As we prepare to celebrate Thanksgiving here in the Unites States, it is a blessing to realize the journey to today in health literacy awareness.   We have much to be thankful for at this time in our history.     Happy Thanksgiving!

We continue our exploration from Wednesday, November 18th with the follow.

An overview/health literacy history article: “Health Literacy: A Review” by Andrus and Roth was published in the Journal of Pharmacotherapy, Volume 22, Number 3, 2002.    It provides a comprehensive history of health literacy up to the year 2002.

Rima Rudd, also a well-known advocate for health literacy, wrote an overview of the growing partnership between health providers and literacy providers around issues of health literacy in 2002 in “Focus on Basics” http://www.ncsall.net/index.php?id=247

The book Advancing Health Literacy 2006  (Zarcadoolas, Pleasant, Greer); Jossey-Bass has a chapter entitled “Advancing Health Literacy: Getting Here From There”, which provides another historical overview of health literacy.

Also, Dr. Pleasant gave a brief history during a National Institute for Literacy Webinar titled “Advancing Health Literacy: Meeting the Needs of Adult Learners.” You can read the transcript here: http://www.nifl.gov/nifl/webcasts/health08/health08transcript.pdf (see top of page 4 in the reference).

In 2007, for the “Review of Adult Learning and Literacy” Volume 7, Chapter 6, Dr. Rudd wrote a review of the medical and health literature. The Review is available from Lawrence Erlbaum Associates.

I found this recent article.   Bankson, H. (2009). “Health literacy: an exploratory bibliometric analysis, 1997-2007”. Journal of the Medical Library Association, 97(2), 148-150.

Len Doak mentioned there were only 5 articles written in the 1970s regarding health literacy.   I recently did a search in several databases with the following results:   CINAHL Plus with Full Text 2019; MEDLINE 905;  MedlinePlus 117; PsycInfo 201.   It is interesting to note, PsycInfo is the only database with a subject heading “Health Literacy”.   Text word searching is used in the other databases!

Studying history can be fun.    It has been an amazing journey with much still to learn, policy to be developed, funding to obtain, awareness to be heightened and citizens to teach.   I encourage you to begin your own journey on that road through the history of health literacy.   It is fascinating!

The U.S. Department of Health and Human Services (AHRQ is an agency within HHS) has generated many documents addressing health literacy initiatives.

1) The Healthy People 2010 health literacy objectives released in Jan. 2000 were/are crucial. They have been the foundation for everything we’ve done in health literacy at HHS. www.healthypeople.gov, see Focus Area 11. We expect to continue with health literacy objectives in Healthy People 2020.

2) The NIH National Library of Medicine first and second health literacy bibliographies released in 2000 and 2004. http://www.nlm.nih.gov/pubs/resources.html

3) The National Cancer Institute’s Making Health Communication Programs Work, which incorporated elements of NCI’s earlier Clear and Simple. http://www.cancer.gov/pinkbook

4) The 2003 health literacy action plan in Communicating Health: Priorities and Strategies for Progress,  http://odphp.osophs.dhhs.gov/projects/healthcomm/objective2.htm

5) NAAL: HHS supported the development of the health literacy component of the NAAL. Health literacy as its own segment wasn’t part of the original NAAL planning, but HHS worked closely with the U.S. Department of Education to create it.

6) 2003 Surgeon General’s Call to Action to Promote Oral Health includes multiple references to oral health literacy http://www.surgeongeneral.gov/topics/oralhealth/nationalcalltoaction.html

7) The National Institutes of Health’s Program Announcement in Health Literacy Research, which laid out research topics and provided the first focused funding for new health literacy research http://grants.nih.gov/grants/guide/pa-files/PAR-07-020.html

The HHS Office of Minority Health’s National Standards on Culturally and Linguistically Appropriate Services (CLAS) http://www.omhrc.gov/templates/browse.aspx?lvl=2&lvlID=15

9) The Unified Health Communication training from the Health Resources and Services Administration (HRSA), which integrates health literacy, cultural competence and clear communication  http://www.hrsa.gov/healthliteracy/training.htm

10) 2006 Surgeon General’s Workshop on Improving Health Literacy  http://www.surgeongeneral.gov/topics/healthliteracy/toc.html

11) Four town halls on local health literacy activities and visions of a health literate society, meeting notes http://www.health.gov/communication/literacy/TownHall/default.htm

12) There are also slide sets, an issue brief, more draft action plans and other resources at www.health.gov/communication/literacy

CDC has in the works a report of an expert panel on older adults and health literacy that should be available this fall and an online training module called Health literacy for Public Health Professionals that we expect to release in Oct.

The HHS Health Literacy Workgroup is finalizing a National Action Plan to Improve Health Literacy that we hope will be released before the end of the year.

