Daniel- I have read your article –repeatedly. It is excellent work. I am so
glad you posted this. Everyone, read it!

 

I am working on an NIH grant that applies your theory of social support
through home visitation and evaluates its role in promoting maternal
functional health literacy. We are analyzing comparable data from 9 sites
around the country in 6+ program models. We re measuring the function in
functional health literacy and progress over time, using the Life Skills
Progression instrument. The project runs through 2008. SS

 

Sandra Smith, MPH CHES

800-444-8806  206 -441-7046

www.BeginningsGuides.net

sandras at u.washington.edu

 

  _____  

From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Shoou-Yih Daniel Lee,
Ph.D.
Sent: Friday, February 02, 2007 5:30 AM
To: The Health and Literacy Discussion List
Subject: [HealthLiteracy 621] Re: question on patientcommunication skills
trainings

 

On the note of treating low health literacy as an individual deficiency and
of ignoring important aspects of the social environment--e.g., social
support and resources, check out a paper in the Social Science & Medicine.
An electronic copy is attached.

Daniel Lee

Sandra Smith wrote: 

Yes! Excellent observation, Andrew.  There is an urgent need to take
understanding of health literacy beyond the medical model which frames low
health literacy as a deficiency disease, measures it as a single
individualistic trait (reading skill) unrelated to social support or
resources,  and prescribes improved information delivery as the cure.
Certainly improved information delivery is important, but it is not likely
to fully mitigate individual and systemic problems related to low literacy
and low health literacy. We need new channels, in addition to healthcare
providers, to promote functional health literacy. One possibility is the
existing national network of home visitation programs, which send nurses and
trained paraprofessionals into the homes of disadvantaged families during
pregnancy and early parenting, a time when readiness to learn is high and
young women are accessing significant health services, often for the first
time, and becoming health decision makers for their growing families. These
home visitors already provide social services and links to resources (often
including literacy enhancing services) and likely promote functional health
literacy without being aware of it. They are well-positioned to empower
clients to make measurable strides toward higher functioning in the
heathcare system and in health contexts at home.  This strategy is limited
to maternal and child health, yet it is highly leveraged since skills
learned during pregnancy and early parenting could improve functioning for
all family members throughout their lives. If we look beyond our own walls,
we are likely to discover similar solutions. SS
 
Sandra Smith, MPH CHES
Health Education Specialist & Principal Investigator
University of WA Center for Health Education & Reseasch
800-444-8806  206 -441-7046
www.BeginningsGuides.net
sandras at u.washington.edu
 
 
-----Original Message-----
From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Andrew Pleasant
Sent: Thursday, February 01, 2007 12:14 PM
To: The Health and Literacy Discussion List
Subject: [HealthLiteracy 614] Re: question on patientcommunication skills
trainings
 
Hi everyone,
 
Isn't this sadly not uncommon story from Ruth 
Davis one of the best reasons to expand the 
field's foci beyond doctor/patient interaction? 
That is a relatively (for most peole) small 
amount of time each year compared to the much 
greater percentage of time that individuals 
interact with information about health, use their 
literacy skills, and make decisions about their 
health.
 
That is not to say do not address doctor/ patient 
interactions but isn't the most effective time to 
equip people with health literacy skills to 
enhance their personal empowerment  to defend 
their right to health and health care before they 
encounter such a physician?
 
Don't these observations also further demonstrate 
that health literacy is much more than the 
ability to pronounce medical words, fill in the 
vocabulary blanks, or (thanks Andres) is 
something that only patients and the public lack? 
For instance, briefly, that scenario is not only 
about writing down health information 
(fundamental health literacy), it is also about 
the components of health literacy related to 
culture (role of physicians in society) and civic 
literacy (navigating systems) and the scientific 
component of health literacy (understanding 
uncertainty and/ or knowledge uptake gaps as it 
relates to utility of second opinions - for 
example). What if, let us hope not, that 
physician also has not kept up with best medical 
practices (as is clearly the case regarding 
communication skills)?
 
Regarding strategies at the larger scale, the 
final path to embed health literacy skills into 
medical education is not only through individual 
grand rounds given or CMEs issued but by putting 
health literacy into medical education and 
hospital accreditation standards as well as 
payment schemes. These are challenging tasks and 
require a bit of a paradigm change in approaches 
to health, health policy and systems, and health 
literacy. Challenging does not mean impossible or 
infeasible.
 
In order to reach those goals, I suggest the 
field must first develop and agree on a 
comprehensive definition and model/framework of 
health literacy grounded in the entire range of 
contexts in which people interact with health 
information and make decisions about health. That 
model must be able to support both the 
development of curriculum for physicians and 
nurses in training as well as a very robust 
assessment tool. On this issue ... this is where 
I have to stop because our article outlining that 
is not yet published.
 
Additionally and importantly, such a broader 
approach could/should also facilitate greater 
interaction between the health system and the 
educational system (esp. ABE/ESOL) writ large.
 
 
Andrew Pleasant
 
 
 
 
 
 
 
  

We have been promoting the use of Ask Me 3 
locally for about 2 years now and it is 
difficult to determine how often it or similar 
efforts are used by the consumers. I was 
presenting the Ask Me 3 information at a local 
university's senior scholars program last week 
when a couple of group participants shared the 
following stories.
 
  During an office visit with a physician, 
a woman stated she had started writing down 
information the  physician was sharing 
with her that she wanted to remember when she 
left the office. He inquired as to      what she 
was writing in her notebook. When she shared 
back with him, she said he told her to put her 
  notebook away and that he would take care 
of her and there was no need for her to be 
writing anything down. She also conveyed 
that he stated he had only 7.5 minutes to spend 
with her and that he did not have       the time 
for her to be writing information down as they 
were talking. When I inquired about how she 
  responded to this, she stated that she 
felt intimidated and stopped writing. She did 
not leave with any       printed information or 
instructions from the visit.
 
