<div>Julie,</div>
<div>Thanks for the mention of the Baby Basics prenatal health literacy program. I've been reading this discussion on art and health literacy education closely. We've just received funding to do a Family's First Year Basics book - which will take our Baby Basics prenatal program into the first year...and take into account the literacy skills, as well as the health, social, cultural and economic concerns of the ENTIRE family - not just the baby, but also the mom, the dad, and grandma if she is serving as a major caregiver.
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<div>I am working to make the art in this next book even more of a major component than it is in the first - and our team is asking ourselves lots of questions, such as:</div>
<div> </div>
<div>- the prenatal guide had photographs of women, men and babies that looked very much like the underserved expecting women we work with. For this next book how can we take these photographs a step forward so they model baby/adult interaction and are tools - not just affirming decoration?
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<div>- The prenatal book has illustrations that closely mirror the written text on the page (Which is written to 3rd grade level in some places, and a 5th grade in others). These illustrations are already used to make a point. But, how can we take all of the research we've read on this listserve and make the art much more than a mirror to the text? Can we create illustrations that stand alone as teaching tools- yet are still on the page with text and are aesthetically pleasing, so that a woman who can read the text would not feel that the book was "not for her"? (One of the things of which we are most proud is that moms say "this book was written for me" in focus groups and surveys.)
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<div>I think the look and feel of written materials for underserved patients and those who do not or can not read is important. We are fortunate to have the funding to hire professional illustrators and designers to create our materials. I hope we're up to the job, but would welcome suggestions from any and all... we will be creating a list of "visual moments" in parenting that could use illustration (or photography) to convey some pretty complicated things - the obvious "care moments" -such as how to diaper a baby - the health literacy moments - such as taking a prescription - but we'll see what else can be shown through illustration. Anyone with suggestions, or interested in learning more, I'm all ears (and eyes)
<br>Lisa</div>
<div> </div>
<div>Lisa Bernstein<br>Executive Director<br>The What To Expect Foundation<br>144 W. 80th Street<br>New York, NY 10024<br>212-712-9764<br><a href="http://www.whattoexpect.org">www.whattoexpect.org</a><br><br>Providing parenthing health and literacy support so that families in need know what to expect when expecting.
<br> </div>
<div><span class="gmail_quote">On 1/12/07, <b class="gmail_sendername">Julie McKinney</b> <<a href="mailto:julie_mcKinney@worlded.org">julie_mcKinney@worlded.org</a>> wrote:</span>
<blockquote class="gmail_quote" style="PADDING-LEFT: 1ex; MARGIN: 0px 0px 0px 0.8ex; BORDER-LEFT: #ccc 1px solid">Thanks, Megan, for addressing the "human connection" and all who agreed.<br>I do think that all of the visuals we have been discussing have always
<br>meant to be passed on in the context of interaction with a health<br>provider or educator, but the point is worth reinforcing. And it<br>reminded me of another message that Len and Ceci Doak sent to the list<br>last summer, which dealt with spoken communication between physicians
<br>and patients during visits, and how to expand the one-on-one teaching<br>time without taking up more of the physician's time. Here is an excerpt<br>from that message:<br><br>"We would like to share with you the way that one clinic addresses these
<br>problems. This large free clinic recognizes the communication - time<br>problem, and has partitioned the process of patient communication. The<br>examining doctor<br>provides the patient with the most critical information and explains its
<br>importance to the patient. The patient returns to the waiting room and<br>then is called for additional discussions with a health care coordinator<br>who has the patient's medical record with the latest comments from the
<br>doctor. Communication methods involve teach-back, demos and "what if"<br>questions."<br><br>One great example of a creative way to enhance patient teaching is the<br>"Baby Basics Prenatal Health Literacy Program", which is built around a
<br>book with pictures and simple text. The patient keeps the book and<br>brings it into appointments, the doctor or midwife usess it to reference<br>answers to questions (pointing to pictures and noting page numbers), and
<br>health educators use it for patient teaching while they are waiting for<br>their appointments. See the following link for a description and link to<br>the website.<br><br><a href="http://wiki.literacytent.org/index.php/The_Baby_Basics_Prenatal_Health_Literacy_Program">
http://wiki.literacytent.org/index.php/The_Baby_Basics_Prenatal_Health_Literacy_Program</a><br><br>Any other examples out there of ways to be creative about about<br>combining human interaction with good pictorial-based materials?
