June 24, 2003 Health Communications Progress Review Focus Area 11

11-1. Household internet access by race and ethnicity, Asian/Pacific Islander White Hispanic Black Note: Asian/Pacific Islander, Black, and White are not Hispanic; Hispanic can be of any race. Source: U.S. Department of Commerce, Bureau of the Census, Computer and Internet Use Supplement to the Current Population Survey target Total Percent

11-1. Household internet access by gender, Female Male Source: U.S. Department of Commerce, Bureau of the Census, Computer and Internet Use Supplement to the Current Population Survey target Percent

11-1. Household internet access by education level of head of household, Less than high school High school graduate At least some college Source: U.S. Department of Commerce, Bureau of the Census, Computer and Internet Use Supplement to the Current Population Survey target Percent

11-1. Household internet access by geographic location, Urban Rural 2010 target Source: U.S. Department of Commerce, Bureau of the Census, Computer and Internet Use Supplement to the Current Population Survey. Percent

11-1. Household internet access, 2001 Black Less than high school Urban Percent 2010 target White Female Male Hispanic High school At least some college Rural A/PI Note: A/PI (Asian/Pacific Islander), Black, and White are not Hispanic; Hispanic can be of any race. Source: U.S. Department of Commerce, Bureau of the Census, Computer and Internet Use Supplement to the Current Population Survey.

Percent of patients who report providers always: Listen carefully 11-6 a-d. Provider-patient communication, 2000 Explain things clearly Show respect Spend enough time 2010 target Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

11-6a-d. Provider-patient communication by race/ethnicity, 2000 BlackWhiteHispanic Listen carefully Explain things clearly Show respect Spend enough time Percent of patients who report providers always: 2010 target Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

11-6a-d. Provider-patient communication by health insurance status, 2000 PrivatePublicNo health insurance Listen carefully Explain things clearly Show respect Spend enough time Percent of patients who report providers always: 2010 target Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

11-6a-d. Provider-patient communication by age, 2000 Listen carefully Explain things clearly Show respect Spend enough time Percent of patients who report providers always: 2010 targetAge 18-24Age 25-44Age 45-64Age 65+ Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Percent Total Not Hispanic Hispanic Female Male Black White 2010 Target 11-6a. Patients reporting that doctors or other health providers always listen to them by race/ethnicity and gender, 2000 Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Percent Education < Target 11-6a. Patients reporting that doctors or other health providers always listen to them by education level, geographic location, and health insurance status, 2000 Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey. Urban Rural Health insurance status Private Public None years years years

Percent 2010 Target 11-6a. Patients reporting that doctors or other health providers always listen to them by disability status and age, 2000 Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey. Disabilities With Without Age groups

Percent Total Not Hispanic Hispanic Female Male Black White 2010 Target 11-6b. Patients reporting that doctors or other health providers always explain things clearly by race/ethnicity and gender, 2000 Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Percent Education < years years years 2010 Target 11-6b. Patients reporting that doctors or other health providers always explain things clearly by education level, geographic location, and health insurance status, 2000 Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey. Urban Rural Health insurance status Private Public None

Percent Disabilities With Without 2010 Target 11-6b. Patients reporting that doctors or other health providers always explain things clearly by disability status and age, 2000 Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey. Age groups

Percent Total Not Hispanic Hispanic Female Male Black White 2010 Target 11-6c. Patients reporting that doctors or other health providers always show respect for what they have to say by race/ethnicity and gender, 2000 Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Percent Education < years years years 2010 Target 11-6c. Patients reporting that doctors or other health providers always show respect for what they have to say by education level, geographic location, and health insurance status, 2000 Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey. Urban Rural Health insurance status Private Public None

Percent Disabilities With Without 2010 Target 11-6c. Patients reporting that doctors or other health providers always show respect for what they have to say by disability status and age, 2000 Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey. Age groups

