Health Literacy and Numeracy Workshop Summary (2014) / Chapter Skim
Currently Skimming:
5 Strategies for Effective Communication
5 Strategies for Effective Communication
Pages 67-90
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 67... ...
Consumers' CHECKBOOK has a health plan comparison tool that can be adapted by the health insurance marketplaces opened under the Patient Protection and Affordable Care Act (ACA)
|
From page 68... ...
Krughoff said the most relevant aspect of Consumers' CHECKBOOK experience is that for 34 years they have produced CHECKBOOK's Guide to Health Plans for Federal Employees.1 Certain features are considered key for a health plan comparison tool, Krughoff said. First, a single dollar amount actuarial estimate of average total cost, including premium and out-of-pocket cost estimates for people with similar characteristics to the consumer, must be provided.
|
From page 69... ...
In recent years, Krughoff said, the Medicare Plan Finder has adopted the same approach. Krughoff said it is very challenging to design a quality comparison tool that does not require strong literacy or numeracy skills.
|
From page 70... ...
Krughoff gave a tour of the tool that Consumers' CHECKBOOK has developed to overcome these challenges. The tool is based on the website used by federal employees to choose plans from the Federal Employees Health Benefits Program and adjusted for use with the health insurance exchanges.
|
From page 71... ...
He is not as healthy as he should be or wishes to be because he has hypertension, is overweight, and does not get enough exercise. Robert decides to use an online risk calculator to find out whether he is at risk for cardiovascular disease.
|
From page 72... ...
Decision-making research uses the term "information evaluability" (Hsee, 1996) , which means that the meaning of a number depends on its context and whether the number can be evaluated by itself or requires reference standards to convey meaning.
|
From page 73... ...
Easy-to-evaluate data have intrinsic meaning. For example, when speaking about health insurance plans and cost, an individual knows how much $100 is worth to him or her.
|
From page 74... ...
For example, investment websites break risk down into categories. The potential investor can see which investments are high risk and high return versus low risk and low return without seeing any numbers.
|
From page 75... ...
EFFECTIVELY COMMUNICATING MEDICATION INSTRUCTIONS Michael Wolf, Ph.D., M.P.H. Health Literacy and Learning Program, Feinberg School of Medicine, Northwestern University Wolf said he was invited to talk about effectively communicating medication instructions, and he would narrow the topic to the numeracy and problem-solving skills required in medication use.
|
From page 76... ...
Research based on data from the National Institute on Aging has shown there is a strong correlation between literacy and numeracy. High reading skills are strongly associated with being able to perform health tasks, and numeracy skills are associated BOX 5-1 Why Is It So Hard to Take Medication?
|
From page 77... ...
But the combination of reading and numeracy skills is far more significant than either of them alone because medication use requires such a diverse set of skills. Wolf proposed a model that he is developing with a colleague as a way of further deconstructing the task of taking medications and understanding targets for intervention (see Figure 5-2)
|
From page 78... ...
These interventions could help people perform the numeracy tasks required and check to make sure that the correct information is heard and understood by patients. This can help simplify the behavior that patients have to perform on a daily basis and prevent it from becoming obtrusive in their lives.
|
From page 79... ...
This tool would use the universal medication schedule for the entire regimen. Eventually the tool could be put onto a patient portal so that patients can receive updated information about their regimens without waiting for a new appointment or for instructions to be mailed.
|
From page 80... ...
There are also several demonstration projects being undertaken with some national pharmacy chains that explore ways to leverage technology to provide direct support to patients by linking and partnering with other providers, Wolf said. There is a question, however, of whether medical practices can give a pharmacist who is not an employee access to a patient's EHR to use that information to provide medication reviews and decision support.
|
From page 81... ...
Many providers will follow the guidelines, which for cardiovascular disease set 10 percent as high risk, DeWalt said. He gave as an example a risk calculator that is used at his clinic with which the patient's risk number turns red when it reaches 10 percent.
|
From page 82... ...
He added that comparing the costs of health plans can be baffling, however, and must be made simpler to allow people to understand it. He said that when soliciting feedback from users, his organization would watch people as they used the health plan comparison tool, record what they do, and then talk to them about why they made the choices they did and what could be improved.
|
From page 83... ...
Roundtable member Linda Harris asked if Consumers' CHECKBOOK would be providing a tool for the health insurance marketplaces. Krughoff said the organization had written a paper on what should be included in the marketplaces to help consumers choose between plans.4 The paper has had some positive response.
|
From page 84... ...
She added that numeracy must also be part of the conversation regarding health insurance exchanges, navigators, and community-based organizations that are working to help people obtain health insurance. Cindy Brach, roundtable member, commented that it was gratifying to learn that Consumers' CHECKBOOK is using Agency for Healthcare
|
From page 85... ...
Separating the two sets of skills will help to conceptualize the challenges that people will face with the ACA and the health insurance exchanges, in particular with the infrastructure
|
From page 86... ...
The guidance and resources that are put toward enrolling people in health insurance plans must confront the challenges of low numeracy skills directly. George Isham, roundtable member, commented that he was interested in the earlier conversation about the meaning of numbers in risk communication.
|
From page 87... ...
McCandless said that her patients were primarily low-income individuals living paycheck to paycheck and that she had found it was more useful to talk to them about the short-term consequences of poor health than the long-term consequences. Hall said that low numeracy skills in the population bring about a similar circumstance and highlight the importance of communicating risk in a language that is meaningful to the audience.
|
From page 88... ...
It is also important to form partnerships with other disciplines; health literacy professionals can do much more when they partner with communication or numeracy experts. That there are many adults with poor literacy and numeracy skills is not new information, Rudd said.
|
From page 89... ...
2011. Risk estimates from an online risk calculator are more believable and recalled better when expressed as integers.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.