in it together: improving health literacy for black msm · i . ii . in it together ~ improving...

In It Together:

Improving Health

Literacy for Black MSM Training of Trainers

Module 4: Written Communication

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

Recap of Module 3

General strategies for clear communication

Ask Me 3 Approach

Teach-back Method

2

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

Training goal

Trainers will increase their

awareness of strategies to

improve delivery of written

information

3

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

4

Objectives

By the end of this training, you will be able to:

Explain how written material can be used to address

health literacy

Identify at least 3 factors to consider when developing or

selecting written material

Identify at least 2 strategies that make prescriptions

instructions easier to understand

Understand the components of eHealth literacy

Describe 3 strategies to improve online communications

0 II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

What is written material?

5

life's a game, and with treatment, I'm winning it day by day." Christopher Washington, DC l 1'+' 1nq w1lh IIIV ••nni 191/,

I wa only 16 yPan. 11 whm Id overed th.lt

I w.n born w11h HIV My mother pil 1-d 11W 1y trom the hs but until g tttnq t ted at a commu, ly hrahh f,111: I Ii.Id no dt• thal I 10(1

was l1w,g w,1h HIV W1th1n a •ew Tionths of my

cha 00\LS I <J ton Ir tlnt"nt •o rol my vu I

lo.xf Smee then, I w- tayOO on t~atnw!nt and

m, ood health. tf'ttmq h ted saved my hf

•nc:tlW'iJ :-dmy Xpt"fttnt1 toh lp uth tun

about HIV prf"WflllOI\ ll' llng nd f,qtrtHlCJ

ugmn l 1Y I l'"f0Y fnend fanuly nnd hv1nq

I h U 1 HIV

Get in care. Stay in care. Live well.

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

What is written material?

6

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

7

Materials development poll

How many of your organizations:

a. Create your own materials?

b. Purchase or download material that is already created?

c. Both?

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

Traditional information exchange

In person from a health care provider

By talking to family and friends

Through newspapers, magazines, books, radio, and

television programs

8

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

9

Value of written material

Written information can:

Improve understanding

and recall of medical

information

Provide more information

about medical conditions,

treatments, or desired

outcomes

Facilitate adherence to

medical advice or

treatment

Reinforce information

provided by the health

professional

Support visual learners

Improve treatment

adherence

Facilitate discussions

about client concerns

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

10

Promising practices

for written material

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

11

Formatting Immediately appealing

Has a clear and obvious

path for the eye to follow

Uses headings and

subheadings (chunk)

Maintains consistent style

and structure

Uses bolding to

emphasize important

points

Uses easy-to-read font in

12 point or larger

Times New Roman

Arial

Calibri

Remember: I may read your handout with my smartphone.

Left-justify text

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

12

Word choice

Simple words with 1 or 2 syllables

Short sentences with 10 to 15 words

Strong, vivid words, including verbs

Words or phrases familiar to the audience

At a 6th grade reading level

Use culturally appropriate words

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

13

Content

Focus on the patient’s experience of the condition

Clearly state:

What the client needs to do

Why the client needs to do it

When the client can expect results

What warning signs the client needs to watch for

What to do if a problem occurs

Who to contact with questions

HIV CAN BE TRANS ITTED THROUGH ...

Sexual Pregn ncy, Ch ldb rth Injection Contact & Breast Feeding Drug Use

• 'I' .. tt

Occupational Exposure

' Blood Transfusion/Organ Transplant

14

literacy

Content (continued): Images and

pictographs

Use images and pictographs

Infographics and pictographs

promote recall

Ensure images are reflective of

target population

36% of American adults

have limited health

AS EARLY AS 2-4 WEEKS AFTER EXPOSURE TO HIV PEOPLE CAN EXPERIENCE ARS,

OFTEN DESCRIBED AS "THE WORST FLU EVER"

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

Images

What does this image communicate?

