Health Literacy Demands of Written Health Information Materials: An Assessment of Cervical Cancer Prevention Materials

Abstract

(DH, CH, NO); and the Behavior Change Research Group, Population Sciences and Cancer Control Program (DH, JC) at the University of New Mexico, Albuquerque, New Mexico. Submitted August 14, 2007; accepted February 26, 2008. Address correspondence to Deborah Helitzer, ScD, Family and Community Medicine, University of New Mexico, MSC 09-5040, Albuquerque, NM 87131. E-mail: helitzer@salud.unm pitalization have been documented. [1][2][3] Evidence demonstrates that patients with lower health literacy incur higher health care costs, 1,4 and health literacy has been linked to lower use of preventive services such as Pap tests, mammograms, and dental care. 5,6 The Institute of Medicine and Healthy People 2010 define 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." 7 Functional health literacy requires complex, multidimensional skills, including reading, writing, listening, numeric literacy, oral and visual communication, and decision-making abilities. It also calls for an understanding of health topics (such as cervical cancer) and the ability to navigate health systems. 8,9 Written health education materials and forms, which the health system IntroductionResearch continues to reveal the association between literacy and health. Literacy is defined as "using printed and written information to function in society, to achieve one's goals, and to develop one's knowledge and potential." 1 Relationships between literacy levels and heart disease, physical health, and rates of hos- most often relies on to convey information and treatment procedures, place certain "demands" on their users or readers. These demands compel health consumers to use their functional health literacy skills to read (at different levels), interpret, comprehend, analyze, and apply the information they gain from these written materials. These demands may be substantial if materials are written at a high reading level, if text and format are too dense, or if concepts are ambiguous and nonmotivating.Thus, health literacy is not a one-sided issue, limited to the capacity or capabilities of the patient/client. Indeed, the health system itself places complex demands on health consumers. These demands include requiring people to self-manage their health care, read difficult texts, and understand their health rights, as well as obliging them to find their way (navigate) in confusing clinic/hospital settings with technical medical signs or without conveniently placed or easy to read maps. 10 National Literacy AssessmentsIn 2003, the National Assessment of Adult Literacy (NAAL) was conducted in the United States with more than 19,000 adults. The NAAL included a separate literacy component intended to measure adults' ability to use literacy skills to read and understand health-related information. The results indicated that most (53%) adults had intermediate health literacy, and 12% scored in the proficient range. The...

Readability of Patient Education Materials Available at the Point of Care

“…In 2004 Wallace et al 13 found that only 7% of the American Academy of Family Practice's PEMS were written below an 8 th grade reading level. Various subspecialties such as cardiology 14,15 , infectious disease, 16 plastic surgery, 17 dermatology, 18 orthopedics, 19,20 palliative care, 21 oncology 22,23 and obstetrics and gynecology 24,25 have studied the readability of the PEMs utilized in their fields, and findings consistently indicate that 9 th -12 th grade reading levels are necessary to read and comprehend these documents.…”

Ciudadanos informados y empoderados: claves para el pleno ejercicio de los derechos en salud

“…Estas actividades podrían redirigir la atención de los gobiernos regionales a los establecimientos de salud del primer nivel, que sufren de múltiples carencias materiales, déficit de profesionales de salud, falta de gestión eficiente, y son justamente los que han sido más olvidados, tomando en cuenta que la falta de conocimientos sobre salud es la principal brecha entre el entendimiento entre los prestadores de salud y la población (6) .…”

Testing innovative strategies to reduce the social gradient in the uptake of bowel cancer screening: a programme of four qualitatively enhanced randomised controlled trials

“…169 Completion of this questionnaire involves assigning a series of scores to the following aspects of the leaflet: literacy demand; numeracy; graphic material; layout and typography; and learning, stimulation and motivation. Scores are given as a percentage and a minimum The leaflet was a national and not a local intervention and so the language used had to be modified to suit a varied UK audience.…”

“…Finally, we evaluated the leaflet using the Suitability and Comprehensibility Assessment of Materials questionnaire. 169 These stages of development are described in more detail below.…”