TEMPLATE DESIGN © Promoting Functional Health Literacy Sandra Smith, MPH, PhD Center for Health Literacy Promotion, Seattle WA Health Promotion Approach A Conceptual Framework forMeasurement & Intervention Methods: Map Pathways to Progress Results: New Possibilities Objectives of the Conceptual Framework References Concept Functional Health Literacy is an Asset An array of skills that enables people to use information & services in ways that regain, maintain or promote health. One of Multiple Functional Literacies Approach: Build the asset Intervention Objectives: Improve use of health information & services Enable people to use information & services in progressively more effective ways to maintain or promote health Develop interpersonal, social & reflective ability to personalize information & apply it in real life Methods: Health education, skills development, social support in community & clinical settings Outcomes Changes in attitudes, motivations, knowledge, self-efficacy; actions behaviors, practices, environments Improved health functioning Concept Low Functional Health Literacy is a Deficit Lack of basic literacy skills that interferes with transmission of information from experts to patients. (Pink on framework) Approach: Identify & manage the risk Clinical Approach Intervention Objective: Improve understanding of health information & services Methods: Simplify information, Improve info delivery in clinical settings Readability, Plain Language, Ask Me 3, Multimedia OPTIONAL LOGO HERE Measurement Objective: Describe & monitor progress Method ?? Instruments ?? Measurement Objective: Identify at-risk patients/poor readers Method: Reading skills tests Instruments: REALM, TOFHLA, NVS Outcomes Improved knowledge Increased compliance Link theory to practice Capture the deeper meaning & practical purpose of functional health literacy Describe & measure improvement Make health literacy promotion practical for implementation Guide intervention to support individuals' & caregivers' efforts to achieve the two-part purpose of health literacy : 1. Use health information & services 2. in ways that maintain or promote health Problem : Understanding of functional literacy is limited to basic skills Innovations : Extend concept of functional literacy, in which skills enable function, to higher levels of health literacy. Now we have room to progress. Link progressive levels of health literacy skills to progressive levels of health functioning. Now we can describe progress. Identify skills, actions, attitudes, behaviors & practices to characterize levels of health functioning in a group of individuals. Construct Likert scales to map progress from inadequate to optimal health functioning. Now we can measure progress. See these methods in action AHRQ Health Care Innovations Exchange Coming soon www. innovations.ahrq.gov Pink = Limited understanding of FHL. Tan shapes & red arrows = health promotion contributions. NEW! Orange shapes, & green arrows = proposed elements & connections Promote Functional Health Literacy in clinical & community settings New Authentic Measures Increase understanding of FHL Capture improvements in information, services & function Inform & guide practice New directions for health literacy intervention Nutbeam, D. (2008).The evolving concept of health literacy. Social Science &Medicine, 67, Smith, SA. (2009). Promoting Health Literacy: Concept, Measurement & Intervention (PhD dissertation. Union Institute & University, Cincinnati). Wollesen, L. & Peifer, K. (2006). Life Skills Progression: An outcome and intervention planning instrument for use with families at risk. Baltimore: Brookes. Reflective Drawing logo art by Laurel Burch Funders: AHRQ, NICHD