1. 0 icfi.com | Building self-efficacy by improving health literacy Supply and Demand April 19, 2012 Prepared for: Centers for Disease Control and Prevention Advisory Committee on Breast Cancer in Young Women by: Ronne Ostby, ICF, rostby@icfi.com

2. 1 icfi.com |

3. 2 Basic Laws of Supply and Demand  If demand increases and supply remains unchanged, then it leads to higher equilibrium price and higher quantity.  If demand decreases and supply remains unchanged, then it leads to lower equilibrium price and lower quantity.  If supply increases and demand remains unchanged, then it leads to lower equilibrium price and higher quantity.  If supply decreases and demand remains unchanged, then it leads to higher equilibrium price and lower quantity.

4. 3 icfi.com | Driving Factors of Behavior Change  Benefits  Barriers  Social Norms  Self-Efficacy Perceived self control  “I know how to do this.”  “I will be successful when I do this.”

5. 4 icfi.com | 4 The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. --Healthy People 2010 Health Literacy

6. 5 icfi.com | 5  Prescription Drug Bottles  Appointment Slips  Educational Brochures  Doctor’s Directions  Consent Forms  Systems and Processes Health Literacy

7. 6 icfi.com | 6  READING  LISTENING  ANALYSIS  DECISION-MAKING  CONFIDENCE  ASSERTIVENESS Health Literacy

8. 7 icfi.com | 7 Patients with poor health literacy have a complex array of difficulties with written and oral communication that may limit their understanding of cancer screening and of symptoms of cancer, adversely affecting their stage at diagnosis. In addition, these barriers impair communication and discussion about risks and benefits of treatment options, and patient understanding of informed consent for routine procedures and clinical trials. Terry C. Davis, PhD; Mark V.Williams, MD; Estela Marin, MA; Ruth M. Parker, MD; Jonathan Glass, MD. “Health Literacy and Cancer Communication.”

9. 8 icfi.com | 8 Patients with cancer are particularly vulnerable to the effects of low HL, owing to the complicated treatment regimens they receive. Oncology nurses can help by identifying patients who may be at risk and implementing strategies that can be used to help patients understand the information they receive. Chastity Burrows Walters, MSN, RN. “Health Literacy: Strategies for Avoiding Communication Breakdown.”

10. 9 icfi.com |  Evaluating information for credibility and quality  Analyzing relative risks and benefits  Calculating dosages  Interpreting test results  Locating health information Skills Needed for Health Literacy

11. 10 icfi.com |  Visual Literacy  Computer Literacy  Information Literacy  Numerical or computational literacy Skills Needed for Health Literacy

12. 11 icfi.com |  Elderly (age 65+)  Minority populations  Immigrant populations  Low income  People with chronic medical or physical health conditions Vulnerable Populations

13. 12 icfi.com |  SIMPLIFIED INFORMATION  Technology-based communications  Counseling and one-on-one treatment planning/assistance  Community-based support Improve Health Literacy I know how to do this. I will be successful when I do this.

14. 13 icfi.com | 1.Developing the Content 2.Organizing the Publication 3.Writing the Content 4.Developing the Design 5.Testing the Publication Simplified Information I know how to do this. I will be successful when I do this.

15. 14 icfi.com | 1.Developing the Content Describe the behaviors Describe the benefits of performing the behavior Determine key messages Tell only what they need to know Use lay terms Develop relevant illustrations to convey behaviors and processes Create opportunity for reader interaction Simplified Information

16. 15 icfi.com | 2.Organizing the Publication Describe what the reader will gain Most important info at the beginning AND at the end Think spatially Use headings that express a complete idea or reinforce a behavior Summarize main points Simplified Information

17. 16 icfi.com | 3.Writing the Content Write at an appropriate reading level for a broad audience Use active voice Friendly, conversational tone Short and declarative sentences Use familiar examples to convey concepts Use simple words and be consistent Avoid abbreviations and acronyms Limit use of statistics Simplified Information

18. 17 icfi.com | 4.Developing the Design Arriving image should be relevant and easy to read Ensure adequate white space Use appropriate fonts/typefaces Avoid using text as an element Use boldface or underline to emphasize Create a layout that aids readability Use color to aid readability Select illustrations carefully Choose familiar visuals Simplified Information

19. 18 icfi.com | 5.Testing communications materials Simplified Information

20. 19 icfi.com | I know how to do this. I will be successful when I do this.

21. 20 icfi.com | Strategic Communications & Marketing Right strategy. Real change. Ronne Ostby rostby@icfi.com