Information Services & Use - Volume 37, issue 2

Authors: Siegel, Elliot R. | Logan, Robert A.

Article Type: Editorial

DOI: 10.3233/ISU-170835

Citation: Information Services & Use, vol. 37, no. 2, pp. 101-103, 2017

Authors: Krist, Alex H. | Tong, Sebastian T. | Aycock, Rebecca A. | Longo, Daniel R.

Article Type: Research Article

Abstract: Effectively engaging patients in their care is essential to improve health outcomes, improve satisfaction with the care experience, reduce costs, and even benefit the clinician experience. This article will address the topic of patient engagement directly and review the relationships between health literacy and patient engagement. While there are many ways to define patient and family engagement, this article will consider engagement as “patients, families, their representatives, and health professionals working in active partnership at various levels across the health care system – direct care, organizational design and governance, and policy making – to improve health and health care [Health Aff (Millwood) …32 (2013), 223–231].” We will specifically focus on the patient engagement and health literacy needs for three scenarios (1) decision-making, (2) health behavior change, and (3) chronic disease management; we will include the theoretical underpinnings of engagement, the systems required to better support patient engagement, how social determinants of health influence patient engagement, and practical examples to demonstrate approaches to better engage patients in their health and wellbeing. We will close by describing the future of patient engagement, which extends beyond the traditional domains of decision-making and self-care to describe how patient engagement can influence the design of the healthcare delivery system; local, state, and national health policies; and future research relevant to the needs and experiences of patients. Show more

Keywords: Patient engagement, patient activation, patient education, health literacy, social determinants of health, delivery of healthcare

DOI: 10.3233/ISU-170826

Citation: Information Services & Use, vol. 37, no. 2, pp. 105-122, 2017

Authors: Kreps, