Health literacy – What’s the story?

There has been a lot of talk about health literacy in the health library and knowledge community over the last couple of years.  Health Education England worked with partners to deliver awareness and train the trainer sessions across England.  Although we were not surprised at the positive response from our colleagues to this programme, we have been heartened and encouraged by the engagement within the health community and beyond.

One of the best ways to illustrate the impact of low health literacy is to share personal stories.  Participants in the training programme generously gave examples of their own issues with health literacy.  Inspired by this, we thought now might be a good time to share some stories from library and knowledge services on their own experiences of delivering health literacy awareness training and the impact this has had both on them personally and on their services.  Here are just a couple of examples of what’s been happening:

 

Sylvia Hughes, Senior Library Assistant, Gateshead Health NHS Foundation Trust

“Last year I helped to deliver health literacy awareness training to library staff from across the North of England.  As I read the feedback from participants, one or two comments reflected the same things that I had been thinking myself when I first heard the suggestion that NHS Libraries were well placed to support the provision of health information to the public and patient: how exactly, could I, as an NHS library assistant, do that?  How could the Library have any impact on information for patients within my Trust, for example, to front-line staff dealing with patient enquiries in the out-patient clinic or the consultant responding to a patient question in the consultation room?

I first got involved in information for patients and the public in 2015.  Our Library and Knowledge Service was looking for ways to supporting patients and carers and I was considering which topic to choose for my MSc dissertation.  The more I began to read about health inequalities, and how poor health literacy can impact negatively on everyone’s health, I began to think what an opportunity this could be for library staff to contribute to supporting the patient AND professional.  Having looked for opportunities to get involved with health literacy and supporting patient information, working with senior nurses and patient information staff, our Library produced and distributed a simple ‘Patients’ guide to health information’ which can now be found in patient areas.  I have now joined our Trust patient information panel, regularly reviewing patient information leaflets, and am hoping to feed awareness of health literacy into our own patient information protocol.  I completed my dissertation (and my MSc!) entitled ‘The informed patient and role of the Library’ in 2018.

Working alongside fellow library staff, we plan to run further health literacy awareness training in our Trusts as a means raise awareness and support staff further in producing patient health information.  But even just noticing and helping the ‘lost’ patient navigating their way around endless hospital corridors via numerous hospital signs (which may not be really helping the patient find their way around) plays a part.  We can also raise awareness of the need to produce information from the patient’s point of view.  We sometimes take our own knowledge and skills for granted when sharing information in our own Libraries (for instance, using the unhelpful term ‘health literacy!’).

I think that we are very well placed to meet the challenge to contribute, to support and help to fill that health information knowledge gap. We are experts in finding, appraising, and delivering information for our readers.  With a little bit of self-reflection, we are also able to imagine the emotion we all feel when faced with an overwhelming whole ‘universe’ of health information, or as one patient told me ‘gobbledygook!’

 

Rachel Steele, Librarian, Tees Esk and Wear Valleys NHS Foundation Trust

“I very much enjoyed delivering health literacy training to a group of library and information services staff members in January 2020 and I hope to deliver more training in the future.  I had participated in previous ‘train the trainer’ sessions organised by the Community Health and Learning Foundation and Health Education England.  These sessions were absolutely invaluable in imparting the knowledge and skills I required to act as a trainer in this area.  The framework conceptualised health literacy as a two-sided coin – the personal and the societal.  Myself and my co-trainers used this framework in our training and it seemed to work well.

Exercises were a key part of the training I delivered.  We asked participants to undertake exercises to practise the techniques of ‘teach back’ and ‘chunk and check’ and we also used exercises originally devised by the Community Health and Learning Foundation designed to give participants an appreciation of how it feels to have low health literacy and not to understand information which is being imparted.  I won’t say too much as to the nature of the exercise (as this may ‘spoil’ the element of surprise in subsequent training!) but acting as trainer in this exercise made me feel as though I was being unkind to participants which made me feel a bit uncomfortable.  It is, however, important that people do gain an appreciation of what it is like to live with low health literacy to fully understand the themes raised and we tried to deal with participants feelings in the ‘de-brief’ following the exercise.  By having a de-brief, they were able to understand why the trainers had behaved as they did and that no malign motives were intended on our part!

I intend to deliver health literacy training in conjunction with others in my Trust to groups in future, in particular to junior doctors as part of regular slots on postgraduate medical education programmes.  Due to the COVID-19 pandemic, it seems increasingly likely that future training will be delivered using virtual training approaches.  I believe these can work well, especially if software is used to share trainers’ screens so that exercises can be displayed for participants to work on.

