1. Kara McGirr, Sue Brandt, Melodie Sherer, and Cheryl Krueger Team 4

2. “The degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.” (Ratzan & Parker, as cited in National Institutes of Health, 2010) Approximately 90 million US adults have difficulty understanding and implementing health information. (Bohlman, et al., 2004)

3.  Improves communication between patient and health professional  Promotes patient access and compliance  Advances understanding of cultural diversity and language  Improves health outcomes and disease prevention  Reduces unnecessary costs

4. (National Assessment of Adult Literacy 2003)

5.  Verbal questions  Do others help you fill out forms?  Exam Room Clues  Makes excuses to read later  Provides incomplete history  Misses appointments  Makes medication errors  Administered Literacy Tests  Newest Vital Signs (NVS)  Test of Functional Health Literacy in Adults (TOFHLA)

6. NVSREALM-R WORD LIST  Fat  Flu  Pill  Allergic  Jaundice  Anemia  Fatigue  Directed  Colitis  Constipation  Osteoporosis (adultmeducation.REALM) (www.pfizerhealthliteracy.com(www.pfizerhealthliteracy.com)

7.  Cultural and Linguistic Competence: The ability of health care providers and health care organizations to understand and respond effectively to the cultural and linguistic needs brought by the patient to the health care encounter. (www.ahrq.gov)

8.  "Culture affects how people communicate, understand, and respond to health information" (www.health.gov)www.health.gov  Barriers : Primary language spoken in the household Beliefs Values Attitudes Traditions LEP: Limited English Proficiency (www.health.gov)

9.  Speak slowly and simply  Use pictures or photos to explain procedures  Encourage patients to bring a family member or friend to the appointment  Ask the patient to repeat prescription or discharge directions

10.  Train medical students how to recognize low health literacy  Create a climate that promotes health literacy  Provide ongoing training for all health care facility employees

11.  Use medically trained interpreters  Convey health information through storytelling  Create photonovellas

12. The National Institute of Health, U.S. Department of Education, American Medical Association, and other agencies currently fund scientific research, analysis, and application in order to promote health literacy. Understanding and improving the level of health literacy is fundamental to the wellness of all Americans and the advancement of our health care system.

13.  National Center for Cultural Competence http://www.clcpa.info/ http://www.clcpa.info/  Healthy People 2010 http://www.healthypeople.gov/Document/HTML/Volume1/11 HealthCom.htm http://www.healthypeople.gov/Document/HTML/Volume1/11 HealthCom.htm  Literacy and Health Outcomes http://www.ahrq.gov/clinic/epcsums/litsum.htm http://www.ahrq.gov/clinic/epcsums/litsum.htm  The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy (NAAL) http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483 http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483

14. Cornett, S. (2009). Assessing and Addressing Health Literacy. OJIN: The Online Journal of Issues in Nursing, 14(3). Retrieved September 13, 2010 http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Tabl eofContents/Vol142009/No3Sept09/Health-Literacy-Through-Storytelling.aspx http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Tabl eofContents/Vol142009/No3Sept09/Health-Literacy-Through-Storytelling.aspx Day, V. (2010). Promoting health literacy through storytelling. OJIN: The Online Journal of Issues in Nursing, 14(3). Retrieved September 13, 2010. http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Tabl eofContents/Vol142009/No3Sept09/Health-Literacy-Through-Storytelling.aspx http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Tabl eofContents/Vol142009/No3Sept09/Health-Literacy-Through-Storytelling.aspx Easton, P., Entwistle, V.A., & Williams, B. (2010). Health in the ‘hidden population’ of people with low literacy. A systematic review of the literature. BMC Public Health, 10 (459), 1-10. http://www.biomedcentral.com/content/pdf/1471-2458-10-459.pdf http://www.biomedcentral.com/content/pdf/1471-2458-10-459.pdf Harvard School of Public Health (2010). Health Literacy Studies Overview. RetrievedSeptember 1, 2010. http://www.hsph.harvard.edu/healthliteracy/overview/ http://www.hsph.harvard.edu/healthliteracy/overview/ Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy (NAAL), http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483 Healthy People 2010,http://www.healthypeople.gov/Document/HTML/Volume1/11HealthCom.htmhttp://www.healthypeople.gov/Document/HTML/Volume1/11HealthCom.htm Hess, J., Whelan, J. S. (2009). Making health literacy real: Adult literacy and medical students teach each other. Journal of the Medical Library, 97(3), 221-224. Literacy and Health Outcomes, http://www.ahrq.gov/clinic/epcsums/litsum.htmhttp://www.ahrq.gov/clinic/epcsums/litsum.htm

15. National Center for Cultural Competence, http://www.clcpa.info/http://www.clcpa.info/ National Center for Education Statistics, Retrieved September 15, 2010. http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483 http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483 National Institutes of Health, Clear communication. An NIH health literacy initiative. Retrieved September 15, 2010 from http://www.nih.gov/clearcommunication/healthliteracy.htm http://www.nih.gov/clearcommunication/healthliteracy.htm Nielsen-Bohlman, L., Panzer, A. M., Kindig, D. A. (Eds.), (2004). Health literacy: A prescription to end confusion (Free Executive Summary), 1-18. Retrieved September 15, 2010, from http://www.nap.edu/openbook.php?record_id=10883&page=1 http://www.nap.edu/openbook.php?record_id=10883&page=1 Newest Vital Sign (NVS), Retrieved September 16, 2010 from http://www.pfizerhealthliteracy.com/pdf/FH_vitalsigns_040605.pdf http://www.pfizerhealthliteracy.com/pdf/FH_vitalsigns_040605.pdf Ratzan, S., Parker, R. Introduction: Health literacy. In: Selden, C., Zora M., Ratzan, S., Parker R. (Eds). National Library of Medicine Current Bibliographies in Medicine: Health Literacy. NLM Pub. No. CBB 2000-1. Bethesda, MD: National Institutes of Health, 2000. Rudd, R. (2010). Literacy and Health. Department of Society, Human Development, and Health: Harvard School of Public Health. Retrieved September 15, 2010. http://www.hsph.harvard.edu/healthliteracy/files/overview_slides.pdfhttp://www.hsph.harvard.edu/healthliteracy/files/overview_slides.pdf Test of Functional Health Literacy, Retrieved September 18, 2010 http://education.gsu.edu/csal/TOFHLA.htmhttp://education.gsu.edu/csal/TOFHLA.htm U.S. Department of Health and Human Services: Office of Disease Prevention and Health Promotion 2009, Quick Guide to Heath Literacy: What is cultural and linguistic competency? http://www.health.gov/communication/literacy/quickguide/factsbasic.htm://www.health.gov/communication/literacy/quickguide/factsbasic.htm Williams, M. V., Davis, T., Parker, R. M., Weiss, B. D. (2002). The role of health literacy in patient-physician communication. Communicating with Special Populations, 34(5), 383-389.