15

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

16

Avoid

ALL CAPITAL LETTERS

Italicized text

Underlined text

Acronyms and contractions

Technical words or jargon

Passive voice

Passive voice: The results of your lab work will be sent to you

Active voice: We will send you your lab results

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

17

Medication instructions,

intake forms, consent

documents, and websites

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

18

Medication instructions

Use actionable language

Be specific

Do not group medication

instructions

Use numerals

Provide visual

descriptions or images

(sun/moon, image of pill)

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

19

Intake and consent forms

Test forms with intended users

Revise as needed based on what you learn from users

Provide plain language forms to all clients (in multiple

languages if appropriate)

Train staff to answer client questions and help clients

complete forms

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

20

Assessments and tools

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

21

How to assess written material

Clinical assessment

Educational assessment

Technical assessment

Appeal assessment

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

22

Reading level assessment tools

Write at or below a 6th grade

reading level

Use readability assessments to

measure the complexity text

Flesch Reading Ease

Fry Graph Readability Formula

The SMOG Readability Formula

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

Clear language tools

Clear Communication Index (Centers for Disease

Control and Prevention)

Toolkit for Making Written Material Clear and Effective

(Centers for Medicare and Medicaid Services)

Patient Education Materials Assessment Tool (Agency

for Healthcare Research and Quality)

23

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

Group exercise: materials review Clinical assessment Accurate Current Sufficient

Appeal assessment Positive tone

Avoids stereotyping Avoids commercial product promotions

Technical assessment Illustrations are simple and easy to

understand Illustrations enhance the text Uses headings Main points are easy to find and understand Sentences are 10-15 words or less Paragraphs are 2-3 sentences Uses lists

Uses white space

Educational assessment Holds interest and attention of

reader Information is well-organized Avoids or defines all acr onyms Written at or below a 6th grade reading level Avoids unnecessary information

24

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

25

How to use written material

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

When to use written material

Use print material during clinical encounter

Use during or when approaching pivotal care points

Reinforce specific, important points about care and treatment

Refer to printed material in future visits and during

follow-up phone calls

26

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

27

How to use written material

Emphasize important information by circling or

highlighting it

Personalize the materials

Confirm client understanding of the material

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

28

Where to offer print material

Waiting rooms

In private areas

Exam rooms or meeting spaces

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

29

The digital age

and e-health

literacy

'

30

Changing landscape for health

information Web 2.0 Web 1.0

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

31

Changing health technology

landscape: Opportunities Increased availability and access to health information

Learning opportunities that are multisensory and

interactive

Access to and management of their own health care

information

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

32

Changing health technology

landscape: Challenges Reading level

Information overload

Cost

Time

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

33

How online health information is

used Find information on topics that are uncomfortable to

discuss in person

Supplement to traditional supports

Use smartphones and tablets to search

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

34

e-Health literacy

The ability to seek, find,

understand, and assess

health information from

electronic sources and

apply the knowledge gained

to address or solve a health

problem

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

Components of e-health literacy Traditional Literacy

Health Literacy Computer Literacy

Media Literacy Information Literacy Scientific Literacy

35

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

36

Developing digital content for

people with limited health literacy Use plain and clear language

Put the most important information first

Write actionable content

Ensure content is relevant to your audience

Use clear, consistent formatting

Design for compatibility with mobile devices

Ensure that content is accessible to people with

disabilities

You ~

Tube

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

Types of social media

37

H!Y,J g~

DIGITAL TOOLS

HIV BASICS FEDERAL RESPONSE DIGITAL TOOLS EVENTS BLOG P O ;:,::u,t ~

P1onrung ond Mono1;;ement

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

38

How health organizations can use

social media Go to HIV.gov to learn more about social

Patient outreach media tools and strategy. and engagement

To engage with

Black gay, bisexual,

and same-gender-

loving men

Promote your health

literacy efforts

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

39

Wrap up Today we learned:

How written material can be used to

promote health literacy

Why, how, when and where to introduce

patient material

How to select effective written material

Tips to use to create effective patient

material

Strategies that make prescription

instructions, intake forms and informed

consent documents easier to understand

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

Next steps

Creating Health

Literate Materials

40

II In It Together I ~ IMPROVING HEALTH LITERACY FOR BLACK MSM

41

If you have questions… Email: hivhealthliteracy@jsi.com

Phone: 404-460-4803

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and

Human Services (HHS) under grant number U69HA30143: Building Ryan White HIV/AIDS Program Recipient Capacity to Engage

People Living with HIV in Health Care Access. This information or content and conclusions are those of the author and should not be

construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

The persons shown in photographs on this website/tool/resource are models and are being used for illustrative purposes only.