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Appendix C Speaker Biosketches Jessica S. Ancker, Ph.D., M.P.H., is an assistant professor in the Center for Healthcare Informatics and Policy at Weill Cornell Medical College in New York City. She uses quantitative and qualitative methods to study how health information technology (HIT) affects decisions, behaviors, and outcomes. Her research interests lie at the intersection of human factors research, decision science, and health literacy. Recent publications and ongoing projects focus on health numeracy, risk communication, data visualization for patients as well as physicians, and decision support. She is the recipient of an Agency for Healthcare Research and Quality (AHRQ) K award to examine ways in which electronic patient portals can be bet- ter adapted to support comprehension and decision making. In addition, Dr. Ancker conducts a complementary set of research activities involving the evaluation of the effects of HIT. She is a deputy director of HITEC (the Health Information Technology Evaluation Collaborative), a multi- institutional research collaborative directed by Dr. Rainu Kaushal at Weill Cornell. Her HITEC projects have included surveys of technology adoption and attitudes, usability evaluation, and mixed-method approaches to study- ing the effects of the nationâs unprecedented movement toward electronic health records. Her current position reï¬ects a career that has focused on effective com- munication of complex information in a variety of ways. Her ï¬rst career was in journalism and writing, including positions as an Associated Press reporter and as the manager of medical editing at the Cleveland Clinic. As a writer, she became fascinated with the ways in which quantitative informa- tion was used and misused in decision making. After earning her M.P.H. 141
142 HEALTH LITERACY AND NUMERACY from the Department of Biostatistics at Columbia University, she completed her Ph.D. from the Department of Biomedical Informatics with the sup- port of a National Library of Medicine (NLM) Fellowship. She worked with a multidisciplinary dissertation committee composed of a behavioral scientist, a decision scientist, and an informaticist/linguist. Dr. Ancker is also a dedicated educator, with experience teaching biostatistics, scientiï¬c writing, statistical graphics, and informatics. The program director for the Weill Cornell Health Information Technology Certiï¬cate, Dr. Ancker was awarded the Excellence in Teaching Award at Weill Cornell in 2013. She continues to guest lecture on statistical literacy issues for journalists. Andrea Apter, M.D., M.A., M.Sc., received her bachelorâs degree with high honors from the University of Connecticut, where she was a Univer- sity Scholar and a member of Phi Beta Kappa. She then earned a masterâs degree in mathematics from Temple University and taught mathematics in secondary school before entering medical school. After receiving an M.D. from the University of Pennsylvania, she completed a residency in Internal Medicine and a Fellowship in Allergy and Immunology at Northwestern University School of Medicine. She practiced general medicine in a rural community for 1 year and then joined the faculty of the University of Con- necticut Health Center. There she developed an interest in clinical research related to asthma that led to completion of an M.S. in epidemiology from the Harvard School of Public Health. In 1998 she moved to the University of Pennsylvania. Dr. Apterâs research focuses on asthma, the environmental and social factors that inï¬uence disease, patientâclinician communication including electronic communication, and the impact of health literacy on health, all with the goal of reducing health disparities. She has been the recipient of funding for research from the National Heart, Lung, and Blood Institute, which has included research grants and two career development awards, one focused on health literacyâs contribution to health. Dr. Apterâs interest in health literacy evolved from her experiences as a school teacher, and then working with patients and the realization that limited educational opportunities affect the acquisition of health care and the self-management of chronic diseases, including asthma. With her collaborators she validated a measure of numeracy speciï¬c for asthma patients, the Asthma Numeracy Questionnaire. She has used it to explore the relationship of numeracy and health and to develop interventions to allow patients to overcome barriers to literacy that might affect access to care and patientâphysician communication. Current projects examine electronic literacy and health communication. Dr. Apter is an associate editor of the Journal of Allergy and Clinical Immunology; she served on the Food and Drug Administration (FDA) Pul- monary Allergy Drug Advisory Committee and as a director of the Ameri-
