Week 3 Flashcards
what is health literacy
a person’s ability to
- access info
- understand meaning of health info
- evaluate health info
- communicate to make informed decisions
what are common health literacy challenges (5)
- not familiar w medical terms or how their body works
- have to interpret or calculate numbers or risks that could have health or safety consequences
- are scared and confused when diagnosed with a serious illness
- have health conditions that require high lvls of complicated self-care instruction
- they are relying on unfamiliar technical info
what people are at the highest risk of health illiteracy (10)
- affects all classes, ethnic groups, ages*
- those who are economically disadvantaged
- older adults
- immigrants
- those w english as a 2nd language
- racial minorities
- high school dropouts
- those who are unemployed
- prisoners
- inner-city and rural residents
- those w poor health statu from chronic mental and physical problems
how can we improve health literacy (5)
- provision of printed leaflets and health info packagaes
- provision of computer-based and internet health info
- targeted approaches to tackle low lvls of health literacy in disadvantaged groups (ex. formal education)
- targeted mass media campaigns (ex. the vaccine campaign rn)
- teach back
what are global learners?
…
describe the relationship between literacy and stigma
- people rarely disclose voluntarily that they are illiterate, even to close relatives
- stigma releated to low literacy creates shame, inadequecy, fear, low self-esteem
what are clues that a pt may have low literacy
- see claire’s notes for veryyyy long list, most are common sense tho
what are 4 examples of tools used to readability of PEMs
- flesch-kincaid scale
- fog index
- fry readability graph
- SMOG formula
what does the flesch-kincaid scale assess (4)
- news reports
- adult education materials
- government publication
- measures readability from 5th grade to college lvl
what is the flesch-kincaid scale based on (2)
2 basic language elements:
- average sentence length (in words) of selected sample
- average word length (measured as syllabus per 100 words of sample)
score is then calculated by combining these two variable
what is the benefit of the fog index (3)
- considered a simpler method
- based on a short sample of words
- does not require counting of syllables of all words
what is the fog index used to assess
- the readability to material from 4th grade to college lvk
how is the fog index calculated
- based on average sentence length and % of multisyllabic worse in a 100-word passage
what is the fry readability graph
- test readability of materials such as books, pamphlets, and brochures at the lvl of 1st grade thru college
how is the fry readability graph calculated
- the number of syllables and number of sentences in 3 100-word selections
what do readability formulas assess (3)
- literacy lvls in PEMs
- provide fairly accurate grade-lvl estimates –> what grade lvl is required to be able to read the material
- do not test people, but rather the written material
people typically read at what lvl?what do they typically prefer?
- at least 2 grade lvls below their highest lvl of schooling
- typically prefer materials written below their literacy abilities
good readers prefer…
- simplified PEMs
what are 2 tests done to measure a pt’s comprehensions of PEMs
- CLOZE test
- listening test
how is a CLOZE test designed
- systematically delete every 5th word from a port of a text
how does a CLOZE test work
- ask the reader to fill in the blanks with the exact word replacements
- one point given for every missed word correct guessed b the reader
- final cloze score = total number of blanks filled in correctly
what is the listening test a good approach for
- determining what a low-literate person understands and remembers when listening
describe how a listening test works
- select a passage from an instructional material that takes about 3 min to read aloud and is written at ~5th grade lvl
- formulate 5-10 short questions relevant to the content of the passage by selecting key points
- read the passage to the person at a normal rate
- ask the listener to answer the questions orally and record the answers
what are some strategies to simplify the readability of PEMS (8)
- limit PEM to what the patient should know/do
- select other media to supplement written info
- organize topics into chunks that follow a logical sentence
- determine preferred reading lvl of material
- keep sentences short
- clearly define any technical words using parentheses
- design layouts should encourage eye movement from left to right
- avoid italics, fancy lettering, and all capital letters
- write in coversational style
- use short, common words, w 1-2 syllables
- spell out words over abbreviations
- keep semtence short (<20 words)
- clearly define technical words in paraenthesis
- more in readings, but all v common sense*
what are some strategies to promote health literacy (10)
- establish a trusting relationship w the pt before the learning process
- use the smallest amt of info possible to accomplish the predetermined behavioral objectives (no more than 15-20 min education sessions)
- make points of info as clear as possible
- teach one step at a tmie
- use multiple teaching methods and tools
- encouraae teach back
- elicit feedback by asking questions and making statements appropriatelu
- keep motivation high
- coordinate procedures into everyday routins
- use repetition
what is a good way to elicit feedback from a pt during teaching about their understanding
- instead of “do you understand”
- ask “tell me what ur understand of this is”
review PEMAT document
…
review health literacy screening tool
…
what is the single item literacy screener
- simple instrument designed to identify pts with limited ability who need help reading health-related material
- where scores greater than 2 indicate some difficulty w reading printed health related material
what 3 questions that often go unasked by pts, are important to talk about w a pt
- what is my health problem
- what do i need to do
- why do i need to do this
what is readability
- the ease with which written or printed info can be read
what is comprehension
- the degree to which individuals understand what they’ve read
define illiterate
- unable to read or write at all
- or having reading and writing skills at the 4th grade lvl or below
define low literacy
- ability of adults to read, write, and comprehend info between the 5ht-8th grade lvl
what is functional illiteracy
-lacking the basic reading, writing, and comprehension skills needed to operate effectively in today’s society
what is an important determinant of health status
- health literacy
what are some consequenced of poor health literacy (6)
- increased illness and death
- unable to read or comprehend med instruction
- poor health outcomes
- increased hospitalization visits
- increased healthcare costs
- less healthy behaviors
describe the relationship between the ability to read and comprehension
- ability to read does not guarantee comprhension
- comprehension is affected by the amt, clairty, and complexity of info provided
why is screening health literacy important?
- self reporting unreliable r/t stigma
what are some important truths (despite many myths) to recognize regarding those w struggle w literacy (4)
- many have average or above average IQ
- appearance alone is an unreliable basis for judgement
- grade-lvl achievement does not correspond to reading ability
- affects diverse backgrounds but majority are white, native born americans
how can health illiteracy effect compliance and adherence
- limits ability to understand instructions for meds
- difficulty handling lrg amt of info
- may think in concrete, specific, literal terms
- may have difficulty analyzing instructions, taking in and organizing new info
- may have difficulty coming up w questions
= the inability to comply is mistaken for noncompliance
health education cannot be considered to have taken place if…
- the written info that has been distributed to pts does not enhance their knowledge and skills necessary for self care
= education relevant to a pts healthcare needs must be understandable and culturally appropriate
what is the SMOG formula (2)
- one of the most valid test for readability
- measures readability from 4th grade to college lvl
the cloze test should be used only with what individuals?
- individuals whose reading skills are at 6th grade lvl or higher
what does a score of 60% or better in the cloze test indicate? 40-59%? less than 40%?
- > 60 = sufficiently understood
- 40-59% = moderate lvl of difficulty, requires supplemental teaching
- <40% = too difficulty, not suitable for teaching
how is the listening test score determined
- divide number of Q answered correctly by total number of questions
what does a score of 90% in the listening test mean? 75-89? less than 75?
- > 90 = easy for pt, can be fully comprehended
- 75-89% = appropriate, but will need some additional assistance for full comprehension
- <75% = too difficult, requires simpler instructional material
when in doubt, write instructional materials at what lvl?
5th grade
