Health Literacy PDF

5 - Health Literacy ED: eating disorder, emergency department, erectile dysfunction DC: discharge, discontinue, CP: cerebral palsy, chest pain, clinical practitioner Health Literacy → Make teaching patient-centered → Use plain language → Focus on Key Messages → Use Teach-Back → Health literacy is...

5 - Health Literacy ED: eating disorder, emergency department, erectile dysfunction DC: discharge, discontinue, CP: cerebral palsy, chest pain, clinical practitioner Health Literacy → Make teaching patient-centered → Use plain language → Focus on Key Messages → Use Teach-Back → Health literacy is a very important part of interprofessional care - How we use language and what this means for patients Health Literacy Refers to the ability to access, understand and use information and services to make informed decisions about health → A lot of people tend to go to the internet Seeking Health Information Healthcare professionals are the most common and trusted source of information Adults 45 years and older prefer healthcare professionals as their first source of health information Health literacy is a shared responsibility between individuals, care providers and systems Individual needs: ○ Skills ○ Proactivity ○ System navigation Care providers must: ○ Communicate clearly ○ Use evidence-based teaching strategies & high-quality resources Healthcare systems provide: ○ Shame-free environments ○ Accessible/equitable care ○ Educational opportunities for staff There are many benefits to health literate care: Increases patient safety ○ When there is clear information, patients know what to do and understand when something is wrong Improves outcomes Helps people understand what they have to do Saves time and money ○ Health literacy causes 3.5% of annual budget Reaches more people Increases engagement OT competencies and Health Literacy Competencies ○ Occupational Therapy Expertise Develop plans with client’s to facilitate occupational participation Setting expectations Establish trusted relationships with clients ○ Excellence in Practice Engage in ongoing learning and professional development Enhance knowledge, skills, etc Learn from feedback, give feedback Keep up with research, protocols, guidelines ○ Communication and Collaboration Be clear when communicating with others Making sure you are on the same page with people Acknowledge the power imbalance ○ Professional Responsibility Medical jargon, articles are lengthy, be able to summarize that information in a way that they understand Includes your communication with clients Respect client’s rights ○ Culture, Equity and Justice Misinformation - important to understand their beliefs so that you can work on them with them Language itself can cause harm ○ Engagement with the Profession Mentorship, creating space in teaching for health literacy Leadership → it is important that we feel confident in ourselves about health literacy Health literacy contributes to the development of OT Strategies for Health Literacy These strategies: ○ Minimize risk ○ Assume that all patients and providers may have difficulty understanding and accessing services ○ Simplify a complicated healthcare system and make it easier to navigate for everyone → Make teaching patient-centered Person-centered means… Respect for patients ○ Foster a safe and shame-free environment Communicating effectively ○ Respect emotional, sociocultural, spiritual, and resource needs ○ Use an interpreter to communicate in the patient’s preferred language Showing compassion and empathy Creating therapeutic partnerships ○ Gather information to tailor care and education to meet patient’s needs ○ Being responsive to patient’s needs and preferences A Compass For Our Care → UHN Patient Declaration of Values  ○ Respect and dignity ○ Empathy and compassion ○ Accountability ○ Transparency ○ Equity and partnership → Use Plain Language Plain language is a way of presenting information that is easy for a person to hear/read, understand and use Plain Language Tips for spoken and written language ✓ Use common words ✓ Avoid jargon ✓ Explain medical terms ✓ Use the active voice ✓ Be concrete ✓ Stay positive ✓ Keep it short and simple Reduce required inferences (i.e., do the math) Do the calculations for your patients when appropriate The Assistive Devices Program (ADP) will pay 75% of the cost of visual aids. This means you will need to pay 25% of the remaining cost. For example, if your glasses are $200, ADP will pay $150, and you will pay the remaining $50 Written Plain language example Before: I, ________, hereby authorize _____________________ to perform the proposed procedure(s) described below (including all preliminary and related procedures, and any additional or alternative procedures as may become medically necessary during the course of the diagnostic procedure and/or treatment). After: Your doctor has proposed this treatment. You have the right to decide whether to accept this treatment or not. If there is anything you do not understand, ask the doctor or health practitioner. The doctor or health practitioner has fully explained to me: ○ What the treatment is  ○ Why the treatment is needed, (…) Let’s practice… Sleep hygiene → what do you do before you go to bed, what is your routine? Abdomen → stomach, point to area Physician → doctor Activities of daily living → routine for day to day life, chores, tasks Conserve your energy by spreading out tasks that deplete your energy stores the most. ○ To save energy, spread out the most tiring tasks ○ Don’t do everything at once Medication side effects can impact your quality of sleep and result in increased fatigue. Improve your memory capacity by engaging in physical activity and mental stimulation. → Focus