<br><br>Julie<br><br>Julie McKinney<br>Discussion List Moderator<br>World Education/NCSALL<br><a href="mailto:jmckinney@worlded.org">jmckinney@worlded.org</a><br><br>>>> "Flint, Suzanne" <<a href="mailto:sflint@library.ca.gov">
sflint@library.ca.gov</a>> 01/12/07 12:45 PM >>><br>I have been reading this listserve for some time now but without<br>comment. It's been a wealth of great information and my next comment is<br>in no way meant to minimize all of our efforts in developing good,
<br>clear, plain language health information. However, Megan's point is<br>worth underscoring. Having been a patient educator at Packard<br>Children's Hospital at Stanford (for almost 20 years) and now working<br>
with the CA State Library, my experience has led me to believe that the<br>importance of the personal interaction cannot be emphasized enough.<br><br>We are all being pressured to reduce everything to the 60 second "sound
<br>or print bite" -- even if we could succeed in doing this (which is<br>doubtful), that is not a guarantee that we will be able to impact<br>behaviors. And ultimately that is what has to change since most health<br>
strategies (both preventative and curative) require a chance in habits<br>and/or behaviors. We could paper the world with information -- but<br>information is NOT what motivates behavior change. So I would encourage<br>us, in addition, to working to create effective health education
<br>materials to also continue to explore the "people skills" that all of us<br>need (health and non-health professionals alike) to effectively bridge<br>the gap between information and behavior change.<br><br>Suzanne Flint, Library Programs Consultant
<br>Library Development Services<br>California State Library<br>P.O. Box 942837<br>Sacramento, CA 94237-0001<br>Phone: 916-651-9796<br>FAX: 916-653-8443<br><br>-----Original Message-----<br>From: <a href="mailto:healthliteracy-bounces@nifl.gov">
healthliteracy-bounces@nifl.gov</a><br>[mailto:<a href="mailto:healthliteracy-bounces@nifl.gov">healthliteracy-bounces@nifl.gov</a>] On Behalf Of Sety, Megan<br>Sent: Thursday, January 11, 2007 12:04 PM<br>To: The Health and Literacy Discussion List
<br>Subject: [HealthLiteracy 566] Re: using pictures in health<br>communications<br><br>As a health educator, illustrations and photographs in any format can<br>add value to understanding. But I've found that what's often missed is
<br>the essential need for human interaction. Materials cannot replace the<br>value of a person taking even 1 minute to explain and teach. Materials<br>are a great place for mutual understanding, and a health provider,<br>
educator, or even a family member who takes a minute to explain how to<br>interpret the information can make all the difference in understanding.<br>When I work on creating materials, I try to think about their<br>distribution and incorporate messages targeting the distributors that
<br>flyers, resource guides, wesbsites, bookmarks, etc aren't just for<br>handing out. They are an opportunity to start a conversation, to start a<br>"learner" on the right foot from the beginning.<br><br>*****************************
<br>Megan Sety<br>Public Health - Seattle & King County<br>Environmental Health Services Division<br>Tacoma Smelter Plume Project<br><a href="mailto:megan.sety@metrokc.gov">megan.sety@metrokc.gov</a><br>206-205-5273<br>
<br>-----Original Message-----<br>From: <a href="mailto:healthliteracy-bounces@nifl.gov">healthliteracy-bounces@nifl.gov</a><br>[mailto:<a href="mailto:healthliteracy-bounces@nifl.gov">healthliteracy-bounces@nifl.gov</a>] On Behalf Of Julie McKinney
<br>Sent: Thursday, January 11, 2007 10:22 AM<br>To: <a href="mailto:healthliteracy@nifl.gov">healthliteracy@nifl.gov</a><br>Subject: [HealthLiteracy 564] Re: using pictures in health<br>communications<br><br>Hi Everyone,
<br><br>I am so grateful to all who have shared so much expertise on this<br>subject! I would like to encourage others to write in and share how you<br>plan to use the information shared during this discussion. In<br>particular, I'd like to hear from these different groups to see how it
<br>may encourage you to do something different in your program:<br><br>--Health Educators<br>--Health Care Providers/Clinicians<br>--Adult Literacy Educators<br>--Policy makers<br><br>And if you have further questions for Peter, Ceci and Len, I invite you
<br>to ask!<br><br>Also, I want to ask those of you on the health side: How can adult<br>literacy educators collaborate to enhance your efforts at improving<br>health communication? There is a large group of the most underserved and
<br>least literate people who are being served in the supportive<br>environments of literacy classes. This group is also most in need of<br>health information and access to care. Everyone could benefit from this<br>type of collaboration, and so I would love to get feedback about how
<br>this could work best.<br><br>All the best,<br>Julie<br><br>Julie McKinney<br>Discussion List Moderator<br>World Education/NCSALL<br><a href="mailto:jmckinney@worlded.org">jmckinney@worlded.org</a><br><br>>>> "Peter S. Houts" <
<a href="mailto:psh2@email.psu.edu">psh2@email.psu.edu</a>> 01/10/07 9:57 PM >>><br>In an earlier message I said I would try to get a pfd file of the review<br><br>article that Ceci, Len, and I wrote. I was successful and it is
<br>attached. There are two files - the first is the full article and the<br>second is an erratum explaining that one of the figures was incorrect<br>and includes the correct figure. I am very happy to learn about other
<br>publications that have been mentioned in this discussion. I plan to<br>read them all.<br><br>I read the article that Sunil Kripalani and colleagues wrote and that he<br><br>included as an attachment to his email message. It is an excellent
<br>article. I agree with them that age is a very important parameter for<br>use of pictures - research suggests that elderly people may react<br>differently to pictures - but we don't understand how differently and at
<br>what ages. This is an important area for future research. I also think<br>that<br><br>their observation on using complex icons is important. Some icons (such<br>as<br>clocks) are not easily understood by people with low literacy skills.
<br>So<br>pilot testing is important to be sure icons are meaningful. In the<br>study with stick figures that I did, we made up some icons to try to<br>make the pictures more easily understood - but then found that the<br>
subjects often<br><br>had trouble remembering what the icons meant. It really gets back to<br>using simple language to explain what the picture or icon means. Icons<br>without explanation can lead to confusion.<br><br>I agree with Julie that photographs could be helpful and her example was
<br>a good one - showing pictures of syringes or pills to illustrate<br>instructions. From her explanation, the pictures were probably very<br>simple<br>- without a lot of distracting detail. The key is to keep distracting
<br>detail to an absolute minimum. If that can be done with photographs,<br>then they will be very useful. But, as Paul mentioned in his email, it<br>is often easier to keep confusing detail down with simple line drawings.
<br><br>I am learning a great deal from this discussion and am looking forward<br>to reading more of your ideas.<br><br>Peter<br><br><br><br><br><br>----------------------------------------------------<br>National Institute for Literacy
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</a><br></blockquote></div><br><br clear="all"><br>-- <br>