It’s probably appropriate that right on the heels of the e-Patient Connections 2010 conference that we enter health literacy month. If the conference, and the e-patient movement more generally, point to a population of active and engaged patients, health literacy month reminds us that there’s much to be done when it comes to creating effective physician-patient partnerships and helping patients take charge of their own wellness and health care decisions.
As stated (or restated) by the US Department of Health and Human Services (HHS) (2010), “‘health literacy’ is a person’s capacity to find, understand, and use basic health information and services needed to make appropriate health decisions.”
As noted in a previous post, health literacy and overall literacy are not the same thing. The Institute of Medicine (IOM) has pointed out that even highly skilled individuals will find it challenging to grasp complex health information when made vulnerable by poor health (Nielsen-Bohlman, Panzer, & Kindig, 2005). As reported by the American Medical Association (AMA), poor health literacy has a significant impact on health care outcomes as poor health literacy is “a stronger predictor of a person’s health than age, income, employment status, education level, and race” (AMA, 1999).
Six steps for creating patient-friendly communications
When creating materials to support health education, it’s worth remember the AMA’s six steps for improving doctor-patient communications (AMA, 2003):
- Slow down, slow down, slow down
- Use plain, nonmedical language
- Show or draw pictures
- Limit the amount of information provided and repeat it
- Use the teach-back method or show-me technique
- Create a shame-free environment
How this translates to online learning
In the elearning world, “slow down” can translate to chunking information into short bits, and using scaffolding techniques. “Teach back” can be mediated via interactive scenarios, metacognition exercises (e.g., asking learners to summarize the main points of what they’ve learned), and problem-based learning opportunities with feedback. Creating a shame-free environment online can be aided by not making assumptions about the tech savvy-ness of learners and providing action-oriented resources as discussed further below.
A nice review of considerations for creating health information web sites is presented in this Slideshare from the HHS (2010).
To summarize the information in this Slideshare, even learners with poor health literacy have some degree of “empowerment” in the sense they generally:
- Are interested and willing to access online health information
- Can achieve health learning goals if a Web site is designed appropriately
Since “success” in creating online learning materials may be very dependent on design, let’s consider this next.
Web site design considerations
As instructional designers and/or as activists in the health care field, we’re generally comfortable with technology and the people we often collaborate with are similarly “connected.” This is a great boon but it can lead to designer blindness. The HHS (2010) has pointed out some issues regarding Web design that may surprise you or be worth revisiting.
In other words:
- Display content clearly on the page
- Organize content and simplify navigation
- Engage users with interactive content
- Make the content action-oriented
Most importantly, evaluate and revise your site throughout the design and development process and make your learners a pivotal part of this process, not just your clients.
For more resources and information on ways to improve health literacy, please feel free to dip into the resources provided here in this open Diigo Group. Consider joining the group and sharing your own resources. (If you’d like more information about using Diigo, read this post.)
U.S. Department of Health and Human Services, Office of Disease and Health Promotion (2010). Health literacy online: A guide to writing and designing easy-to-use health Web sites. Washington, DC: Author, Retrieved from http://www.slideshare.net/blueeyepathrec/health-literacy-online-a-guide-to-writing-and-designing-easytouse-health-web-sites
American Medical Association. (1999). Report on the Council of Scientific Affairs, Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs. Journal of the American Medical Association, 281(6), 552-7.
American Medical Association Foundation and American Medical Association. Health Literacy: A Manual for Clinicians. Chicago: AMA Foundation and AMA; (2003) Retrieved from http://www.ama-assn.org/ama1/pub/upload/mm/367/healthlitclinicians.pdf (PDF – 60 pages)
Health Literacy: A Prescription to End Confusion. Nielsen-Bohlman L, Panzer AM, Kindig DA, eds. Washington, DC: The National Academies Press. Available at: http:books.nap.edu/catalog/10883.html. Accessed June 19, 2010.