[submitted to the Health Literacy Listserv by Cynthia Baur, Ph.D.
Director, Division of Health Communication and Marketing;
National Center for Health Marketing; Centers for Disease Control and Prevention; U.S. Department of Health and Human Services
cynthia.baur@cdc.hhs.gov]

I have been passionate about Health Literacy most of this decade.    One of the areas I have been exploring are the roots of HL.     I was going back through some April, 2009 posts on the Health Literacy Listserv and found several contributions on the topic of the history of Health Literacy.    It is always good to look back to see how far we have come and realize where we need to go.      I thought I would share some of the information posted, for this column.

Len and Ceci Doak are well known expects in the area of Health Literacy.     Their work goes back over 35 years.  Two landmark publications were written by the Doaks in collaboration with other authors.

They shared a number of facts, represented with this time line …

1973 Ceci (a USPHS Health Educator) asked, “But what do these people do when they don’t understand their health care instructions?”  Len (a volunteer adult literacy tutor) answered, “They fake it. If asked if they understand they will likely say “yes”. This led eventually to our collaboration on a small contract from the USPHS to assess the reading skill levels of 100 patients at the Norfolk, PHS hospital, and compare the results with the readability demands of 100 written patient instructions in use there.  (Published in Patient counseling and education, Winter 1979-80)

1970s -literature search found only five papers related to this subject. A paper in Nursing Research in 1964 by Mohammed cited just four such papers.

1970s and early 80s little interest shown

1978 paper presented at Western Branch APHA conference on Closing the Comprehension Gap – a link between health and literacy.

Beginning in the late 1970s the Doaks gave over 200 one and two day workshops in collaboration with other pioneers in the field.

1985 Interest in health literacy began to grow with the Lippincott publication of their first book, Doak, Doak, Root, Teaching Patients with Low Literacy Skills.

Beginning in the mid-1980s, NIH’s National Cancer Institute established a working group on health and literacy led by Wendy Mettger.  The group included members from diverse fields, including government agencies, academia, pharma, and others. Results of the group’s deliberations were published in medical journals, which further increased awareness.   NIH’s NHLBI let a number of contracts to increase our knowledge about health and literacy. Several universities, notably the University of North Carolina, Harvard, Johns Hopkins and Emory, were involved in work related to health literacy.

Several government agencies sponsored training in health literacy, notably the Bureau of Indian Affairs, the Veterans Administration Hospitals, and DHHS.  Pfizer pharma sponsored annual conferences and gave dozens of grants for studies about health literacy. And Canadian literacy organizations included this subject at national conferences.  Broader international awareness was fostered by  Voice of America segments on health literacy they recorded with us and translated into 43 languages.

In the 1990’s and beyond, health literacy took off.  Research work  by Barry Weiss, Schillenger, Ruth Parker, Terry Davis and so many others have moved the field forward immensely.”

The Doaks can be heard giving a 30-year overview about the history of health literacy in a Health Literacy Out Loud podcast, “Len & Ceci Doak Discuss Health Literacy’s Past, Present, and Future.”   Here is the link, http://www.healthliteracyoutloud.com/2009/03/23/hlol-13-len-ceci-doak-discuss-health-literacy%e2%80%99s-past-present-and-future/

…more later.

In September the Health Literacy Listserv posted a series of pieces on the topic “project to identify documents – policy statements, reports, and projects etc that have been influential in driving health literacy initiatives at state, national and international level”.    There were numerous postings with very interesting facts about the topic.    the contributions provided by other listserv participants provide a great review of the valuable resources contributed during this decade.   Because listing these rich resources contribute to the theme of “history of health literacy”,   I thought I would devote the next few posts on this blog to reviewing what was shared.

Current Bibliographies in Medicine 2004-1 from the National Library of Medicine.  http://www.nlm.nih.gov/pubs/cbm/healthliteracybarriers.html

(contributor:

Julie Esparza, MLS, AHIP

Clinical Medical Librarian

LSU Health Sciences Center – Shreveport, LA

“Thanks to a grant from the National Network of Libraries of Medicine to a collaborative team from New York (Edward G. Miner Library, University of Rochester and Rochester Committee on Refugee Resettlement), Healthy Roads Media has been able to partner to create a number of new materials in Karen (http://www.healthyroadsmedia.org/karen/index.htm).  Karen is the language spoken by a new refugee group arriving from Burma (Myanmar). The materials are free in multiple formats and can be downloaded. Healthy Roads Media also has materials in 19 other languages.”

[posted on the Health Literacy listserv]

 

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We hope you can “catch” some fun this weekend. Enjoy!

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Here’s to a beautiful Autumn weekend!

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http://www.healthypeople.gov/hp2020/comments

The U.S. Department of Health and Human Services invites you to comment on the DRAFT set of objectives for Healthy People 2020. For three decades, Healthy People has provided a set of national 10-year health promotion and disease prevention objectives aimed at improving the health of all Americans. [Healthy People Listserv http://www.healthypeople.gov/Contact/ ]

Phtographs and illunstrations are very important in understanding information. “K4Health Photoshare http://www.photoshare.org/ is a leading editorial photography collection showcasing international health programs in action and the people they serve. Developed exclusively for nonprofit educational use, Photoshare’s collection of over 17,000 images are available upon request and free-of-charge.“

…as seen on BHIC blog today.