[NIFL-HEALTH:3421] Literacy testing in a health care setting

From: Plnenglish@aol.com
Date: Wed Oct 24 2001 - 17:16:57 EDT


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Subject: [NIFL-HEALTH:3421] Literacy testing in a health care setting
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Greetings, listers, 

The trend to test patients' literacy skills that Archie Willard brought up is 
an interesting one. After years of working in adult literacy and seeing how 
intimidating testing can be, I believe, like Ursula Parker, that this is a 
destructive practice. Thankfully, it is only embraced by a small number of 
health care providers. I believe it began because the Joint Commission on 
Accreditation of Healthcare Organizations added some guidelines to their 
patient and family education standards a few years ago. The standards require 
healthcare organizations to "take literacy levels into account." Some people 
thought that meant you had to test patients to determine their reading 
ability. I consulted the JCAHO standards department about this. They 
confirmed that testing is NOT required, and in fact, is not desirable. 

Another source of this practice, I believe, is the development of some 
specific tests for literacy in health care settings. These tests are quite 
effective, have good correlations with other tests, and are fine for use in 
research settings. However, for many reasons already cited by others, these 
tests are not appropriate for use in a general medical setting. Testing is a 
sure way to alienate many of your patients, no matter their reading 
abilities. 

Moreover, we don't need to test patients' literacy skills. For over 20 years, 
studies have shown that the majority of health care materials are not 
understandable to the majority of the public. And in today's more complicated 
health care environment, patients are expected to know and understand far 
more than ever before. 

The answer is to make all communication between health care providers and 
patients clear and easy-to-understand. We all need this kind of help. Let's 
be clear that low health literacy is not specific only to those people who 
have low overall literacy skills. 

Audrey Riffenburgh, MA
President, Riffenburgh and Associates
Specialists in Plain Language and Health Literacy since 1994
1606 Central SE Suite 201
Albuquerque, NM  87106    USA 
Phone: 505-242-5808  Fax: 505-246-9164  
E-mail: plnenglish@aol.com 

"An eye for an eye makes the whole world blind."  Ghandi



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