Tag Archives: Health Literacy

Applying the International Handbook of Health Literacy to health library and knowledge services

Personal reflections by Ruth Carlyle

The International Handbook of Health Literacy was published at the beginning of August 2019. Thanks to funding from the German Federal Ministry of Education and Research, the 740 page volume is available open access

The editors bring together a truly international set of papers in the 45 chapters. The volume is in four parts: research into health literacy, an overview of recent developments; programmes and interventions to promote health literacy; policy programmes to promote health literacy; and future dialogue and new perspectives.

As a collected work, the International Handbook of Health Literacy affirms the relevance of health literacy across a wide range of disciplines and ‘the potential that has been attributed to health literacy in order to understand, explain and tackle individual as well as group differences in various health outcomes’ (p. xxi). Despite this potential, there is no unanimously accepted definition or measurement of health literacy (p. xxii, 139). Most of the definitions also focus on the ‘literacy’ aspects of ‘health literacy’ rather than the ‘health’ aspects (p. 649).

In the closing chapter, Stephan Van der Bourke suggests that there are three types of strategy that can be applied to address low health literacy: better health communication; better health education for the general population; and creating health literacy-friendly settings (p. 706).

Considered from the perspective of library and information services, the specific references to libraries and librarians appear in the third section of the volume, on policy programmes to promote health literacy. It is notable that the most extensive references appear in Chapter 28 on the development and implementation of Making it easy and Making it easier as health literacy policies for Scotland. NHS Education for Scotland works with library and knowledge services across a range of sectors to improve ‘signposting to useful health information’ (p. 425) and identifies closer working with librarians as one of the areas for further development (p. 431). Librarians elsewhere are involved in supporting health literacy through training the healthcare workforce (National Network of Libraries of Medicine, United States, p. 499), embedding health literacy into research and practice (British Columbia, p. 447) and creating portals of resources (New Zealand, p. 508).

The multidisciplinary and international nature of the handbook provide a resource that emphasises the scale of low health literacy as an issue and the need for a shared approach working across disciplines. The individual chapters provide insights into research studies and the needs of specific audiences, such as children and older people. Themes through the volume provide evidence of the importance of improving the awareness and communication of healthcare professionals, signposting to high-quality health information for the public and creating health literacy-friendly environments. These reinforce the value of the roles that health library and knowledge services can play in health literacy.

Health Literacy: an issue for life

To make good decisions about our health, we need to find, understand, appraise and apply health information.  This is the essence of good health literacy.

 

What is the issue?

Levels of health literacy in England are very low: 43% of working age adults cannot understand textual health information, rising to 61% when a numeracy element is added (1); and 43% adults are unable to calculate paracetamol dosage for a child based on age and weight (2).  Individual health literacy also varies.  If someone has just had a significant diagnosis, then their ability to comprehend information will be reduced.

As people live longer with multiple health conditions, they need to be able to make the treatment choices that are right for them, and to understand how to use self-management techniques or take medications.

 

What role for health library staff?

Working with patients and the public takes different forms within NHS library and knowledge services.  All depend upon library and knowledge services staff having the confidence to see how core skills in finding evidence and appraising sources apply to health information materials for patients and the public.  Supporting the health literacy awareness of colleagues, and identifying information resources of differing levels of complexity, can enable library and knowledge services to have an impact on the way that patient information materials are used.  This supports treatment choice and effective self-management of health conditions.  For this reason, health literacy is a priority for Knowledge for Healthcare work on patient and public information in 2018-2020

Library personnel in education and public library sectors are keen to collaborate on health literacy, as the information literacy and digital literacy skills that they promote feed into health literacy. Whereas good information literacy in education may be seen as a short-term benefit for coursework, health literacy is a life skill.

 

What next?

In 2018-19 we will be offering training on health literacy awareness and accredited “train the trainer” training for health library and knowledge services staff in England, which can be used as the basis of training for NHS staff and partner organisations, including public libraries.

In the meantime, resources are available to increase your awareness of health literacy issues, with tools that you can use.  Working with NHS England, Public Health England and the Community Health and Learning Foundation, Health Education England has developed a health literacy toolkit, including case studies and a “how to” guide https://www.hee.nhs.uk/our-work/health-literacy .

If you have ideas, questions or would like to be involved in shaping health literacy activity, contact Ruth.Carlyle@hee.nhs.uk

Ruth Carlyle

References

  • Rowlands, G. et al. A mismatch between population health literacy and the complexity of health information: an observational study. British Journal of General Practice Jun;65(635):e379-86. doi: 10.3399/bjgp15X685285. https://www.ncbi.nlm.nih.gov/pubmed/26009533
  • Mayor, S. 2012. Nearly half adults in England don’t understand health information, study indicates. British Medical Journal 345:e8364 https://www.bmj.com/content/345/bmj.e8364

Update from HEE LKS Leads

A few points of feedback for LKS managers and teams from the meeting of the HEE Library and Knowledge Service Leads Group on 26 February:

  • Developing and making the case for an equitable funding model for NHS LKS is a current high priority. We hope to be able to engage with Trusts on our proposals during this year.
  • With the Department of Health, we are currently negotiating extension of the CLA Licence Plus for the NHS in England for a further five years from April 2018.
  • With NICE, we are progressing re-procurement of a new national core content collection from April 2019, and also exploring options for extended collaborative purchasing of e-resources. Our thinking informed by feedback from the 90% plus LKS teams who responded to our survey and provided information about local investment in e-resources – thank you!
  • Work continues on development of the new national LKS quality assurance process, which will feature a much reduced number of quality standards with associated evidence requirements, and graded levels of attainment. The process will be piloted by a small number of LKS this year.
  • Building on the work to date within the Knowledge for Healthcare Public and Patient Information work stream, it has been agreed that the role of health librarians in supporting health literacy will be the focus of this work stream for the next two years. A blog post about this will follow shortly.
  • The Workforce Planning and Development work stream has identified CPD priorities for the LKS workforce for the next two years, drawing on feedback from recent development needs analyses and a review of strategic priorities. Meanwhile, we are submitting a response about the healthcare LKS workforce to the consultation on ‘Facing the Facts, Shaping the Future’ (the draft national workforce strategy for health and care for England to 2027).
  • Three more STEP literature searching e-learning modules are now available, and a new set of knowledge management e-learning modules are in development, with the design of the knowledge management postcards being refreshed to match.
  • More #AMillionDecisions social media cards are being created, featuring quotes about the role of library knowledge specialists from senior national NHS leads. An HEE LKS presence at June’s NHS Confederation Conference will provide a further opportunity for high level advocacy, and we are delighted that a number of Knowledge for Healthcare-related papers have been accepted for this year’s HLG and EAHIL conferences.

If you have comments or queries relating to this bulletin, please contact your HEE LKS Lead.