  Another participant asked what was being 
done in medical schools related to training on 
communications.  He further stated that 
his former physician had retired and that his 
current physician always seemed to      be in a 
rush and was not very patient when he had 
questions or asked for clarification. Others in 
the      group nodded their heads and several 
stated they experienced similar behaviors.
 
While I realized this is not always what 
individuals encounter with their primary care 
providers, I think it brings to light some very 
real situations that consumers of health care 
are facing when seeking information from health 
professionals. Many times the reality of getting 
health professionals to pay attention to the 
many issues associated with health literacy is 
not deemed to be a high priority. I have found 
it has been difficult and sometimes impossible 
to get on the agenda of professional groups' 
staff meetings to discuss health literacy (using 
the Ask Me 3 information) or to provide a 
continuing educational offering on the program. 
Also, health professional educational programs 
seldom seem to address the complex issues 
related to health communications to any depth in 
our area.
 
The frustration of this reality is that we may 
help our consumers to be more engaged in seeking 
information, but if health care professionals 
are not receptive to this active involvement, 
the consumers most likely will retreat.
 
Ruth R. Davis MSN, RN, CHES
Community Health Nursing Supervisor
        for Public Health Education
Madison County Health Department
1001 Ace Drive, P.O. Box 1047
Berea, KY  40403
859-228-2041
Website address:
www.madison-co-ky-health.org
 
 
 
-----Original Message-----
From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov]On Behalf Of Dickerson, Robert
Sent: Friday, January 26, 2007 7:35 PM
To: The Health and Literacy Discussion List
Subject: [HealthLiteracy 603] Re: question on patientcommunication
skills trainings
 
 
We have done some focused work with Ask Me 3 with some very positive
results. Unfortunately I think it is a program that is not used properly
at times or to it's full potential.
 
Thanks,
Bob
 
Bob Dickerson, MSHSA, RRT
Quality Improvement Coordinator, Clinical Quality
Iowa Health - Des Moines
Des Moines, Iowa
Phone: (515) 263-5792
Fax: (515) 263-5415
E-mail: DICKERR2 at ihs.org
Website: www.ihsdesmoines.org
 
 
-----Original Message-----
From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Julie McKinney
Sent: Friday, January 26, 2007 12:35 PM
To: healthliteracy at nifl.gov
Subject: [HealthLiteracy 597] Re: question on patient communication
skills trainings
 
Mindy,
To add to the plug for AskMe3, it is also designed to train patients as
well as providers. You can find it at:
http://www.askme3.org/
 
Also, look at the the online videos from AMA's group: Educating
Physicians on Controversies in Health
http://www.ama-assn.org/ama/pub/category/15369.html
 
Check this out for lots of links to other good resources:
 
The Health Literacy area of the ALE Wiki:
http://wiki.literacytent.org/index.php/Health_Literacy
 
Good luck!
 
Julie
 
Julie McKinney
Discussion List Moderator
World Education/NCSALL
jmckinney at worlded.org
 
    

 "Zeitz, Howard"  <mailto:hzeitz at uic.edu> <hzeitz at uic.edu> 01/25/07 8:49 PM

>>>

          

With regard to training for health care professionals, consider the ASK
ME 3 program. It targets healthcare organizations and professionals.
 
With regard to patients, consider the programs from Stanford Univ (Dr.
Kate Lorig and colleagues). They include a 6 week program known as the
Chronic Disease Self Management Program (CDSMP) as well as programs
targeted to individuals with specific diseases (eg, HIV, arthritis,
etc).
 
Howard J Zeitz
 
========================================================================
===
On Thu, January 25, 2007 12:15 pm, Mindy Domb wrote:
    

 Hello. I really enjoy being part of this list and having access not
      

only
    

 to some great minds and terrific resources, but participating in
 networking that really supports our work.  This is the first time I
      

have
    

 reached out to the network. I am developing training curriculum that
      

is
    

 indirectly about patient communication skills, patient/physician
 communication.  The training is for health and human service providers
      

on
    

 how they can better support their clients with HIV and Hepatitis C to
 better communicators with their medical providers.
 
 I am wondering if anyone has done this kind of training before or
 trainings on the importance of patient/physician communication, or
      

 > building patient communications skills , what resources, activities,
    

 powerpoints were effective.
 
 Many thanks!
 Mindy Domb
 
 Mindy Domb
 Director
 HIV/viral Hepatitis Integration Programs SPHERE/The Statewide
 Homeless/HIV Integration Project HCSM, Inc.
 942 W. Chestnut Street
 Brockton, MA 02301 USA
 413.256.3406
 fax: 413.256.6371
 www.hcsm.org/sphere  <http://www.hcsm.org/sphere>
<http://www.hcsm.org/sphere>
      

========================================================================
===
    

 Julie McKinney
 Discussion List Moderator
 World Education/NCSALL
 jmckinney at worlded.org
 
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 ----------------------------------------------------
      

Howard J Zeitz, MD
Rockford Regional Partnership for Health Literacy (RRPHL)
1601 Parkview Ave
Rockford, IL 61107
T: 815-395-5964
F: 815-395-5671
 
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--
-----------------------------------------------
Andrew Pleasant
Assistant Professor
Department of Human Ecology
Extension Department of Family and Community Health Sciences
Rutgers, the State University of New Jersey
Cook Office Building, 55 Dudley Road #207
New Brunswick, NJ 08901
phone: 732-932-9153 x. 320; fax: 732-932-6667
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