Building the Case for
Health Literacy
PROCEEDINGS OF A WORKSHOP
Joe Alper, Rapporteur
Roundtable on Health Literacy
Board on Population Health and Public Health Practice
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
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This activity was supported by contracts between the National Academy of Sciences and AbbVie Inc.; Aetna Foundation; American Dental Association; Bristol-Myers Squibb; East Bay Community Foundation (Kaiser Permanente); Eli Lilly and Company; Health Literacy Media; Health Literacy Partners; Health Resources and Services Administration (HHSH25034011T); Humana; Institute for Healthcare Advancement; Merck Sharp & Dohme Corp.; National Library of Medicine; New York University Langone Health System; Northwell Health; Office of Disease Prevention and Health Promotion (HHSP23337043); and UnitedHealth Group. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-47429-0
International Standard Book Number-10: 0-309-47429-9
Digital Object Identifier: https://doi.org/10.17226/25068
Additional copies of this publication are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
Copyright 2018 by the National Academy of Sciences. All rights reserved.
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Building the case for health literacy: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25068.
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PLANNING COMMITTEE ON BUILDING THE CASE FOR HEALTH LITERACY1
SUSAN BOCKRATH (Chair), Health Literacy Nebraska
LORI HALL, Director of Health Literacy, Eli Lilly and Company
STANTON HUDSON, Associate Director, University of Missouri Center for Health Policy
LAURIE MYERS, Global Health Literacy Director, Merck Sharp & Dohme Corp.
LAURA K. NOONAN, Director, Center for Advancing Pediatric Excellence, Levine Children’s Hospital at Carolinas Medical Center
AUDREY RIFFENBURGH, President, Health Literacy Connections
BERNARD M. ROSOF, Chief Executive Officer, Quality HealthCare Advisory Group, LLC, and Professor of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
STEVEN RUSH, Director, Health Literacy Innovations Program, UnitedHealth Group
MICHAEL VILLAIRE, President and Chief Executive Officer, Institute for Healthcare Advancement
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
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ROUNDTABLE ON HEALTH LITERACY1
BERNARD M. ROSOF (Chair), Chief Executive Officer, Quality HealthCare Advisory Group, LLC, and Professor of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
WILMA ALVARADO-LITTLE, Associate Commissioner, New York State Department of Health, and Director, Office of Minority Health and Health Disparities Prevention
SUZANNE BAKKEN, Alumni Professor of Nursing and Professor of Biomedical Informatics, Columbia University
CINDY BRACH, Senior Health Policy Researcher, Agency for Healthcare Research and Quality
GEMIRALD DAUS, Public Health Analyst, Office of Health Equity, Health Resources and Services Administration
TERRY C. DAVIS, Professor of Medicine and Pediatrics, Louisiana State University Health Sciences Center
CHRISTOPHER DEZII, Director, Healthcare Quality and Performance Measures, Bristol-Myers Squibb
JENNIFER DILLAHA, Medical Director for Immunizations, Medical Advisor, Health Literacy and Communication, Arkansas Department of Health
JAMES DUHIG, Head, Risk Communication and Behavioral Systems, Office of Patient Safety, AbbVie Inc.
ALICIA FERNANDEZ, Professor of Clinical Medicine, Department of Medicine, Division of General Internal Medicine, University of California, San Francisco
LAURIE FRANCIS, Executive Director, Partnership Health Center
LORI HALL, Director of Health Literacy, Global Medical Strategy and Operations, Eli Lilly and Company
LINDA HARRIS, Director, Division of Health Communication and eHealth Team, U.S. Department of Health and Human Services
JOAN KELLY, Chief Patient Experience Officer, New York University Langone Health System
LAURIE MYERS, Global Health Literacy Director, Merck Sharp & Dohme Corp.
