Health Literacy Improving Health, Health Systems, and Health Policy Around the World: Workshop Summary (2013) / Chapter Skim
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5 Innovations in Health Literacy
5 Innovations in Health Literacy
Pages 59-82
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From page 59... ...
A growing number of residents are Hebrew-speaking from birth. The diversity of cultures presents a tremendous challenge for health services, health literacy, and health promotion, Levin-Zamir said.
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From page 60... ...
, defines health literacy as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." There is not yet a national overall initiative for health literacy in Israel; however, there are several policy landmarks that are encouraging, LevinZamir said. The 2020 development goals and objectives include developmental goals on health literacy.
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From page 61... ...
A number of health literacy tools have been developed, Levin-Zamir said. More than 3,000 physicians and nurses engage in in-service training each year.
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Israel is also mounting the National Survey on Health Literacy, which is similar to the European Health Literacy Survey. The survey was developed based on focus groups with key informants.
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There were three aims of the project: to set up national advisory boards on health literacy in the eight countries, to establish a European health literacy network, and to measure health literacy in Europe. Measuring health literacy required developing a questionnaire that could be used in the eight countries.
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From page 64... ...
At the center are the four steps of processing information: accessing, understanding, appraising, and applying information to make decisions. Moving out from the center circle are the three areas of health: health care, disease prevention, and health promotion.
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Life course Situational Health Health determinants service use costs Understand Access Health Health behavior outcomes Knowledge Motivation Cure and Disease Health Competence care prevention promotion Participation Empowerment Health Appraise Information Apply Equity Sustainability Personal determinants Societal and environmental determinants Individual level Population level FIGURE 5-2 HLS-EU conceptual model of health literacy. SOURCE: Sørensen et al., 2012.
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From page 66... ...
should have? Health promotion Find information on Understand Judge how where you Make decisions to improve healthy activities such information on food live affects your health your own health?
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From page 67... ...
Next steps include working with additional countries to implement the European Health Literacy Survey, Sørensen said. Including health
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pioneering health literacy research efforts and the more recent European Health Literacy Survey have provided critically important evidence of the extensivity, health impacts, and costs of weak health literacy, Apfel said. These data give scientific authority to the area and have been used to support advocacy aimed at raising professional and political awareness of and attention to health literacy.
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From page 69... ...
can help individuals strengthen their health literacy by examining their own key risks, understanding where they need to act, and identifying where resources are available. The Digital Health Scorecard generates a single number score from 0 to 100 for seven common risk factors.
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This can be done through a combination of regulation, education, and social marketing initiatives. Although a full discussion of these approaches is beyond the scope of this workshop, one key factor in any strategy aimed at countering hazard promotions relates to "framing," shaping the contexts within which people perceive and understand issues, Apfel said.
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From page 71... ...
Those working to enhance health literacy can benefit from learning from the rapidly growing expertise and experience of public health communication science, especially in the area of social marketing and audience segmentation techniques, Apfel said. These approaches build communication strategies based on first understanding "customers" and insights into people's health literacy and how it is influenced by their everyday lives, hopes, fears, values, beliefs, and behaviors.
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From page 72... ...
They are often called "education programs," "health promotion initiatives," "interpretation," "translation," and "cultural adaptation services." Others relate to helping people navigate complex systems, linking people with needed resources, or connecting them with others like themselves. Many of these health literacy agents do not even know what health literacy is.
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From page 73... ...
2. Eighty percent of employees have completed a health risk pro file and know their key health indicators.
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This is accomplished through offering multiple approaches to health programs, from person-to-person efforts within the clinic, to fitness or wellness centers and energy break rooms, to e-health messages when the environment allows for such an approach. Johnson & Johnson also has a population health risk assessment process that tracks 11 indicators: obesity, high cholesterol levels, high glucose, high blood pressure, tobacco use, physical inactivity, high stress levels, high alcohol use, unhealthy eating, no use of seat belts, and depression.
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From page 75... ...
This program currently reaches 16,000 employees who attend either a half-day, 1-day, or 2-day training session that teaches them how to expand their energy beyond their current status. Isaac said that in terms of overall impact of the health promotion program on health outcomes and cost in the United States, "company employees benefited from meaningful reductions in rates of obesity, high blood pressure, high cholesterol, tobacco use, physical inactivity, and poor nutrition.
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From page 76... ...
But numerous times patients stop taking the medicine when they assumed it might interfere with a newly prescribed antibiotic, for example. Similarly, he noted, patients placed on cholesterol medications sometimes abandon them as soon as their cholesterol reaches appropriate levels.
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From page 77... ...
He said that while creating understanding about diseases and its medicines in patient prescribing information and medication guides is not new, the company has been helping advance health literacy through more formal initiatives in three main areas: advancing the understanding of health literacy as a discipline, including research and its communication; developing and applying health literacy principles in disease education and related materials; and developing tools and services for patients, health care pro iders, and the v broader environment, such as online resources and speaker programs. Rosenblatt added that health literacy principles enable all to help patients better understand and weigh their choices -- not only the risk– benefit of medicines but also the risk–risk ratio -- as well as the possible risk of letting the disease take its natural course versus the possible risks of treatment.
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Sørensen said this was something that is beginning to be looked at. The data do show a strong social gradient, and there are additional burdens related to age, low education, or social deprivation.
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Elena Rios, president of the National Hispanic Medical Association in the United States, addressed her question to Apfel. In the United States, she said, there has been a rise in ethnic media, not just Hispanic but also Asian and African American media, including television, newspapers, and magazines.
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Sørensen said that the European Health Literacy Project, in a joint venture on health literacy with Corporate Social Responsibility Europe, conducted a scan to determine to what degree various companies are involved in health literacy. The results showed that Johnson & Johnson, Merck, and Nestlé were in the forefront.
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However, when one travels outside the United States, what is discussed is engagement, using health programs as a method for recruitment and retention, especially in emerging markets. Rima Rudd congratulated Sørensen and Pelikan for the efforts and findings of the European survey.
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From page 82... ...
The European Health Literacy Survey (HLS-EU)
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