on Key Messages Focus on key messages Limit teaching to 1 to 3 key messages Identify ‘need to know’ versus ‘nice to know’ information Repeat and build on the information → Use Teach-Back What is teach-back? Teach-back is a technique to check for understanding in a caring way It involves asking a patient to explain, in their own words, what they need to know or do It is not a test of the patient’s knowledge It allows you to check whether you’ve communicated clearly Elements of Competence for Using Teach-back Effectively Use a caring tone of voice and attitude Display comfortable body language and make eye contact Use non-shaming, open-ended questions Use reader-friendly print materials and visual aids to support learning Document use of and patient response to teach-back Teach-back Model Using teach-back: Asking questions Less effective Closed-ended questioning Do you understand? Do you have any questions? Does this make sense? Are you using your inhaler? Are you sure you’re using it right? Most effective Teach Back To be sure I explained this clearly, could you tell me what Use lead-in and open-ended you will do at home? questioning Show-me example: - Why don’t you show me how you use your inhaler? For Example: Instead of: Do you know how to get an accessible parking permit? Try: How do you start the process of applying for your accessible parking permit? Use a lead-in: I want to make sure that I’ve explained everything clearly. Where will you go to start the process of applying for an accessible parking permit? Close-ended Question → Open-ended Question Close-ended questions ○ Did you schedule a follow-up appointment? ○ Do you know how to find transportation options? ○ Do you have any further questions? Open-ended questions ○ When is your next appointment? ○ How will you book your wheel train ride? ○ What questions do you have? Teach-Back Documentation 1. Learner/s and their needs ○ Dev and his partner were interested in learning how to make pureed foods at home. Dev’s hearing aids are in place 2. Topic(s) of patient education and resources used ○ The “Pureed foods for people with dysphagia” education brochure was discussed and provided. 3. Assessment and Outcome ○ Dev was able to teach-back how to prepare pureed foods at home and how to check that food is pureed What makes a high-quality resource? Written in plain language Credible Up-to-date Accessible and inclusive Uses images to reinforce messages UHN Patient Education Collection Home safety Clean intermittent catheterization (male) Tips for Developing Patient Education Check existing resources before creating something new Consider a variety of patient education strategies, not just written info Consider how to support system transitions, patients’ social needs Maximize your impact by consulting with other team members, clinics and units Patient & Family Learning Centres (Libraries) Find quality resources from UHN and other organizations → Using universal precautions to address health literacy: Improvement Opportunities Tools to improve spoken communication Tools to improve written communication Tools to improve self management and empowerment Tools to improve supportive systems Health Literacy Resources Always Use Teach-back Training Toolkit ○ http://www.teachbacktraining.org/home Health Literate Care Model ○ https://health.gov/sites/default/files/2019-10/HLCM_09-16_508.pdf Resources & Style Guides for Framing Health Equity & Avoiding Stigmatizing Language ○ https://www.cdc.gov/healthcommunication/Resources.html Health Literacy Universal Precautions Toolkit ○ https://www.ahrq.gov/health-literacy/improve/precautions/toolkit.html Canadian Reports A Vision for a Health Literate Canada: Report of the Expert Panel on Health Literacy ○ http://www.cpha.ca/uploads/portals/h-l/report_e.pdf Intersectoral approach for health literacy: ○ http://www.phabc.org/userfiles/file/IntersectoralApproachforH ealthLiteracy-FINAL.pdf Calgary Charter on Health Literacy: ○ http://www.centreforliteracy.qc.ca/sites/default/files/CFL_Calgary_Charter_2011.pdf Choose Health Professional Development for health care professionals or soon to be health care professionals: ○ Choices and Changes ○ Brief Action Planning ○ See dates for trainings on https://selfmanagementtc.ca BC Medical Journal Basic Health Literacy: Canada is doing Poorly https://bcmj.org/blog/basic-health-literacy-canada-doing-poorly#:~:text=According%20to%20the%20Public%20Health,ins tructions%20on%20a%20medicine%20bottle Creating health awareness and promotional events is a core function of public health as they support governments, communities, and individuals to cope with and address health challenges. In 1974 Dr S.K. Simonds put forward the concept of health literacy as an important aspect of health education in schools In 2016 the World Health Organization recognized the importance of health literacy as perhaps one of the critical determinants of individual and public health In most general terms, having adequate literacy skills means being able to understand, evaluate, use, and engage with written texts In that survey, the percentage of Canadian adults with suitable literacy skills was 48% Seventeen percent of Canadian adults functioned at a level so low that, for example, the person was not able to understand instructions in a cookbook. According to the Public Health Agency of Canada, 60% of Canadian adults and 88% of seniors are not health literate. Some seniors cannot follow instructions on a medicine bottle. CAOT Position Statement - Enabling Health Literacy in Occupational Therapy (2013) https://caot.ca/document/3690/E%20-%20Enabling%20Health%20and%20Literacy%20in%20OT.pdf Youtube Video: This is Bad Enough https://www.youtube.com/watch?v=R3tJ-MXqPmk