1/29/20 Health Literacy Reading the word and reading the world (Paulo Freire, 1976) Presentation to Ministry of Health NGO Health & Disability Sector National Forum, 12 October, 2016
Ref: http://asha-india.org/ C: The worst part, hardest part is, what questions to ask. Have you got any questions? You know, well, well. Can I have a cigarette? You know what I mean? [laughs]
Ref: Balmer (2015) Context Change C: Heres the blocked artery there . . . Pretty blocked intnt it. R: Yeah, it really is. C: Oh shit thats me, thats inside me!
Six weeks later: C: . . . last thing I can remember was this feeling of something going through my chest like someone poured water across it and that was it. Right you can go now and then they come back with that horrible photo (laughs). . R: Oh yeah thats a great photo though C: Yeah, yeah, Ive got that pinned on my wall. (laughs heartily) Oh no! When I think about a cigarette, I look at it.
Health Literacy The capacity of individuals to obtain, process and understand basic health information and services needed to make appropriate health decisions. (Ratzan & Parker, 2000; IOM 2004 USA) The degree to which individuals can obtain, process and understand health information and services they need to make appropriate health decisions (Health Quality & Safety Commission, NZ)
The capacity to find, interpret and use information and health services to make effective decisions for health and well-being. ( www.health.govt.nz , 2016) Health literacy has to do with the social and cultural practices that individuals and groups may engage in, in the process of understanding, accessing and using healthrelated tools and services (Papen and Walter, 2008). Health Literacy definition discussion continues Component 1: Include system demands and complexities as well as individual skills and
abilities must address both sides of the context individual, health professional, system demands Component 2: Include measureable components, processes, and outcomes Component 3: Recognize potential for an analysis of change HL is dynamic, changing Component 4: Demonstrate linkage between informed decisions and action provision of information to people in a way they understand to help them make informed decisions/action Ref: Pleasant, Rudd, et al (2016) Considerations for a new definition of health literacy. Discussion paper. National Academy of
Medicine, Washington DC. HL & Outcomes The evidence confirms a relationship between health literacy and poorer health outcomes (albeit using a range of literacy/reading measures)
worse glycaemic control amongst type 2 diabetic patients 1 predicted all-cause mortality and cardiovascular death among community-dwelling elderly persons 2 increased hospitalisations and emergency care 3 decreased mammography screening and influenza immunizations 3
less ability to properly manage and understand their medications 3 1.(Schillinger et al, 2002; Rotham et al, 2005) 2. Barker, et al. (2007) 3. Berkman et al (2011) Ref: Thorn, W. (2016)
Ref: Thorn, W. (2016) Ref: Thorn, W. (2016) Ref: Thorn, W. (2016) A Health literate organisation . . . makes it easy for people to navigate,
understand, and use information and services to take care of their health. (Brach et al, 2012) 6 Dimensions
Leadership & management Consumer involvement Workforce Meetings needs of population
Access and navigation Communication Access to information on condition and care Mrs Newton: The same one told me before you eat anything in the morning get up go to the toilet, get weighed and record it. So when they tell me that, they've worked hard to become doctorsI respect them for itso this is the least they ask me to do. . . . If it wasn't for doctors like that, I wouldn't still be here. So I have to play my part and do what I am told.
Mrs Newton: I looked at the last page of the book and read the symptoms and started to cry. [later on] . . . it was such a relief to get some answers because Im going to go out in the afternoon and couldnt get my damn shoes on and think why are my damn feet swelling up like this. . . . That book . . . It told me all of the things like getting - why I get short of breath like I do. But my doctor is a damn good doctor, she really is. She probably knew these things but
she didnt bother telling me about it. New vocabulary Technical c.f difficult vocabulary A patient needs enough technical vocabulary to talk about their condition - offer a simple pen and paper Adults can and do learn very quickly to read and
write words which they use every day and which make sense to them (Rogers & Street, 2012, p161). Learning is related to real problems or concerns in our lives. References Australia India Institute, The Nossal Institute for Global Health, The University of Melbourne, (2011) Asha: Hope and Transformation in the Slums of Delhi http://asha-india.org/wpcontent/
Balmer, D. G. B. (2015) Health Literacy: Patient texts, context and mediation. (Doctoral Thesis , University of Waikato, Hamilton, New Zealand) Retrieved from http://hdl.handle.net/10289/9487 Barton, D., & Hamilton, M. (2000). Literacy practices. In D. Barton, M. Hamilton & R. Ivanic (Eds.), Situated literacies: Reading and writing in context (pp. 715). London: Baker, D. W., Wolf, M. S., Feinglass, J., Thompson, A., Gazmararian, J. A., & Huang, J. (2007). Health literacy and mortality among elderly persons. Archives of Internal Medicine, 167(14), 1503-1509. Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J., & Crotty, K. (2011). Low health literacy and health outcomes: An updated systematic review. Annals of Internal Medicine, 155(2), 97-107. Brach, C., Dreyer, B., Schyve, P., Hernandez, L. M., Baur, C., Lemerise, A., and Parker, R. January 2012. Attributes of a Health Literate Organization. Institute
of Medicine of the National Academies of Sciences, USA. Freire, P., & Macedo, D. (1987). Literacy: Reading the world and the word. South Hadley, MA: Bergin Garvey. Ministry of Health. (2012) Rauemi Atawhai: A guide to developing health education resources in New Zealand. Ministry of Health, Wellington Papen, U. (2005). Adult literacy as social practice: More than skills. Oxen, UK: Routledge. Papen, U., & Walters, S. (2008). Literacy, learning & health. London, UK: National Research and Development Centre for Adult Literacy and Numeracy. Pleasant, Rudd, et al (2016). Considerations for a new definition of health literacy. Discussion paper. National Academy of Medicine, Washington DC. Routledge. Ratzan, S. C, Parker, R. M. 2000. Introduction. In: National Library of Medicine Current Bibliographies in Medicine: Health Literacy. NLM Pub. No. CBM 2000-1.
Selden CR, Zorn M, Ratzan, S.C., Parker, R.M., Editors. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services Rodgers, A., & Street, B. (2012). Adult literacy and development: Stories from the field. Leicester, UK: National Institute of Adult Continuing Education. Rotham, R. L., Malone, R., Bryant, B., Wolfe, C., Padgett, P., DeWalt, D. A., . . . Pigone, M. (2005). The spoken knowledge in low literacy in diabetes scale: A diabetes knowledge scale for vulnerable patients. The Diabetes Educator, 31, 215-224. Schillinger, D., Grumbach, K., Piette, J., Wang, F., Osmond, D., Daher, C., . . . Bindman, A. B. (2002). Association of health literacy with diabetes outcomes. JAMA, 288, 475-482. Street, B. (1984). Literacy in theory and practice. New York: Cambridge University. Thorn, W. (2016). Why skills matter: A summary of results from the survey of adult skills, Directorate for Education and Skills, OECD
Semi-structured data. Common way to transfer data between software applications. Because plain-text is universal, datasets are often posted using semi-structured formats. Unstructured data. It's everywhere. Up to 70% to 80% of an organization's data may be in unstructured forms (Wikipedia)
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