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4 Health Literacy Facilitates Public Health Efforts
Pages 49-74

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From page 49...
... One of her colleagues, having similar disappointing interactions, concluded that "people don't change, but it's our job to tell them what to do." Recognizing a serious problem, she began to explore how to better communicate, and this quest has turned into a lifelong career focused on using participatory processes to design, implement, and evaluate public health educational programs. As a professor of public health and Principal Investigator of the Health Research for Action Center at the School of Public Health at the University of California, Berkeley, Neuhauser said she has the opportunity to work with researchers, students, communication experts, and policy analysts who study issues of health literacy.
From page 50...
... Draft content using health literacy design principles 5. Conduct Usability testing -- until it works 6.
From page 51...
... Therefore, integrating health literacy into licensing requirements is needed in the area of nutrition, as well as for all the other health professions. Neuhauser described research she conducted to determine whether the government website related to the food pyramid adhered to health literacy principles (Neuhauser et al., 2007a)
From page 52...
... The third example is a project of the Eli Lilly Company and involves a booklet on healthy eating that was developed using health literacy principles and usability testing, and that was awarded the Institute for Healthcare Advancement's first place for published materials award in 2008. The final project included a picture of a plate that simply illustrated the size of healthy serving portions.
From page 53...
... According to study findings: • Only one-third of state plans mentioned the Deaf/HH population. • Fewer than half of the community organizations serving the Deaf/ HH population provided emergency preparedness materials.
From page 54...
... CHRONIC DISEASE PREVENTION Jennifer Cabe, M.A. Canyon Ranch Institute Cabe said she was introduced to the importance of health literacy by Alice Horowitz and Cynthia Bauer when she served as a speechwriter to the 17th U.S.
From page 55...
... If health literacy proficiency could be directly linked to improved chronic disease outcomes, a strong social and economic argument could be made to promote health literacy. The financial costs of treating chronic diseases, many of which are preventable, are large and mounting, she said.
From page 56...
... The authors concluded that improving health outcomes "will require increased public and private investment in the social and environmental determinants of health, beyond an exclusive focus on access to care or individual health behavior." In considering the findings of the Kindig and Cheng (2013) study, Cabe posed the question, "Does it then follow that health literacy can help public health systems to empower people to prevent chronic disease, regardless of socioeconomic status or other social determinants of health?
From page 57...
... Cabe said Rutland gives presentations in Cleveland churches to share her experiences. She is helping other people engage in healthy behaviors to BOX 4-2 Testimony of Dean Rutland I saw the flyer about the Canyon Ranch Institute Life Enhancement Program (LEP)
From page 58...
... Health literacy can guide public health agencies and the people they serve in choices about where, when, why, and how to invest in chronic disease prevention. Health literacy is often neglected in public health efforts to prevent chronic disease, Cabe said.
From page 59...
... To set the stage, Schillinger reviewed the distribution of diabetes types among U.S. children ages 10 to 19 by race/ethnicity (see Figure 4-1)
From page 60...
... Schillinger described some activities that have been undertaken as part of "The Bigger Picture" project. Four medically curated writing workshops have been held with participation from 30 poets affiliated with the group, "Youth Speaks" (http://youthspeaks.org)
From page 61...
... The poem is called "Sole Mate" and can be viewed at the Bigger Picture website (http://youthspeaks.org/thebiggerpicture/2013/02/01/ sole-mate-3)
From page 62...
... Schillinger added that he would like the project to extend to other chronic diseases because the social and environmental conditions causing diabetes are also causing hypertension, heart disease, and other conditions. In addition, there are plans to enhance and evaluate the Bigger Picture's digital platform and to increase the campaign's impact by developing and incorporating materials and content in other languages.
From page 63...
... University of Maryland School of Public Health Alice Horowitz pointed out that oral health is not generally viewed as an integral part of overall health. Yet oral diseases are often called a neglected epidemic.
From page 64...
... The survey asked respondents what they knew about preventing tooth decay, and how they rated the communication skills of their dental providers. The results of the survey indicated that low-income adults with young children do not understand how to prevent tooth decay (Horowitz et al., 2013a)
From page 65...
... . The purpose of this initiative, according to Horowitz, is "to help moms help themselves and their infants to have good oral health." The initiative provides education to pregnant women through prenatal classes, WIC and Head Start programs, and high school programs for pregnant teens.
From page 66...
... In terms of next steps, Horowitz said the Maryland Dental Action Coalition will implement all of the education tools developed thus far in the settings serving pregnant women and women with young children. The educational tools were tested on that target audience, and the participating women told the design team what they wanted to see.
From page 67...
... HEALTH LITERACY FACILITATES PUBLIC HEALTH EFFORTS 67 FIGURE 4-3  Poster providing guidance on preventive dental care. SOURCE: Herschel S
From page 68...
... Then, after a chronic disease such as diabetes is diagnosed, some of the communications shift to secondary and tertiary prevention, for example, avoiding an amputation. Schillinger said there is also confusion between prevention in terms of individual behavior change and the broader view of community change.
From page 69...
... Sarah Fine, the Bigger Picture project director, added that the workshops try to take a social justice perspective and shift the conversation from a "blame-the-victim scenario" to one that focuses on the environmental and systemic forces that affect chronic disease. She added that the messages need to go beyond "don't drink this soda or eat this food" and address issues such as why there are fewer resources allocated for outdoor spaces in poor neighborhoods than in wealthy neighborhoods.
From page 70...
... Horowitz said that if states realize they can benefit financially by preventing young children from being treated for severe tooth decay, they will eagerly adopt the program. Schillinger stated that with respect to The Bigger Picture project, all that is needed is a major underwriter because platforms to launch the program and reach a wider audience are available through the national organization, Youth Speaks, which has a presence in most major urban areas.
From page 71...
... 2012. The relationship between patients' oral health literacy and failed appointments.
From page 72...
... 2013. Applying health literacy principles to public health efforts in prepared ness and nutrition.
From page 73...
... 2009. Development and evalu ation of an oral health literacy instrument for adults.


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