Percent Total Not Hispanic Hispanic Female Male Black White 2010 Target 11-6d. Patients reporting that doctors or other health providers always spend enough time with them by race/ethnicity and gender, 2000 Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Percent Education < years years years 2010 Target 11-6d. Patients reporting that doctors or other health providers always spend enough time with them by education level, geographic location, and health insurance status, 2000 Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey. Urban Rural Health insurance status Private Public None

Percent Disabilities With Without 2010 Target 11-6d. Patients reporting that doctors or other health providers always spend enough time with them by disability status and age, 2000 Source: Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey. Age groups

11-2:Improve the health literacy among persons with inadequate or marginal literacy skills 11-3:Increase the proportion of health communication activities that include research and evaluation 11-4:Increase the proportion of health-related World Wide Web sites that disclose information that can be used to assess the quality of the site. 11-5: Increase the number of centers for excellence that seek to advance the research and practice of health communication (now has baseline) Developmental Objectives

11-2. Health literacy The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

Scope and nature of literacy problem  Lowest level: Simple, routine tasks involving brief and uncomplicated texts and documents, e.g., can locate time and place of a meeting on a form or identify a specific piece of information in an article  About 25% of Level 1 individuals are non-native speakers of English; about 66% didn’t finish high school; about 33% are 65+; and about 25% have disabilities  Second lowest level: More varied than Level 1 but still limited; can make simple inferences, integrate easily identifiable information, and perform simple numerical calculations About 50% of U.S. adults are in the two lowest levels of five levels of functional literacy skills

11-2. Nature of health literacy problem  Health literacy requires written as well as other communication skills to understand and act on health information and services  Selected research findings on health literacy:  Low literacy diabetic patients are less likely to know symptoms and disease management  Low literacy asthma patients have less effective management  Low literacy is associated with poorer self- reported health status and greater risk of hospitalization

11-2. Baseline data source  Health Literacy Component, 2003 National Assessment of Adult Literacy, National Center for Education Statistics, U.S. Dept. of Education  Three clusters of health literacy:  Clinical (e.g., filling out a patient information form)  Prevention (e.g., deciding to get a cancer screening)  Navigation of the health care system (e.g., understanding co-pays and deductibles in health insurance plans)  Expected results in 2004: Health literacy index scores on the ability of U.S. population groups to understand health-related information

11-3. Research and evaluation of health communication activities  Most likely focus for measurement: Federal health communication campaigns  Campaigns are typically assessed against internal goals, not external criteria related to campaign design  Need for consensus-building on criteria for objective research and evaluation components in campaign designs

11-3. What needs to be assessed  The universe of health communication activities that should have research and evaluation components (the denominator)  The actual number of health communication activities that do have research and evaluation components (the numerator).  Short-term goal: the measurement of research and evaluation within federally-funded or HHS communication activities.  Long-term goal: to identify and target for improvement any health communication programs not typically expected to include research and evaluation.

 Number of health-related Web sites is constantly changing, which makes measurement difficult  Model of disclosure of quality criteria is still evolving  Government role in assessing quality of Web sites is unclear Quality of internet health information

11-4. Information that should be disclosed to users of health Web sites  Identity and contact information of the developers and sponsors of the site and information about any potential conflicts of interest or biases  Explicit purpose of the site, including any commercial purposes and advertising  Original sources of content on the site  How the privacy and confidentiality of any personal information collected from users is protected  How the site is evaluated  How the content is updated

11-5. Centers for excellence in health communication criteria  A focus on health communication research and practice  An operational emphasis on multi/interdisciplinary research teams  Solid institutional support  Translation of research into practice  Training of health communication professionals and integration of health communication training into other disciplines

11-5. Centers for excellence in health communication baseline  Four centers have been identified by NCI (baseline) in 2003  These centers are focused on cancer communication  A target-setting method has been proposed Source: National Institutes of Health, National Cancer Institute.

Data and slides for Healthy People 2010 progress reviews are available at: hphome.htm