Tag Archives: Patient and Public Information

Health Literacy Month

October is Health Literacy Month. For the last 20 years, organisations across the world have used October as an opportunity to raise awareness of health literacy.

So what is health literacy?

Health literacy is the ability to access, understand, appraise and use health information to make health-related decisions. In the UK, we know from work by Gill Rowlands that 43% adults struggle with text-based health information; rising to 61% if the health information includes numbers as well as text.

Health and social care staff need to be aware of health literacy issues to support access to information. Techniques such as “teach back” and “chunk and check” can increase understanding and the ability of individuals to own decisions about their health and wellbeing.

What is the local impact? This Health Literacy Month we are launching borough-level data on health literacy levels, for textual content and for health information that includes both text and numbers. This is analysis provided by Gill Rowlands and academic colleagues at the University of Southampton. We hope that this dataset will enable you to raise the profile of the issue locally and to prioritise activity.

What can NHS library and knowledge services do?

NHS library and knowledge services are well placed to advise colleagues on techniques to support people with low health literacy, to sign-post to patient information materials and to provide training. The health literacy toolkit includes a range of resources and guidance on techniques. We are currently cascading training to library and knowledge services staff, with a suite of materials in development to use in 2020.

How can I use Health Literacy Month?

Health Literacy Month provides an opportunity to have conversations about health literacy. These may be conversations within your service, using the toolkit to assess how you might be more health-literacy friendly. Or, they may be conversations with colleagues in other departments, or with partner organisations. There are international resources available to help you to add profile to Health Literacy Month.

If you would like to share ideas, do get in touch. Ruth Carlyle, Ruth.Carlyle@hee.nhs.uk, Strategic Lead NHS library and knowledge services – East of England and Midlands

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