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From: "Robert Dickerson" <DICKERR2@ihs.org>
To: Multiple recipients of list <nifl-health@literacy.nifl.gov>
Subject: [NIFL-HEALTH:4550] RE: Iowa Health and Literacy Conference
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Thank you Archie for taking the time to put together this summary of the
New Readers of Iowa Coalition "Health and Literacy Working Together"
Conference.
I had the opportunity to participate in the first day of the conference
as a health care provider. This was truly a unique experience. I have
been a respiratory therapist for over 20 years treating and educating
patients with lung disease. During that time I thought I learned a great
deal about patient education and patient understanding of health
information. Participating on the health professional panel and
interacting with attendees gave me a whole new perspective on the issues
surrounding literacy and health literacy.
I hope this can be held up as a model for other states. More health care
professionals need to become engaged and understand the issues of
literacy and health literacy. We can read about it in articles and
reports but it is not until we participate in experiences such as this
conference offered do we more fully understand it. Hearing directly from
people who are new readers, about the experiences and difficulties they
have had with the health care system and how we communicate (or rather
don't communicate effectively), was very revealing. It provided a forum
for new readers to safely and respectfully express their health literacy
concerns to health care providers. It provided an opportunity to let
people know that they can hold their health care providers accountable
for communicating clearly using plain language. It fostered a greater
understanding of the issues and problems people have with health
literacy.
Health literacy is something we (health care professionals, new readers
and all laypeople) need to work on together to help narrow the
communication chasm. Conferences like this help establish the grounds
for productive interaction, understanding and ultimately improved
communication.
Bob Dickerson, MSHSA, RRT
Clinical Resource Coordinator, Clinical Quality
Iowa Health - Des Moines
Des Moines, Iowa
Phone: (515) 263-5792
Fax: (515) 263-5415
E-mail: DICKERR2@ihs.org
Website: www.ihsdesmoines.org
-----Original Message-----
From: nifl-health@nifl.gov [mailto:nifl-health@nifl.gov] On Behalf Of
Archie Willard
Sent: Thursday, September 23, 2004 10:59 PM
To: Multiple recipients of list
Subject: [NIFL-HEALTH:4545] Iowa Health and Literacy Conference
The New Readers of Iowa's "Health and Literacy Working Together"
Conference is over. I don't think there has ever been a state new
readers conference like this one before. This health and literacy
conference could be held up as a model to be used by other states. In
the past someone with higher education has spoken for the adult
learners. They have talked with us, asked us questions, and have written
reports about us. They have gone to Congress and other groups to give
their opinions on what they think it's like for those of us with reading
problems. At this conference the adult learners spoke for themselves,
and people listened to and learned about our point of view of health
care. In Iowa after fifteen consecutive years of adult learner
conferences, we have developed leadership and we have a group of good
adult leaders within our state who will speak out.
People from ten different states attended this conference. That makes
the voice of this conference a lot stronger. People with literacy
problems, educators, people from the medical field and others were
there. If anyone takes a good look at what happened at this conference,
it could be the spark that makes things come about to build better
communications in health care.
There was a panel of health professionals from the Iowa Health System
with each person speaking from his/her own perspective. The message from
all of them to us was to not give up on ourselves and for us, the adult
learners, to tell the people in the medical field about our reading
problems. They will then understand and help us. They encouraged us to
ask more questions and to take more responsibility for our own health
care. They also told us about how they have to struggle to provide good
health care when they aren't made aware of our poor literacy skills. We
all left the conference with a better understanding of each other.
The adult learners looked at forms that the Iowa Health System uses. We
told them about the things we didn't understand about the forms as well
as pointing out the good things. The feedback about our work that I have
received from the Iowa Health System has been very positive.
At the end of the first day people were able to talk about their
medications with one of a group of pharmacists provided by Drake
University School of Pharmacy. Being able to do this was a big hit with
the adult learners. Some of them said they had been taking their
medications wrong and were very pleased to receive this new information.
The most important thing the adult learners did was to make some
comments and a statement concerning how we feel about health literacy.
This statement will always be out there for people to see and it belongs
to the adult learners who were at the Iowa Conference. You can read this
statement a little further below.
A lot of good things happened at this conference - in fact there were
too many to mention all of them. You just had to be there to take them
all in. A lot of good people and organizations came to help and even
some people who came on their own were there to help make this
conference a success. I don't know how to start to say thanks, but I do
want to say, Thank you so much!!" to you all.
The Institute of Medicine (IOM) in their Health Literacy Executive
Summary, "A Prescription to End Confusion," reports problems in health
care today because of poor literacy and communication skills in this
country. At the Iowa Health and Literacy Working Together Conference
many of these issues were brought to the surface.
My thinking about what has happened and what should come next after this
conference:
Adult learners were there to help the AMA make their video, "Health
Literacy - Help Your Patients Understand", and some of the adult
learners who were at the Iowa Conference were also in this video. This
video could not have been possible without the help of the adult
learners. The video has reached and brought awareness to thousands of
doctors all over the country and it is still reaching more. Now The New
Readers of Iowa have a model health literacy conference to work from.
