOTES

1. U.S. Department of Health and Human Services, http://health.gov.

2. Jacque Berri, Susan Koch-Weser, Russell Faux, and Karina Meiri, “Addressing Health Literacy Challenges with a Cutting-Edge Infectious Disease Curriculum for the High School Biology Classroom.” Health Education & Behavior 43 (2016): 43-53.

3. Suad F. Ghaddar, Melissa A. Valerio, Carolyn M. Garcia, and Lucy Hansen, “Adolescent Health Literacy: The Importance of Credible Sources for Online Health Information,” Journal of School Health 82 (2012): 28-36.

4. Nancy D. Berkman, Stacey L. Sheridan, Katrina E. Donahue et al., “Low Health Literacy and Health Outcomes: An Updated Systematic Review.” Annals of Internal Medicine 155 (2011): 97-107.

5. Alla Keselman, Einas A. Ahmed, Deborah C. Williamson et al., “Harnessing Health Information to Foster Disadvantaged Teens’ Community Engagement, Leadership Skills, and Career Plans: A Qualitative Evaluation of the Teen Health Leadership Program,” Journal of the Medical Library Association 103, no. 2 (2015): 82-86.

6. Michael Mackert, Sara E. Champlin, Keryn E. Pasch, and Barry D. Weiss, “Understanding Health Literacy Measurement Through Eye Tracking,” Journal of Health Communication18 (2013): 185-96.

7. Li-Chun Chang, “Health Literacy, Self-Reported Status and Health Promoting Behaviours for Adolescents in Taiwan,” Journal of Clinical Nursing 20 (2010): 190-96.

8. Carolyn Dickens, Bruce L. Lambert, Terese Cromwell, and Mariann R. Piano, “Nurse Overestimation of Patients’ Health Literacy,” Journal of Health Communication 18, Supplement (2013): 62-69.

REFERENCES AND RESOURCES

Magazines, Journals, and Newspapers

Berkman, Nancy D., Stacey L. Sheridan, Katrina E. Donahue et al. “Low Health Literacy and Health Outcomes: An Updated Systematic Review.” Annals of Internal Medicine 155 (2011): 97-107.

Chang, Li-Chun. “Health Literacy, Self-Reported Status and Health Promoting Behaviours for Adolescents in Taiwan.” Journal of Clinical Nursing 20 (2010): 190-96.

Dickens, Carolyn, Bruce L. Lambert, Terese Cromwell, and Mariann R. Piano. “Nurse Overestimation of Patients’ Health Literacy.” Journal of Health Communication 18, Supplement 1 (2013): 62-69.

Ghaddar, Suad F., Melissa A. Valerio, Carolyn M. Garcia, and Lucy Hansen. “Adolescent Health Literacy: The Importance of Credible Sources for Online Health Information.” Journal of School Health 82, no. 1 (2012): 28-36.

Jacque, Berri, Susan Koch-Weser, Russell Faux, and Karina Meiri. “Addressing Health Literacy Challenges with a Cutting-Edge Infectious Disease Curriculum for the High School Biology Classroom.” Health Education & Behavior 43 (2016): 43-53.

Keselman, Alla, Einas A. Ahmed, Deborah C. Williamson et al. “Harnessing Health Information to Foster Disadvantaged Teens’ Community Engagement, Leadership Skills, and Career Plans: A Qualitative Evaluation of the Teen Health Leadership Program.” Journal of the Medical Library Association 103, no. 2 (2015): 82-86.

Mackert, Michael, Sara E. Champlin, Keryn E. Pasch, and Barry D. Weiss. “Understanding Health Literacy Measurement Through Eye Tracking.” Journal of Health Communication 18 (2013): 185-96.

Morrison, Andrea, Ruben Chanmugathas, Marilyn M. Schapira et al. “Caregiver Low Health Literacy and Non-Urgent Use of the Pediatric Emergency Department for Febrile Illness.” Academic Pediatrics 14, no. 5 (2014): 505-9.

Stewart, Diana W., Claire E. Adams, Miguel A. Cano et al. “Associations Between Health Literacy and Established Predictors of Smoking Cessation.” American Journal of Public Health 103, no. 7 (2013): e43-e49.

Ye, Xiao-Hua, Yi Yang, Yan-Hui Gao et al. “Status and Determinants of Health Literacy Among Adolescents in Guangdong, China.” Asian Pacific Journal of Cancer Prevention 15, no. 20 (2014): 8735-40.

Web Site

U.S. Department of Health and Human Services. http://health.gov .

  This information is not a tool for self-diagnosis or a substitute for professional care.