Return-Path: <nifl-health@literacy.nifl.gov> Received: from literacy (localhost [127.0.0.1]) by literacy.nifl.gov (8.10.2/8.10.2) with SMTP id h8PE43V10848; Thu, 25 Sep 2003 10:04:03 -0400 (EDT) Date: Thu, 25 Sep 2003 10:04:03 -0400 (EDT) Message-Id: <001101c3836d$5b61dd00$99b05b82@DB7MY> Errors-To: listowner@literacy.nifl.gov Reply-To: nifl-health@literacy.nifl.gov Originator: nifl-health@literacy.nifl.gov Sender: nifl-health@literacy.nifl.gov Precedence: bulk From: "Ian Bennett" <ibennett@mail.med.upenn.edu> To: Multiple recipients of list <nifl-health@literacy.nifl.gov> Subject: [NIFL-HEALTH:4158] RE: "Health literacy" out X-Listprocessor-Version: 6.0c -- ListProcessor by Anastasios Kotsikonas X-Mailer: Microsoft Outlook, Build 10.0.2627 Content-Transfer-Encoding: 7bit Content-Type: text/plain; Status: O Content-Length: 5146 Lines: 134 I think so. I don't think the REALM, just because it uses "health" words is necessarily measuring a different domain than literacy measures. I think the WRAT-R and SORT correlations are consistent with that. Health literacy is a multi-domain concept that usually includes reading ability (depending on who is defining it) along with health-navigation, physician-patient communication, and others. The 20 minute TOFHLA was designed to get at some more of this but not all and it also was "validated" against the literacy instruments. The new NAAL apparently attempts to get at this more and it may become the new gold standard that we will be able to use to measure this construct. Ian M. Bennett, M.D., Ph.D. Department of Family Practice and Community Medicine University of Pennsylvania -----Original Message----- From: nifl-health@nifl.gov [mailto:nifl-health@nifl.gov] On Behalf Of shalini.forbis@wright.edu Sent: Wednesday, September 24, 2003 10:24 AM To: Multiple recipients of list Subject: [NIFL-HEALTH:4152] RE: "Health literacy" out This is an interesting discussion. I have always assumed that there is a strong correlation between health literacy and literacy. this is based on the fact that the REALM has been shown to strongly correlate (0.8 or higher) with other tests of reading ability, such as the WRAT-R or the SORT. Is this a correct assumption? Sincerely, Shalini >===== Original Message From nifl-health@nifl.gov ===== >Hiya Audrey, >Points well taken. >I do think we should be clear though that I am not aware of any evidence >that an adult with good reading skills (as measured by literacy instruments >including the REALM and TOFHLA) but have some difficulties with issues in >the health literacy domains have negative health outcomes or cost the >health system anything (maybe it does but we just don't have any data on >this). When we talk about the data that health literacy and health outcomes >are linked we are actually talking about literacy and health outcomes. >That is not to say that we should get doctors to speak more clearly, we >should, and it will benefit everyone. >Ian > >Greetings, Ian and other "listers": > >I read your post about the term "clear health communication" with >interest. I attended the Pfizer Health Literacy conference in DC last week, >too, and, personally, I was glad to see the new term in use. My colleagues >in the Clear Language Group and I have been working with Pfizer on its >health literacy initiative since its inception 6 or 7 years ago. We have >talked quite a bit with Pfizer about our concerns that the focus on people >with low literacy skills was too narrow. I am glad to see the new term >coming into wider use. > >I came into my health literacy work from the adult literacy field (I've >worked at the local, state and national level). I am VERY aware of the huge >challenges these people face and I don't want to dilute the attention given >to them. At the same time, I felt that framing the problem as mainly a >"literacy" issue rather than a lack of plain language usage by health care >professionals was problematic. I always felt that focusing on people with >limited overall literacy skills put the responsibility for lack of >communication at their feet. It laid too much blame on them, especially >when we talked about how much low HEALTH literacy costs the medical system. >Instead we need to put more of the responsibility for communication on to >health care providers. I also think that if we are talking to health care >providers about 20% of US adults, it's harder to get their attention. They >can more easily dismiss the information by saying, "I don't have any of >those people in my practice." Whereas framing the issue in a larger context >can help those providers understand the serious scope of the problem. > >I think we must continue to speak out about the challenges people with low >overall literacy face, the impact of low literacy skills on their health, >etc. I don't believe they will get lost in the transition. I think >widening the focus may even help them more than the current view. I like >reframing the issue in the new way because it helps health care providers >and people who develop print materials understand the responsibility which >is rightly theirs in the communication process. It' s not just about people >who struggle to read. It's about how difficult it is for ALL of us to >understand and use health information when it's presented in such a way >that the general public can't make sense of it. > >I look forward to hearing others' perspectives on this issue. > >Audrey Riffenburgh, M.A. >President, Riffenburgh & Associates >P.O. Box 6670, Albuquerque, NM 87197-6670 >Phone: (505) 345-1107 Fax: (505) 345-1104 >E-mail: ar@plainlanguageworks.com >Specialists in Plain Language & Health Literacy since 1994 >============================================= >Principal & Founding Member, The Clear Language Group www.clearlanguagegroup.com Shalini Forbis, MD Assistant Professor, General and Community Pediatrics One Children's Plaza Dayton OH 45404-1815 (937)641-3277 shalini.forbis@wright.edu
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