Developing Health Literacy Skills in Children and Youth Proceedings of a Workshop (2020) / Chapter Skim
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4 People: Research and Lessons from Addressing Specific Populations' Health Literacy Needs
4 People: Research and Lessons from Addressing Specific Populations' Health Literacy Needs
Pages 41-60
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From page 41... ...
The panel was charged with exploring research and lessons learned from addressing specific populations' health literacy needs. HEALTH LITERACY FOR YOUTH WITH SPECIAL HEALTH CARE NEEDS Deena Chisolm, The Ohio State University "Adolescents with special health care needs" (SHCN)
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From page 42... ...
. This hurdle to receiving health care in young adulthood can be attributed to a variety of factors, for example, health insurance access or health literacy skills.
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2. To assess the relationship between adolescent health literacy, parent health literacy, and adolescent health indicators, including health related quality of life and health care utilization.
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Electronic Health • Transition Core Indicator • Transition Readiness Assessment Questionnaire • Health care utilization (Medicaid Claims Data) The sample size was 591 adolescents between ages 15 and 17, with an average age of 16.8 years.
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From page 45... ...
Last, when asked to apply literacy and numeracy skills simultaneously through the NVS, just under 40 percent of participants had adequate health literacy skills, Chisolm explained. e-Health Literacy Assessment Using the eHEALS e-health tool, investigators also compared participants' confidence using e-health information with their previously assessed health literacy skills level.
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From page 46... ...
In the REALM assessment, 42 percent of Black participants and 54 percent of NHW participants had adequate health literacy, while NVS assessments showed that 26 percent of Black participants and 48 percent of NHW participants had adequate health literacy.4 However, the self-reported health literacy assessment revealed that there was little to no difference in the study participants' views of their own health literacy skills (see Figure 4-3)
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From page 47... ...
Clinicians were more likely to discuss adult health care needs and insurance with youth with lower health literacy skills than with youth with adequate health literacy skills but were more likely to encourage personal responsibility for health needs among youth with higher literacy levels. One possible explanation for this is that clinicians may have noticed an additional need for communication on needs-based questions with youth with LTA health literacy, and had more belief in the skill sets of youth with adequate health literacy for promoting self-management.
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SOURCE: Adapted from a presentation by Deena Chisolm at the workshop on Developing Health Literacy Skills in Children and Youth on November 19, 2019.
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Beginning to take action 4. Maintains behavior over time SOURCES: Adapted from a presentation by Gail Nunlee-Bland at the workshop on Developing Health Literacy Skills in Children and Youth on November 19, 2019; Hibbard et al., 2004.
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From page 50... ...
The tech group participants also downloaded the MyFitnessPal and FitBit apps so they could record their caloric intake and track movement. Investigators provided the participants with personal health records from the Howard University Hospital Diabetes Treatment Center, which were integrated into and linked with their individual MyFitnessPal accounts.
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Information gathered does help to formulate an initial understanding of these populations but should not be considered conclusive or generalizable. Additional studies looking at youth formerly in foster care and Preparation for Adult Living program curricula across states are needed before firm recommendations can be made.
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SOURCES: Adapted from a presentation by Steven Hoffman at the workshop on Developing Health Literacy Skills in Children and Youth on November 19, 2019; Trout et al., 2014.
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, necessarily delaying a major focus on education and thus delaying a large building block of health literacy skills development. Of note, every single focus group in the study had participants that were not aware that they were covered with former foster youth Medicaid health insurance until age 26.
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There is inconsistency across and within states: Many states contract their programs out, and others operate independently, county by county. States that do have a statewide curriculum have little emphasis on critical health literacy so, practically, the existence of a PAL program does not provide any tangible health literacy skills development among youth aging out of foster care.
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From page 55... ...
It is important to recognize that the relationship between parent and child is different for each family, and all of those components need to be accounted for when building a model to promote health literacy among all youth. Trina Anglin, formerly from the Health Resources and Services Administration, noted that since 2011, if states have PAL programs, they are required by the Administration for Children and Families to participate in the National Youth in Transition Database, reporting on six areas, all of which are related to health literacy: 1.
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Hoffman was unsure about every state's requirements but confirmed that Texas started PAL programs about 1 year prior to discharge from the foster system, with monthly meetings. He noted that considering the cognitive developmental frameworks discussed earlier in the day, starting transition readiness programs "the year before youth turn 18 is probably a little late." Hoffman added that if he could choose one recommendation, it would be how PAL programs are delivered, adding, "Most states are doing something, and we can change or mandate content, but delivery is often a challenge." The NVS, REALM, and Other Assessment Tools Hannah Lane from the Duke University School of Medicine noted that each panelist used the NVS in their work.
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From page 57... ...
And rather than burden the patient to increase their health literacy level, the burden is placed on providers and pharmaceutical companies to ensure that their materials are optimized and tailored in a way such that the patient would understand them fully. Davis noted that her research showed that using the NVS could interfere with doctor–patient relationships because patients were ashamed or embarrassed about their literacy skills.
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From page 58... ...
Chisolm added that health systems and organizations need to be flexible enough to keep up with youth because whatever technology is best used one year among youth to share health information will be considered passé the next. Hoffman noted that one of his two takeaways from the former foster youth study he conducted in San Antonio was that everyone should have a phone.
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In her research, reviewing health care utilization and outcomes going forward, there does not appear to be a significant relationship with transition readiness. As a researcher, the Transition Readiness Assessment Questionnaire (TRAQ)
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2014. States enroll former foster youth in Medicaid.
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