I would very much encourage others to participate in health literacy training themselves and look for opportunities to deliver health literacy training in their Trusts.  Health literacy is a very important issue (particularly in the context of the COVID-19 pandemic) and it is therefore vital to raise awareness of it in our various local contexts.”

 

Now more than ever, health literacy is vitally important and impacts both on the individual and on the whole of society.  If these stories have inspired you to get involved and you would like some more information, training or advice, contact Ruth, Sue, Holly, Catherine or Joanne or email KFH.england@hee.nhs.uk

Joanne Naughton
HEE LKS Development Manager

Coronavirus information for patient groups

A key role for library and knowledge specialists through the pandemic is to signpost to trusted information. Notably, we can help NHS organisations fulfil their obligations under the Accessible Information Standard to provide information for patients, service users, carers and parents with a disability, impairment or sensory loss.

HEE’s Library and Knowledge Services team identified that it is difficult to find information about COVID-19 in accessible formats and for specific patient groups. In liaison with Public Health England, NHS England/Improvement and the Patient Information Forum, we have compiled information:

We will be adding information for carers, for people with specific conditions and on health and well-being.  Please help us to promote these invaluable resources to health and care staff and to information workers in other sectors.

The resources at https://library.nhs.uk  are the first part of a website promoting the work of NHS library and knowledge specialists to the healthcare workforce, the public and other stakeholders.  If you have thoughts on topics that you would like to see covered on Coronavirus or in the new website, please contact KFH.England@hee.nhs.uk

AI For Healthcare: Equipping the Workforce for Digital Transformation

AI For Healthcare was a course created by Health Education England and the University of Manchester, to provide a general overview of AI and how it can and is being used in the health sector. Anyone could access this course for a limited amount of time, although it was designed for healthcare workers in mind.

As someone who’s really interested in AI and machine learning (and a big fan of the Topol Review), I took the plunge and had a go. The course was incredibly useful, providing a great introduction to AI. It showed working examples of how it could be utilised, and the pros and cons of implementing new technologies.

Discussion was actively encouraged, and I chatted with wide variety of people working within the healthcare sector. There was the occasional quiz, but mostly people benefited from the rich conversations taking place in the comments sections.

The course was split into five weeks:

  • Week 1: Motivating AI in Healthcare
  • Week 2: What is Artificial Intelligence
  • Week 3: Data in Healthcare
  • Week 4: Making it Work
  • Week 5: Supporting and Skilling the Workforce

The first week was a brief introduction to the course, and looked at the opportunities and challenges of working within the health sector; using technologies to assist with healthcare in an increasingly demanding setting.  It was also an opportunity to introduce ourselves within the discussion, and how we believe our roles could utilise AI in the future. I mentioned monitoring library usage (seeing what resources/topics are popular) and targeted promotion, making resources more accessible and findable for users, more relevant current awareness updates and taking the edge out of literature searching.

We focused on ethical and social aspects of AI and machine learning, generating interesting discussion around if we would be comfortable with being provided personal information and news regarding our health by AI, and whether AI should be used by healthcare professionals to inform decision making. There was also debate on whether AI could essentially ‘replace’ certain services, such as GPs. The general consensus was that as the technology is designed to support, rather than replace services, that it is not capable or desirable for technology to replace human roles.

Further down the line, we looked at cases of AI in action with regards to identifying cancer in breast images. This was particularly topical as it had been recently reported in the news.

There was also an introduction to ‘team science’ theory, creating interdisciplinary teams to work together on projects. Experts from all kinds of different fields and backgrounds will be required for the development of AI in healthcare. Having a diverse range of professionals with different backgrounds, expertise and insights would be highly beneficial, both to reduce bias in software and to create something which can be used by a wide variety of people. I was keen to point out that LKS workers have great skills around Knowledge Management, accessibility and user-centred design, and that having LKS staff embedded into multidisciplinary teams would be an excellent use of our expertise.

We also looked at the challenges of AI; its implementation, management, and the need to educate and train staff on how to use it effectively. I believe this in particular is a golden opportunity for LKS staff; to educate, train, and advocate for the user, enabling them access to quality technology and providing them a safe space to learn and develop new skills.

All in all, the course was an excellent introduction. Being able to network with healthcare professionals was also very useful, as I was able to gage their thoughts and feelings about AI. The course tutors and mentors were fantastic, contributing to discussion and encouraging people to think outside the box. It was heartening also to see the support and interest from others in the roles of LKS staff, and how AI can be a useful tool in our libraries.

Below is a list of some resources which were recommended by the course:

 

Hannah Wood
Librarian
Weston Area Health Library
hannah.wood8@nhs.net