Health Literacy Making Your Health Materials Understandable for All

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Health LiteracyMaking Your Health Materials
Understandable for All

• Paul D. Smith, MD
• Associate Professor
• University of Wisconsin
• Department of Family Medicine

Paul.Smith_at_fammed.wisc.edu
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Topics today

• How to plan written materials
• Testing readability
• Other factors to consider

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Reading Levels

• 20 of American adults read at or below the 5th
  grade level.
• Most health care materials are written above the
  10th grade level.

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Why is it so hard?

• Complexity of information
• Big words and medical jargon
• Navigating the system
• Insurance
• Forms
• Locating services

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Why is it so hard?

• Other barriers
• Stress
• Pain
• Language

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Why is it so hard?

• Other barriers
• Fatigue
• Time constraints
• Visual impairments

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Planning Steps

• Define the audience
• Limit the objectives
• Limit the message
• Writing and production
• Pre-testing

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Define the Audience

• Age
• Gender
• Culture

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Define the Audience

• Literacy level
• Readiness to learn
• Include audience in planning and writing

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Limit the Objectives

• Behavior change
• Health belief model
• Steps completed in a specific order
• Procedural model
• Gain attention
• Story model

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Limit the Message

• Short and sweet
• Must include information only!

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Writing and Production

• Select format
• Description
• Story
• Questions and answers
• Use examples

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Writing and Production

• Decide how to include interaction
• Ask reader questions
• Taking a quiz
• Test readability

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Written Materials- Common Mistakes

• Too much detail
• Hard words are not explained
• Pictures do not reinforce the message
• No examples

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Written Materials- Common Mistakes

• Readability level is too high
• Long sentences
• Reader not asked to interact with material
• Use of passive voice

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Passive vs. Active

• Medicine should be taken at mealtimes.
• Your arm will be bandaged by the nurse.

• Take your medicine with your meals.
• The nurse will bandage your arm.

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Value Judgment Words

• Exercise regularly
• Dont lift anything heavy
• Get adequate rest

• Exercise 3-5 days per week for 40 minutes
• Dont lift anything over 10 pounds.
• Get at least 7 hours/night

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Readability

• Review materials for reading level
• 5th 6th grade reading level
• Flesch-Kincaid grade level
• Flesch Reading Ease
• SMOG- Simple Measure Of Gobblygook

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Objectives

• Acquire an understanding of the definition of
  literacy, health literacy and the magnitude of
  the problem in Wisconsin.
• Identify people at increased risk of low literacy
• Acquire an understanding of specific activities
  they can do to improve verbal communication with
  all patients, especially low literacy adults
• Identify the important issues to address when
  developing educational documents for low literate
  adults
• Flesch-Kincaid Grade Scale 12

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Objectives

• Acquire an understanding of the definition of
  literacy, health literacy and the magnitude of
  the problem in Wisconsin.
• Identify people at increased risk of low literacy
• Acquire an understanding of specific activities
  they can do to improve verbal communication with
  all patients, especially low literacy adults
• Identify the important issues to address when
  developing educational documents for low literate
  adults
• Flesch-Kincaid Grade Scale 12

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Topics today

• General health literacy information
• How to recognize people with low literacy
• How to improve communication
• Factors to consider when creating documents
• Flesch-Kincaid Grade Scale 12

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Topics today

• Health literacy.
• Finding people with low literacy.
• How to improve communication.
• How to make things easier to read.
• Flesch-Kincaid Grade Scale 7.1 (talking for
  communication 5.1)

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Written Materials

• Look on the internet.
• Print as is.
• Use as a place to start.
• Rewrite as necessary.

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Written Materials

• Use short sentences
• 10-15 words
• Simple language
• Monosyllable words

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Written Materials

• Be consistent with words and terminology.
• Define technical or difficult words.

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Written Materials

• Important concepts first
• Use bulleted lists instead of blocks of text
• Use headings and subheadings

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Written Materials

• Use a readable type styleusually one with
  serifsthe little feet on the bottoms of the
  letters that you see in this type.
• Arial
• Helvetica
• Times New Roman

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Written Materials

• Use 12-14 point type for text.
• Use 16-18 point bold type for headings.
• Use upper case and lower case for the text. ALL
  CAPITALS ARE HARDER TO READ

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More hints.

• Have a 50/50 blend of white space and type.
• Use summary techniques.
• Do not justify the right margin
• Use columns 50-60 characters wide.
• Use pictures.

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Diabetes Pamphlet Example
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Beyond handouts

• Pictures and models
• Audiotapes and CDs
• Videotapes and DVDs
• CD-ROM
• Internet

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Group Exercise

• Review a patient handout
• Rewrite underlined passage
• Pick a recorder
• Rewrite at 5th grade level
• Bring up front when done

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Group Exercise

• Critically appraise the handout
• Recorder will summarize for group
• Identify appropriate techniques used
• Identify things that could be done better

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Summary

• Readability matters, but is just the beginning
• Plan carefully
• Activate the reader
• Test with the audience

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More Information

• Health Literacy Resources.doc
• On your Summit CD

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Keep in Mind

• Health Literacy Definition
• The degree to which individuals have the capacity
  to obtain, process, and understand basic
  information and services needed to make
  appropriate decisions regarding their health.
• Universal Design

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Contact Information

• Contact me if you want the Power Point file
• for this presentation
• Paul.Smith_at_fammed.wisc.edu

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