CATINA O’LEARY, President and Chief Executive Officer, Health Literacy Media
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
MICHAEL K. PAASCHE-ORLOW, Professor of Medicine, Boston University School of Medicine
TERRI ANN PARNELL, Principal and Founder, Health Literacy Partners
KIM PARSON, Strategic Consultant, Proactive Care Strategies, Humana
KAVITA PATEL, Managing Director for Clinical Transformation and Delivery, The Brookings Institution
ANDREW PLEASANT, Senior Advisor on Health Literacy Interventions, Research, and Evaluation, Health Literacy Media
LINDSEY A. ROBINSON, Thirteenth District Trustee, American Dental Association
STACEY ROSEN, Associate Professor of Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, and Vice President, Women’s Health, The Katz Institute for Women’s Health
RIMA RUDD, Senior Lecturer on Health Literacy, Education, and Policy, Harvard School of Public Health
STEVEN RUSH, Director, Health Literacy Innovations, UnitedHealth Group
MICHAEL VILLAIRE, Chief Executive Officer, Institute for Healthcare Advancement
EARNESTINE WILLIS, Kellner Professor in Pediatrics, Medical College of Wisconsin
AMANDA J. WILSON, Head, National Network Coordinating Office, National Library of Medicine
MICHAEL S. WOLF, Professor, Medicine and Learning Sciences, Associate Division Chief, Research Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University
WINSTON F. WONG, Medical Director, Disparities Improvement and Quality Initiatives, Kaiser Permanente
Consultant
RUTH PARKER, Professor of Medicine, Pediatrics, and Public Health, Emory University School of Medicine
Health and Medicine Division Staff
LYLA M. HERNANDEZ, Senior Program Officer
MELISSA G. FRENCH, Program Officer
ALEXIS WOJTOWICZ, Senior Program Assistant
ROSE MARIE MARTINEZ, Senior Board Director, Board on Population Health and Public Health Practice
Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
JULIE MCKINNEY, Exceptional Lives, Inc.
GREG O’NEILL, Christiana Care Health System
HELEN OSBORNE, Health Literacy Consulting
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by HUGH H. TILSON, University of North Carolina. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.
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Acknowledgments
The sponsors of the Roundtable on Health Literacy made it possible to plan and conduct the workshop Building the Case for Health Literacy, which this publication summarizes. Federal sponsors from the U.S. Department of Health and Human Services are the Agency for Healthcare Research and Quality, Health Resources and Services Administration, National Library of Medicine, and Office of Disease Prevention and Health Promotion. Nonfederal sponsorship was provided by AbbVie Inc.; Aetna Foundation; American Dental Association; Bristol-Myers Squibb; East Bay Community Foundation (Kaiser Permanente); Eli Lilly and Company; Health Literacy Media; Health Literacy Partners; Humana; Institute for Healthcare Advancement; Merck Sharp & Dohme Corp.; New York University Langone Medical Center; Northwell Health; and UnitedHealth Group.
The Roundtable on Health Literacy would like to thank each of the speakers and moderators for their time and effort. Speakers and moderators were Thomas K. Bauer, Chris Carlson, Jennifer Dillaha, Laurie Francis, Cathryn Gunther, Lori K. Hall, Stanton Hudson, Laura K. Noonan, Jennifer Pearce, Martin Ratermann, Audrey Riffenburgh, R. V. Rikard, Bernard M. Rosof, Lawrence G. Smith, and Christopher R. Trudeau.
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Contents
Organization of the Proceedings
2 THE PATIENT PERSPECTIVE ON THE NEED FOR HEALTH LITERACY
3 IMPROVING HEALTH AND THE BOTTOM LINE: THE CASE FOR HEALTH LITERACY
Presentation of the Commissioned Paper
A Pharmaceutical Company Perspective on Why Health Literacy Matters
Achieving the Quadruple Aim: Health Literacy Interventions as an Essential Component
5 ADOPTING HEALTH LITERACY IN AN ORGANIZATION
What Research Shows About Adopting and Implementing Health Literacy in a Health Organization
Box, Figures, and Tables
BOX
FIGURES
3-1 Health literacy and the bottom line
3-2 The ethical case for health literacy
4-1 Priority areas for national action to transform health care quality in the United States
4-2 A patient’s experience of the cycle of crisis care in the absence of health literacy
4-3 A patient’s experience with health literate care
4-4 A universal precautions approach in a health literate care model
5-1 Building the case for health literacy interventions
5-3 The two components of the consumer’s journey in the health care system
Acronyms and Abbreviations
|
ACA |
Patient Protection and Affordable Care Act |
|
ADH |
Arkansas Department of Health |
|
AHRQ |
Agency for Healthcare Research and Quality |
|
CANDOR |
Communication and Optimal Resolution |
|
CMS |
Centers for Medicare & Medicaid Services |
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EHR |
electronic health record |
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FQHC |
federally qualified health center |
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HCAHPS |
Hospital Consumer Assessment of Healthcare Providers and Systems |
|
HHS |
U.S. Department of Health and Human Services |
|
HIPAA |
Health Insurance Portability and Accountability Act |
|
PCORI |
Patient-Centered Outcomes Research Institute |
|
VA |
U.S. Department of Veterans Affairs |
|
WIC |
Special Supplemental Nutrition Program for Women, Infants, and Children |
