According to the American Medical Association, poor health literacy is a stronger predictor of a person’s health than age, income, employment status, education level and race. What’s more, the Institute of Medicine reports that 90 million people in the United States have difficulty understanding and using health information. As a result, patients often take medicines on erratic schedules, miss follow-up appointments, and do not understand instructions like "take on an empty stomach.”
Health literacy, which is defined as the degree to which individuals have the capacity to obtain, process and understand basic health information and services, is not simply the ability to read. It requires a complex group of reading, listening, analytical and decision-making skills, and the ability to apply these skills to health situations. It includes the ability to understand instructions on prescription drug bottles, appointment slips, medical education brochures, doctor’s directions and consent forms, and more.
As health care professionals, it is our responsibility to ensure that each patient we see leaves with a full understanding of their visit and their condition, plan for care and prescription information. For patients with obvious language barriers, we call in interpreters. But what steps do we take for everyone else?
The handouts we offer patients to explain conditions, vaccinations and medications prove to be an effective communications tool in combating poor health literacy. Are your patient education materials as effective as they could be? We have a few tips for making sure that they are, and are encouraging patients to heed their information:
First and foremost, the content of patient handouts should be written at a level that can be understood by the majority of the population—one in five American adults reads at the fifth-grade level or below while the average American reads at the eighth- to ninth-grade level. Most health care materials, on the other hand, are written above a tenth-grade level.
The task of all handouts is to provide information that will reduce patients’ uncertainties about their health problems and care. This can be done by considering three types of information: awareness, how-tos, and principles:
- Awareness information makes people aware of new possibilities, and sometimes this kind of information is all you need to provide. For example, simply informing patients suffering from low back pain that the pain usually goes away on its own can dispel many fears.
- How-to information allows people to act; to take advantage of new treatment options. Showing the patient with low back pain how to relieve the pain by lying supine with the calves on a chair to reduce lumbar lordosis is how-to information.
- Principles information explains why something works or why it is important. This kind of information helps people accept the necessity of unpleasant behaviors and it allows them to respond appropriately in new situations. Teaching patients with back pain about what makes a muscle spasm and what actions reduce the spasm allows them to use these principles to find their own solutions to individual problems.
Pictures and diagrams, as we all know, are great tools in demonstrating concepts and instructions. Design or seek out patient handouts that incorporate visuals in an effective way. Beyond this number one rule, keep in mind these other design considerations, too:
- Avoid decorative fonts—stick to highly readable fonts, like Times New Roman or Arial, and be consistent. Avoid using multiple fonts in one handout.
- Use bulleted lists (like this one!) to help highlight important information or instructions.
- Don’t be afraid of “white space”—the more words there are on a page, the more difficult to read and comprehend the content becomes. Keep things simple by incorporating breaks and space between visuals and text, between one concept and another.
Patient handouts are only of use if they are being used. Don’t wait for a patient to look confused or to ask questions. Instead, make sure your team is in the habit of providing literature to patients as a customer service gesture in addition to a crucial communications tool.
- For handouts that reference popular information, such as information on preventing the spread of colds and infections, vaccination information, procedural information pertaining to specific service lines and more, prominently place literature in the waiting and exam areas with a literature rack.
- For patients receiving a multitude of educational materials, be sure to offer a secure means for them to take everything home. Such as a bag or folder.
- Be sure to include prominent contact information on patient handouts and point them in the direction of further help or interpretation. Feature this same information on pens or magnets.
Handouts and flyers play a critical role in communicating with patients—especially those with poor health literacy. Consider revamping your health care organization’s materials today.