NAAL can also provide some insights into how materials can be better
developed for lower level populations.

________________________________

From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Lendoak at aol.com
Sent: Wednesday, September 19, 2007 1:53 PM
To: healthliteracy at nifl.gov
Subject: [HealthLiteracy 1246] A prescription for health lteracy


Dear Cynthia and list,
 
Thank you for your comments on the 2003 NAAL data on literacy and health
literacy.  And we agree with your suggested action to address the
individuals, the (healthcare) systems, and their  interaction.  However,
we suggest that the majority of effort be focused on the latter two, for
the following reasons:
 
1. Large improvement in the literacy skills of the adult US population
will take many decades if it is practical at all.  We see little or no
improvement when comparing the NAAL data of 1993 with the recent NAAL
data. Our tutoring experience, and that of others, shows that "success"
is helping the adult student advance about two grade levels after a year
of hard study - if you can motivate them to hang in there for a year.  
 
Future decades may be brighter for children who may be helped by federal
and state education initiatives. 
 
2. Methodologies are well researched and documented on ways to make
written (and other) forms of communication easier to understand, and
more motivating. But these methods are barely used, most likely because
those producing the written health care instructions are not trained in
these methods.  For example, a few years ago after one of our workshops
a health  educator said to us:"I've graduated with an MPH from one of
the best universities in the country, and I never heard of readability
formulas, or the many other ways you've presented on how to make
instructions more understandable."
 
Such training needs to be a part of every curriculum for health care
professionals. It would not be enough to train just state and federal
agency health workers because hospitals and clinics produce most of the
written health care instructions. (Over the years Ceci and I analyzed
the suitability of over 2,000 such instructions from a very broad range
of sources and noticed that over two thirds of the written materials
were produced by hospitals and clinics rather than government and
private agencies.)
 
3. Awareness of the benefits of patient-with-provider interaction seems
to be just beginning. The Pfizer sponsored "Ask Me 3" project is a
hopeful start.  The health care systems are not likely to give doctors
more time to interact with patients, so less costly, and trained,
health personnel need to be added to do this. A few clinics already do.

 
CDC, HHS and AHRQ and others could do a lot to improve interaction by
sponsoring research to show the huge payoffs that would accrue in both
costs and patient wellness.  Social marketing programs could use the
benefits data to promote change.
 
In summary, NAAL data show where the people are in terms of literacy and
health literacy.  So much effort goes into measuring the skills of the
population.  History shows us that the people aren't going to change
much.  
Isn't it time to give equal effort to measure the health communication
skills of our health care systems; and then train our professionals to
do better?  
 
Does anyone have a list of current programs to do this training?
 
Len and Ceci Doak




________________________________

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