APPENDIX C 143 can Board of Allergy and Immunology. She is currently a board member of the American Academy of Allergy, Asthma and Immunology (AAAAI). She has been named a U.S. News & World Reportâs Top Doctor, Top Doc by Philadelphia magazine, and Distinguished Clinician by the AAAAI. Terry C. Davis, Ph.D., a pioneer in the ï¬eld of health literacy, is a professor of medicine and pediatrics at Louisiana State University Health Sciences Center in Shreveport. For the past 25 years, she has been studying the impact of patient literacy on health and health care. Seminal achievements include development of the Rapid Estimate of Adult Literacy in Medicine (REALM) and creation of user-friendly patient education and provider training materials that are being used nationally. Dr. Davis has more than 120 publications related to health literacy and health communication. She has served on Health Literacy Advisory Boards for both the American Medical Association (AMA) and the American College of Physicians (ACP). She was an independent agent on the Institute of Medicine (IOM) Com- mittee on Health Literacy and a developer of the AMAâs Train-the-Trainer Health Literacy Curriculum. Currently she is a member of the Healthy People 2020 Health Literacy/Health Communication Section and serves as a health literacy advisor to the FDA. Dr. Davis is the Health Literacy Principal Investigator (PI) on a National Institutes of Health grant for the Louisiana Clinical and Translational Sci- ence Center, an unprecedented collaborative effort among eight academic institutions in Louisiana. She is PI on a 5-year National Cancer Institute (NCI) health literacy intervention to increase regular breast and colorectal cancer screening among patients in Federally Qualiï¬ed Health Centers. Building on this work, she was recently awarded an American Cancer Society (ACS) grant to evaluate follow-up strategies to improve regular colorectal cancer screening in rural clinics in the state. Dr. Davis is also working with Drs. Mike Wolf and Ruth Parker on AHRQ-funded studies to improve patient understanding and actual use of prescription medication labels in English and Spanish. Along with a team from the University of North Carolina and University of California, San Francisco, she has been funded by the ACP to develop and test practical self-management guides and videos for patients with diabetes, chronic obstructive pulmonary dis- ease, coronary artery disease, obesity, and rheumatoid arthritis. The ACP has distributed more than 5 million copies of these guides. Lynda Ginsburg, Ph.D., is a senior research associate for mathematics education and associate director at the Center for Mathematics, Science and Computer Education at Rutgers University. Her research interests include mathematics education for adult populations, intergenerational mathematics learning, and adult teacher professional learning. She is cur-
144 HEALTH LITERACY AND NUMERACY rently the associate director of a MathâScience Partnership project funded by the National Science Foundation (NSF), New Jersey Partnership for Excellence in Middle School Mathematics. For the recently completed Department of Education/OVAE Adult Numeracy Instruction project, she was lead author of the Guidelines for Adult Numeracy Instruction and evaluated the projectâs professional development initiative. She conducted research on parent involvement in mathematics learning in urban settings for the recently completed, NSF-funded CLT, MetroMath: The Center for Mathematics in Americaâs Cities. Previously, she was a senior researcher at the National Center on Adult Literacy at the University of Pennsylvania for 12 years, directing or contributing to a number of national research and professional development projects. She has served on numerous national advisory groups, was a founding member of the Adult Numeracy Net- work, designs and provides professional development on numeracy for multiple states, and has published and presented her work nationally and internationally. Dr. Ginsburg holds a Ph.D. in urban education/mathemat- ics education from the University of WisconsinâMilwaukee and has taught mathematics or mathematics education at the high school, adult education, and university levels. Marguerite Holloway, M.S., is the director of science and environmental journalism and a professor at Columbia Universityâs Graduate School of Journalism, where she has been teaching since 1997. For many years, Holloway codirected a dual-degree program in Earth and Environmental Science Journalism; in 2004, she designed the science and health report- ing curriculum for the M.A. program, a new degree that was launched in 2005-2006 to provide subject-area expertise to experienced journalists. That M.A. course today, known as the Robert Wood Johnson Foundation Program in Health and Science Journalism, is cotaught by experts in various ï¬elds. Holloway was a long-time editor and writer at Scientiï¬c American, where she covered public health, women in science, neuroscience, and natural history, and where she worked closely with researchers on their articles. She has written for many other publications as well, including The New York Times, the Village Voice, and Discover, and began her career as a reporter for a medical biweekly. Her ï¬rst book, The Measure of Manhat- tan, which tells the story of the exacting, irascible, and colorful surveyor and inventor who laid the grid on New York City, was published earlier this year by W.W. Norton. Holloway has a B.S. from Brown University and an M.S. from Columbia. Robert Krughoff, J.D., is president of the Center for the Study of Services/ Consumersâ CHECKBOOK, an independent, nonproï¬t consumer informa- tion organization whose mission since 1974 has been to educate and inform