The next step should be a health literacy summit where adult learners
who have experience in health literacy meet face to face with the
medical field to build better communications.
Archie Willard
Adult Learner
The Information below was compiled at the Iowa Health and Literacy
conference by Maricel G. Santos and Lisa Soricone from the Harvard
School of Public Health.
What the adult learners generated
Part I. Challenges and barriers. In groups, the learners examined the
picture prompts and then discussed the following questions:
1. What common problems related to these activities do you notice?
2. What kinds of things should adult learners do to try and overcome
these difficulties?
3. What kinds of things do you think doctors and nurses should do to
make things easier for adult learners?
4. What kinds of things do you think adult educators should teach so
that adult learners are better prepared to handle these difficulties?
Here is a summary of their responses.
Message to medical professionals
Make instructions more readable
Bigger print on read-outs, ranges
Make steps clearer
Explain what is 'high' /'low' - the range Make sure prescription is
filled correctly Tell us when pill colors change Keep pharmacy informed
about prescriptions (like when my medications change) Doctors should
write clearly What is the reading level of prescription labels?
Explain medications when prescribing
What is it? What's it for? How to take or use it?
Treat us with respect - don't be in a hurry, and we'll treat you with
respect Use more picture symbols in instructions Information about drugs
- reactions, instructions Clearer information about side effects
Simplify instructions - explain or read Don't assume that patients
understand and can read Don't feel sorry for us.
We won't take 'no' for an answer
Print info in other languages
Message to adult educators
Be aware of students who have illnesses
Take the time to help with students' questions Better explanations from
teachers and doctors Looks may be deceiving Learn that we won't take
'no' for an answer
Message to adult learners
Tell your teacher that you have a condition/disease Ask teacher for help
Know your medical conditions (reactions, history, allergies) Repeat what
the doctors say "What I heard you say was..."
Open up prescription at store
Don't focus on "I can't read." Instead, say "I don't understand the
label."
Part II. Drafting the literacy statement. The adult learners worked in
groups to craft a statement which captured what they wanted to say about
health and literacy. This message will be sent out to people who work in
the medical field. The adult learners were asked, What do you want to
tell doctors, nurses, and other health professionals about adult
learners like yourselves? Here is a summary of their statements:
Draft Statements
1. Slow down, take your time, be responsible to me as a patient.
2. Make sure patients understand about their meds and their treatment
before they leave the office.
3. We want you to try and understand us more.
4. You respect us and we'll respect you.
5. Once you find out we have reading problems, you should do follow ups.
6. Ask us questions to make sure we understand about our health care.
7. We have always been here. We've always been the backbone of this
country. We need help from doctors now. We need the best explanations
about tests, procedures, and prescriptions. We are human beings that
need to be understood. We need help to help ourselves and our families.
It's about human respect. Yes, we lack skills. But we are not less than.
8. Speak clearly.
9. Wash hands before treating us.
10. Explain side effects so we can understand.
11. Talk to us about prescriptions so we understand them.
12. Don't be in a hurry.
13. What you learn today will last you a lifetime.
14. Treat your patients like you would like to be treated.
15. Explain in different ways (pictures, video, etc.) how to take
medications, use tools.
The final statement (the group voted and decided on the following)
Statement #1
We have always been here. We've always been the backbone of this
country. We need help from doctors now. We need the best explanations
about tests, procedures, and prescriptions and their side effects. We
want to tell doctors, "We need help to help ourselves and our families.
Slow down and take your time. Treat us as you would like to be treated.
Simplify your work so that it can be cost-efficient for both patients
and doctors. Once you find out we have reading problems, you should do
follow ups."
We are human beings that need to be understood. Make sure that we
understand. It's about human respect. Yes, we lack a skill. But we're
not less than.
Statement #2
A doctor's office is no place for a reading test.
What the teachers and health professionals generated
Teachers were asked the following questions:
1. How does the photo remind you of your own experiences in carrying out
similar activities?
2. What kinds of challenges might this kind of activity pose to your
students?
3. What do these challenges suggest for your teaching, in terms of:
a) Skills to focus on
b) Lesson ideas for teaching those skills in a health context
Here is a summary of their responses:
Challenges
Reading
Terminology
Fixed income
Medicines, heat, food
Time
Numeracy - percents
Abbreviations
Manual skills
Being able to read forms
Language barriers
Apprehension/fear of forms and asking questions
Mobility
Understanding communication
Ability to ask questions
Skills
Improve speaking skills
Being able to teach back
Listening skills
Assertiveness - ask for help
Math
Organization
Reading/writing skills
Learning healthcare vocabulary
Manual skills
Healthy life styles
Lesson ideas for teaching
Units on healthy eating
Calculator use
Demonstrate pill sorter
List of medicines to carry with them - allergies, surgical procedures,
health history
Medical history forms - to practice on
Insurance forms - and practice terminology
Publicize availability of med cards
Demonstration of instruments
Sight word recognition
Health care provider to come in
Log book to record eating time and blood sugar
ClearHealth.com
--
Archie Willard
URL - http://www.readiowa.org/archiew.html
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