1. PATIENT EDUCATION: Patient Empowerment Maria A. Marzan, MPH Principle Associate, Family Medicine Associate Director, ICM

2. HEALTHY PEOPLE 2010 Leading Health Indicators, focusing on key health improvement activities, are described in Healthy People 2010: Understanding and Improving Health. All of these indicators will rely to some extent on effective Leading Health Indicators, focusing on key health improvement activities, are described in Healthy People 2010: Understanding and Improving Health. All of these indicators will rely to some extent on effective HEALTH COMMUNICATION www.healthypeople.gov www.healthypeople.gov

3. Relevance Patient-provider communication Patient-provider communication Health literacy Health literacy Patient education Patient education

4. HEALTH COMMUNICATION Communication can contribute to all aspects of disease prevention and health promotion as well as adherence to medical treatments. Provider-patient relations Provider-patient relations Search for and use of health information Search for and use of health information Adherence to clinical recommendations and regimens Adherence to clinical recommendations and regimens Public Health messages & campaigns Public Health messages & campaigns Population at risk information – “risk communication” Population at risk information – “risk communication” Mass media and the culture at large Mass media and the culture at large Access to public health and health care systems Access to public health and health care systems Development of telehealth applications Development of telehealth applications

5. Patient-Provider Communication Studies indicate patients find communication with providers: Studies indicate patients find communication with providers: Difficult Difficult Does not provide enough information Does not provide enough information Is not clear Is not clear Do not provide practical regimens Do not provide practical regimens

6. Pt.-Provider Comm. (cont.) Effective communication is essential for prevention and educational efforts at the clinical level…… Effective communication is essential for prevention and educational efforts at the clinical level…… Culturally and linguistically appropriate Culturally and linguistically appropriate Delivered at patient’s health literacy level Delivered at patient’s health literacy level Negotiate understanding of treatment options Negotiate understanding of treatment options Increases adherence Increases adherence

7. HEALTH LITERACY National Adult Literacy Survey indicate 90 million adults have inadequate literacy skills National Adult Literacy Survey indicate 90 million adults have inadequate literacy skills Print materials used are usually at 10 th grade level Print materials used are usually at 10 th grade level Culturally and linguistically limited resources Culturally and linguistically limited resources Disparities within certain target groups Disparities within certain target groups

8. HEALTH EDUCATION Goals & Objectives Most health education/promotion programs seek to: 1. Improve the learners’ knowledge and/or skills in a way that will 2. Improve their health behavior and 3. Improve their health status (outcomes)

9. LEARNING OBJECTIVES Learning objectives describe the knowledge, attitude, or skill development changes the program/education will seek to put into effect as means of encouraging favorable changes in behavior. Learning objectives describe the knowledge, attitude, or skill development changes the program/education will seek to put into effect as means of encouraging favorable changes in behavior. Example: The client can describe 3 actions that can alleviate a strong desire to smoke a cigarette Example: The client can describe 3 actions that can alleviate a strong desire to smoke a cigarette

10. Keep in mind: Human Behavior is Complex Participants/clients/patients base their opinion on their perception 1. How relevant the program or health education seemed to be in terms of their needs 2. How interesting it was in terms of subject matter and learning activities Tips: Assess the learner perceptions early Tips: Assess the learner perceptions early Adapt/adjust activities if needed Adapt/adjust activities if needed

11. Why is it important to educate patients about health? Promotes healthy living Promotes healthy living Prevents or minimizes disease Prevents or minimizes disease Increases adherence to treatment Increases adherence to treatment Impacts health outcomes Impacts health outcomes

12. What’s the process of patient education? Teaching Teaching Negotiation Negotiation Motivation Motivation

13. What are the challenges? Lack of readiness for change Lack of readiness for change Circumstances Circumstances Literacy level Literacy level Language barriers Language barriers Socio-economic level Socio-economic level Cultural and spiritual beliefs Cultural and spiritual beliefs 50% retention of information 50% retention of information

14. Patient Education TIPS Discuss; DON’T LECTURE! Discuss; DON’T LECTURE! Consider circumstantial & socio-economic factors Consider circumstantial & socio-economic factors Respect cultural/spiritual beliefs and attitudes Respect cultural/spiritual beliefs and attitudes Ask the patient what they understand about the health issue Ask the patient what they understand about the health issue Assess the patient’s readiness for change Assess the patient’s readiness for change Keep it simple Keep it simple Reinforcement, reinforcement, reinforcement Reinforcement, reinforcement, reinforcement Relapse is part of changing behavior Relapse is part of changing behavior

15. What are the opportunities? Group health education Group health education One on one health education One on one health education Patient-provider encounter – The clinical examination Patient-provider encounter – The clinical examination

16. What are some tools? Literature – pamphlets, leaflets Literature – pamphlets, leaflets Videotapes Videotapes Models Models Flip charts Flip charts Teaching boards Teaching boards Focused discussion Focused discussion

17. The 4 A’s for Individual Education Ask Ask Advise Advise Assist Assist Arrange Arrange

18. Conclusion Future research needs to address identification of optimal methods for communicating with patients who have low literacy skills Future research needs to address identification of optimal methods for communicating with patients who have low literacy skills Fam Med 2002;34(5):383-9 Fam Med 2002;34(5):383-9

19. “I never teach my pupils. I only attempt to provide the conditions in which they can learn.” “I never teach my pupils. I only attempt to provide the conditions in which they can learn.” Albert Einstein