APPENDIX C 145 consumers to help them select and deal with service providers, including individual health care providers (doctors, hospitals, dentists, etc.) and insur- ers (auto, homeowners, health). For more than 33 years, the organization has published Guide to Health Plans for Federal Employees and Retirees, a health plan comparison tool. The organizationâs publications and websites have been supported by individual consumers who ï¬nd the information useful enough that they pay for access. Krughoff has been responsible for developing measures of service quality and cost and assessing which are of greatest interest and usability for consumers (e.g., which measures of physician quality and health plan cost and quality), and has documented widespread market failures. Krughoff has served on the board of directors of the Consumer Fed- eration of America, the board of directors of Consumers Union/Consumer Reports, and advisory and study panels for the Institute of Medicine, Agency for Healthcare Research and Quality, National Quality Forum, and other organizations. He has been the recipient of the National Press Clubâs First Place Award for Excellence in Consumer Journalism, the Esther Peter- son Consumer Service Award from the Consumer Federation of America, the Consumer Advocate award from the National Association of Consumer Agency Administrators, and the annual Friend of Consumer Award from the American Council on Consumer Interests. A graduate of Amherst Col- lege and University of Chicago Law School, Krughoff early in his career served as special assistant to the Assistant Secretary for Planning and Evaluation and then as director of the Ofï¬ce of Research and Evaluation Planning at the U.S. Department of Health and Human Services (HHS; then the U.S. Department of Health, Education, and Welfare). Ellen Peters, Ph.D., is a professor in Ohio State Universityâs (OSUâs) Depart- ment of Psychology. She graduated from the University of Pennsylvania with bachelorâs degrees in engineering and marketing and earned her Ph.D. in psychology from the University of Oregon. She joined Decision Research in 1998 and was promoted to senior research scientist in 2006. In 2010, she became an associate professor in OSUâs Psychology Department and was promoted to professor in 2012. Dr. Peters is a recognized leader in risk perception/communication and the psychology of health decision making, publishing papers on the effects of affect, numeracy, number processing, and aging. With more than 80 peer-reviewed publications, her research focuses on how affective, intuitive, and deliberative processes help people to make decisions in an increasingly complex world. She is a Fellow of the American Psychological Society and has worked extensively with fed- eral agencies (e.g., NCI, FDA) to advance the science of human decision making as it applies to health decisions and communication. In particular, she was a founding member of the FDAâs Risk Communication Advisory
146 HEALTH LITERACY AND NUMERACY Committee and has chaired that committee. She has also been a consultant to the FDAâs Tobacco Products Scientiï¬c Advisory Committee, and she has worked extensively with the design of decision aids to maximize their comprehension and use across diverse populations. Lynn Quincy, M.S., is a senior health policy analyst for Consumers Union, the policy and advocacy division of Consumer Reports. Ms. Quincy works on a wide variety of health policy issues, with a particular focus on consumer protections, consumersâ health insurance literacy, and health insurance reform at the federal and state levels. Her recent work includes studies testing consumer reactions to new health insurance disclosure forms; launching an initiative to measure consumersâ health insurance literacy; a study that explores approaches to actuarial value estimation; and a study that examines the use of âchoice architectureâ in health plan chooser tools. Work in progress includes consumer testing explanations of the new health premium tax credit. Ms. Quincy also serves as a consumer expert in sev- eral venues: as a consumer representative with the National Association of Insurance Commissioners, a member of the Covered California Plan Man- agement Advisory Workgroup, and on the technical expert panel advising the development of new exchange enrollee satisfaction surveys. Prior to joining Consumers Union, Ms. Quincy held senior positions with Mathematica Policy Research, Inc., the