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2nd January 2017

10 ways to boost health literacy

These simple tricks can improve patients’ ability to understand health information

Roughly one in two people in Europe have health literacy problems, according to a study of eight European countries. As outlined in an earlier post, this is an important issue for Europe, particularly as the population ages and we all take a more active role in managing our own health.

So can anything be done to ensure people understand vital health information?

Thankfully, the answer is ‘yes’! There are plenty of steps that can be taken to improve communication and check comprehension. Plus, new information technologies provide high-tech tools for connecting patients and health professionals:

1. Doctors, nurses and pharmacists should always use the Teach Back method when sharing information with patients, according to Frank Federico of the Institute for Healthcare Improvement in the US. The idea is simple: once a patient has been given details of their condition or medication, ask them to explain what they have just heard.

2. Similarly, when patients or caregivers are taught how to use a medical device or eHealth technology, asking them to show the trainer how to use the product will quickly confirm whether they are capable of using it independently. This is often called ‘Show Back’ – a close cousin of the Teach Back approach.

3. General literacy is closely related to health literacy: if a patient cannot read well, they are considerably less likely to understand text. A simple test of whether the patient can use written material is to hand them an instruction leaflet upside down while discussing it – and observe whether they turn it around.

4. Simple language can also help. Some communication barriers arise when patients have lower levels of education or do not share a common first language with their healthcare providers. Overuse of technical jargon is inconsiderate. In order to be understood, health professionals should choose their words well. In English, examples can include: saying ‘swallow’ instead of ‘take’, saying ‘fats’ instead of ‘lipids’, saying ‘belly’ instead of ‘abdomen’.

5. Pictures and graphics can also help. But be warned: complex diagrams or needlessly complicated charts can be overwhelming for those not familiar with them. Think how a well-designed advertisement would seek to communicate a complex topic – like how washing powder works or why toothpaste can help fight dental plaque

6. Patients are not the only targets of health communication, nor are health professionals the only ones who must communicate health information. The EU-funded IROHLA project highlights several key principles of good health literacy interventions, including empowerment of caregivers. They highlight the Filmauve project which equips caregivers with the skills they need to work with family members living with dementia.

7. Community-based initiatives can play a valuable role in sharing and reinforcing health messages. One example is the Austrian project Lebenswerte Lebenswelten which taps into existing community networks to empower older people to care for their own health. Home visits from volunteers, health cafes and international learning help to support older women with low socio-economic status.

8. Online networks can help too. For example, the Dutch website 50plusnet provides an accessible way to connect with peers and professionals in order to address social inclusion and mental health. It can be a source of health information and a support network for people struggling with health literacy challenges.

9.eHealth tools are one of the fastest growing areas of health literacy. One Finnish project called EXSOTE has studied remote monitoring and health coaching in reaching vulnerable older adults with chronic diseases. Researchers used a combination of eHealth and mobile techniques, along with personal health coaches, to improve the health of their patient target group. Their findings? That remote monitoring of diseases is most effective when combined with human support.

10. Mobile apps also have great potential to explain health information, offer video tutorials and provide diary or reminder systems. However, some experts are concerned that the growing role of consumer technologies could exacerbate health inequalities. The risk is that those who are best able to cope with complex information and to use sophisticated digital tools will become increasingly proficient at managing their health, while those who are already disadvantaged by low levels of health literacy fall further behind. That’s why app developers have a responsibility to design solutions that work for everyone – not just the tech-savvy iPhone aficionados.

Whether it’s paper, tablet, laptop or personal contact, it’s important to keep in mind that most patients are not medical experts. Some have low levels of education while others are experts in non-medical areas.

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