Health Literacy

By Ginny Hosbach, RN, MSN

Health literacy is the ability to read, understand and act on health information. About 90 million Americans (nearly 1 in 2 adults) do not understand basic health information, according to the Institute of Medicine (IOM) Report.  By some IOM estimates, low literacy levels cost the healthcare system more than $58 billion annually.  The Partnership for Clear Health Communication is the first national coalition of organizations who are working together to promote awareness and solutions around the issue of low health literacy and its effect on health outcomes. This organization supports the findings in the IOM report, “Health Literacy: A Prescription to End Confusion.”

The organization’s first initiative is “Ask Me 3”, a quick and effective tool designed to improve communication between patients and providers. “Ask Me 3” promotes three simple but essential questions that patients should ask their providers in every health care interaction: What is my main problem? What do I need to do? And Why is it important for me to do this?

“Ask Me 3” provides tips for clearer health communication.  Some of these tips include having the patient commit to asking these 3 questions, bring a friend or family member to help at their doctor visit, make a list of health concerns to tell their doctor or nurse, bring a list of all medicines, and ask their pharmacist for help when they have questions about my medicines.

Is your patient able to read their prescription drug bottles, appointment slips, medical education brochures, doctor's directions and consent forms? What is their numerical or computational ability to calculate or reason numerically? With the development of the Internet as a source of health information, health literacy may also include the ability to search the Internet and evaluate websites.

There are three tools that were designed to specifically measure health literacy, The Test of Functional Health Literacy in Adults (TOFHLA), The Rapid Estimate of Adult Literacy in Medicine (REALM) and the Newest Vital Sign (NVS). Check these out for use in your situation.

Offer help confidentially, provide privacy and be non-judgmental. Offer assistance and get feedback from the patients to identify what they know.  Use the teach-back and show-back strategies to identify the patient’s understanding of the information provided.