Academic journal article Online Journal of Issues in Nursing

Enhancing Written Communications to Address Health Literacy

Academic journal article Online Journal of Issues in Nursing

Enhancing Written Communications to Address Health Literacy

Article excerpt

Abstract

Health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Poor health literacy affects nearly one in two United States adults and greatly increases the cost of healthcare. Most patient education materials are written at a grade level too high to understand. This article describes how to write and design printed patient education materials to make them more understandable and usable. A review of reading tests to determine grade level and design appropriateness is provided. A comprehensive guide for writing patient education materials is presented. The need for continuous evaluation of written materials is discussed.

Citation: Mayer, G., Villaire, M., (Sept. 30, 2009) "Enhancing Written Communications to Address Health Literacy" OJIN: The Online Journal of Issues in NursingVol. 14, No. 3, Manuscript 3. Available: www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No 3Sept09/Enhancing-Written-Communications.aspx

Keywords: effective communication, health behavior, health communication, health education materials, health literacy, health material design, literacy, medical jargon, patient education, readability, readability tests, written material design

Health literacy means different things to different people. Some people equate health literacy with the ability to read. Their assumption is that if one can read, one can understand health information. However, this assumption is not necessarily valid. Neither a high school education nor advanced reading skills guarantee that a person will understand health information (Nielsen-Bohlman, Panzer, & Kindig 2004). For example, the term "myocardial infarction" may not be understood by a person who has had a college education but who lacks knowledge of healthcare terms. However, a person who has difficulty reading may understand this term if a friend or family member has had a heart attack and the term was used during that experience.

Health literacy has many definitions. Healthy People 2010 has defined health literacy as "the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions" (Ratzan & Parker, 2000). A key point in this definition is the behavioral component associated with health literacy. Not only do people have to be able to understand the words, but they have to be able to critically assess the information and take appropriate action. Therefore it is important to write in a manner that everyone can understand - the simpler and more straightforward, the better. Written documents must be easy to read, simple to understand, and lead to appropriate action.

More than half the adults in the United States (US) may have difficulty understanding health information. As many as 90 million people in this country read at less than a fifth grade level (Kirsch, Jungeblut, Jenkins, & Kolstad, 2003), and 36% have only basic or below basic health literacy skills (Kutner, Greenberg, Jin, & Paulsen, 2006). Low health literacy in the US costs the healthcare system anywhere from $106 to $236 billion dollars a year (Vernon et al., 2007). Those with poor literacy skills have trouble navigating the healthcare system; obtaining, understanding, and using their health insurance plans appropriately; reading, understanding, and acting correctly on medical instructions; taking their medications as prescribed; and actively participating in their healthcare decisions (Rudd, Kirsch, & Yamamoto, 2004). Hence, those with poor literacy skills are not receiving quality healthcare and typically overuse high-cost healthcare venues, such as emergency rooms and hospitals. They are also frequently rehospitalized for failure to correctly follow discharge and after-care instructions (Villaire & Mayer, 2007). …

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