Institute for Health Policy Solutions, and Watson Wyatt Worldwide (now Towers Watson). She holds a masterâs degree in economics from the University of Maryland. Rima Rudd, Sc.D., M.S.P.H., is the senior lecturer on health literacy, educa- tion, and policy at the Harvard School of Public Health. Her work centers on health communication and on the design and evaluation of public health community-based programs. She has been teaching courses on innovative strategies in health education, program planning and evaluation, psycho- social and behavioral theory, and health literacy since 1988. Dr. Rudd is focusing her research inquiries and policy work on literacy relatedâ disparities and literacy-related barriers to health programs, services, and care, working closely with the adult education, public health, oral health, and medical sectors. Dr. Rudd wrote several reports that helped shape the agenda in health literacy research and practice. They include the health literacy chapter of the HHS report Communicating Health: Priorities and Strategies for Prog- ress (2003) and the 2010 National Call for Action. She coded all health- related items in the international surveys for assessments of adult literacy skills enabling Australia, Canada, New Zealand, and the United States and other countries to assess national health literacy skills. She authored the Educational Testing Services report Literacy and Health in America (2004)
APPENDIX C 147 and contributed to other national assessments. Dr. Rudd provided two in- depth literature reviews (Review of Adult Learning and Literacy volume 1 in 2000 and volume 7 in 2007). She served on the IOM Committee on Health Literacy, the National Research Council Committee on Measuring Adult Literacy, the National Institute of Dental and Craniofacial Research Workgroup on Oral Health Literacy, and the Joint Commission Advisory Committee on Health Literacy and Patient Safety. She also contributed to the ensuing reports and white papers as well as to several IOM Roundtable on Health Literacy publications. She has received national and international awards for her work in health literacy. Most recently, the University of Maryland named a doctoral scholarâs award in her honor. Michael S. Wolf, M.A., M.P.H., Ph.D., is professor of medicine, associ- ate division chief (Internal Medicine and Geriatrics), and director of the Health Literacy & Learning Program (HeLP) within the Feinberg School of Medicine, Northwestern University. He also holds appointments in Cog- nitive Sciences, Communication Studies, Medical Social Science, Psychia- try, and Surgery. As a behavioral scientist and health services researcher, Dr. Wolf has extensively studied cognitive and psychosocial determinants of health, speciï¬cally in the area of health literacy and health communications research. His work has focused primarily on deconstructing self-care tasks and understanding health care complexity. Dr. Wolf has led several large- scale, real-world controlled trials to evaluate multifaceted interventions to promote patient engagement in health, targeting use of clinical preven- tive services, chronic disease self-management, and medication safety and adherence. He is the PI of the National Institute on Agingâfunded cohort study referred to as LitCog, which examines the associations among read- ing, numeracy, and an expanse of cognitive abilities and their inï¬uence on health behavior. Brian Zikmund-Fisher, Ph.D., is an assistant professor in the Department of Health Behavior and Health Education, University of Michigan (UM) School of Public Health and a research assistant professor in the UM Department of Internal Medicine. In addition, he is afï¬liated with the UM Center for Bioethics and Social Sciences in Medicine, the UM Risk Science Center, and the UM Health Informatics Program. Dr. Zikmund-Fisher received his Ph.D. in behavioral decision theory (a combination of decision psychology and behavioral economics) from Carnegie Mellon University. He uses this interdisciplinary background to study factors that affect individualsâ ability to use data to inform their health and medical decision making. An author of more than 75 articles and book chapters, Dr. Zikmund-Fisher researches the design of formats and visual displays to make health risk and test data more intuitively mean-
148 HEALTH LITERACY AND NUMERACY ingful and studies the effects of numeracy (peopleâs ability to use numbers to inform their health decisions) on health communication. His projects have included the National Survey of Medical Decisions (often called the DECISIONS Study), a grant funded by the National Institute of Environ- mental Health Sciences, studying perceptions of risk from dioxin exposure within affected communities; an ACS award regarding the development and testing of visual displays of risk; and several small projects examining how patient testimonials inï¬uence risk perceptions and decision making. At UM, Dr. Zikmund-Fisher teaches graduate courses in risk communication and designing health messages.