Communicating is essential to being healthcare smart!
- One out of five American adults reads at the 5th grade level or below, and the average American reads at the 8th to 9th grade level.
- Most health care materials are written above the 10th grade level.
- Limited health literacy increases the disparity in health care access for vulnerable populations (such as racial/ethnic minorities and the elderly).
- According to the Center for Health Care Strategies, a disproportionate number of minorities and immigrants are estimated to have literacy problems: 50% of Hispanics, 40% of Blacks, 33% of Asians¹
Providers need to tailor information to the health literacy level of patients/parents.
Behaviors That May Indicate Low Health Literacy
- Frequently missing appointments
- Failing to complete registration forms
- Unable to name medications or explain their purpose or dosing
- Identifying pills by looking at them, not reading label
- Being unable to give coherent, sequential medical history
- Showing lack of follow-through on tests or referrals
- Repeatedly use statements such as “I forgot my reading glasses,” “I’ll read through this when I get home,” or “I’m too tired to read,” when asked to discuss written material.
(See Resources for 1-7)
Focus on 3 communication domains:³
- Use plain language.
- Avoid jargon/acronyms.
- Partition information to avoid overwhelming families.
- Use interpreter services for limited English families.
- Encourage families to ask questions.
- Summarize key points at the end of each visit.
- Use the teach-back technique to confirm understanding.
- Make information culturally relevant and personal.
- Use print materials to enhance health education.
- Use print materials in the appropriate language for the family.
- Ideally use materials at the 4th-6th grade reading level.
- Use materials that have pictures to help explain text.
- Use materials to summarize key points.
- Avoid materials with dense areas of text. Long lists of bullets also
- Include families in any action steps.
- Set concrete, realistic goals.
- Assess family’s confidence in meeting the goals and adjust accordingly.
- Set a time frame for accomplishing the steps/goals and review at a follow-up visit.
- Acknowledge challenges/barriers (socioeconomic, cultural, etc)
1. Statistics from Center for Health Care Strategy – www.chcs.org
2. Center for Health Care Strategy Fact Sheet #2
3. Three communication domains appeared in “Mastering the Language”: April 12 issue of Contemporary Pediatrics