I am Director of Clinical Content Management at Geisinger. I work with Laurie, who is a member of our advisory group. We read the article and members questioned if this was something that was feasible or a benefit to try. We were just asking to see if others were using the tool to justify our decision.

Thanks, this discussion has been helpful.

Sue

Sue Brown RN MHA CPHQ
Director, Clinical Content Management
Phone: 570-826- 7622
Pager 830-7549
Fax 570-819-5541
Internal Zip: 41-19


"Peer Review generated records generated solely for Quality Improvement purposes pursuant to 63 P.S. Section 425.1 et seq and/or the Mcare Act.- Not for redistribution outside the System's Peer Review Committee"



>>> "Winston Lawrence" <WinstonL at lacnyc.org> 3/20/2007 10:18 AM >>>

Hi all: I am in agreement with questioning the usefulness of wanting to give either the TOHFLA or the NVS tests to patients especially if it's for the purpose of knowing their literacy level. At LAC here in New York, we have always expressed our concern to groups that have wanted to go this route. Perhaps it would be great to hear the rationale for wanting to give the test. Are you doing a research project? Or do you just want to know how literate patients are so you can serve them better?
Laurie, could you shed some light on this? Why does your agency want to give either test?
Winston
 

--------------------------------------------------------------
Winston Lawrence Ed. D
Senior Professional Development Associate
Literacy Assistance Center
32 Broadway, 10th Floor 
New York, NY 10004
Tel: 212-803-3326
Fax: 212-785-3685
Email: winstonl at lacnyc.org 

-----Original Message-----
From: healthliteracy-bounces at nifl.gov [mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Linda Shohet
Sent: Monday, March 19, 2007 12:27 PM
To: The Health and Literacy Discussion List
Subject: [HealthLiteracy 767] Re: health literacy assessment

I strongly second both Andrew and Joanne.  In ongoing projects since 1995 at 
the McGill University Health Centre (MUHC), five large Montreal hospitals, 
we have long suggested this approach. Even if we were to have perfect 
instruments, it is neither within the expertise or the ethical domain of 
health care providers to test clients' literacy.  Health professionals are 
not trained to do this, and patients and clients already have a degree of 
anxiety about their health without adding a further layer of fear ( and 
possibly a deterrent to seeking help if they beleive they will be given a 
literacy test).  There are more humane ways of responding.  

In addition to Joanne's excellent suggestions, we have suggested asking all 
patients to complete (themselves or with a volunteer) a simple "Learning 
preference profile" that indicates how they like to get information or learn 
a new skill.  If all patients were to fill this in along with their standard 
health history, physicians and other providers would get both a sense of the 
literacy capacity and the learning preferences of the person( even highly 
literate people have a range of learning preferences).  In the long term, we 
envisage a system that will be able to customize health instructions and 
information according to those preferences. Many of our current technolgoies 
already allow it.  

Finally, if health care providers develop links to community literacy 
groups, they can make appropriate referrals when they come across a patient 
with literacy needs(by "appropriate", we mean if a patient either asks for 
or shows an inclination to want literacy tutoring or classes; we do not mean 
giving patients a "test").

The idea of testing is actually much stronger in the US than it is in Canada 
or Britain. It is quite interesting to look at some of the cultural 
differences that underpin responses to issues of health literacy in various 
countries.  

Linda Shohet


On Mon, 19 Mar 2007 09:13:29 -0500, Joanne Schwartzberg wrote

> I would like to second Andrew's comments - because we know that all

> patients appreciate clear, concise and concrete information, AMA has

> been encouraging an approach for all patients called "Safe Communication

> Universal Precautions"..Clear,plain language, advance organization of

> spoken and written communication into 2 -3 key points and use of the

> "teach back" to confirm the patient's understanding (and if no

> understanding to stimulate the health professionals to re-explain and

> arrange for further assistance/health education/followup phone

> calls/family support/additional visits with more time/consider 

> patient safety, etc, etc. The concept grew out of a belief in 

> "universal design" in language as benefiting all patients, and 

> "universal precautions" as benefiting all health professionals....

> 

> Joanne G. Schwartzberg, MD

> Director, Aging and Community Health

> American Medical Association

> 515 N. State St.

> Chicago, IL  60610

> 312-464-5355

> fax: 312-464-5841

> Joanne.Schwartzberg at ama-assn.org 

> 

> -----Original Message-----

> From: healthliteracy-bounces at nifl.gov 

> [mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Andrew Pleasant

> Sent: Sunday, March 18, 2007 11:13 AM

> To: The Health and Literacy Discussion List

> Subject: [HealthLiteracy 759] Re: health literacy assessment

> 

> Instead of dedicating resources toward labeling patients as lacking 

> in what the TOFHLA or the Newest Vital Sign actually measure, why 

> not direct resources toward lowering barriers for everyone?

> 

> Andrew Pleasant

> 

> >Does anyone on this listserv use the TOFHLA regularly for health 

> >literacy assessment in the clinical setting? What do you think of its 

> >clinical applicability and ease of use?

> >

> >

> >Laurie Anson

> >Geisinger Wyoming Valley

> >Wilkes-Barre, PA

> >

> >----------------------------------------------------

> >National Institute for Literacy

> >Health and Literacy mailing list

> >HealthLiteracy at nifl.gov 

> >To unsubscribe or change your subscription settings, please go to 

> >http://www.nifl.gov/mailman/listinfo/healthliteracy 

> 

> --

> -----------------------------------------------

> 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

> ----------------------------------------------------

> National Institute for Literacy

> Health and Literacy mailing list

> HealthLiteracy at nifl.gov 

> To unsubscribe or change your subscription settings, please go to

> http://www.nifl.gov/mailman/listinfo/healthliteracy 

> ----------------------------------------------------

> National Institute for Literacy

> Health and Literacy mailing list

> HealthLiteracy at nifl.gov 

> To unsubscribe or change your subscription settings, please go to 

http://www.nifl.gov/mailman/listinfo/healthliteracy 


--
Linda Shohet, PhD
Executive Director
The Centre for Literacy of Quebec
3040 Sherbrooke Street West
Montreal, Quebec
Canada, H3Z 1A4
Tel.:(514) 931-8731, ext. 1411
Fax: (514) 931-5181
E-mail: lshohet at dawsoncollege.qc.ca 

----------------------------------------------------
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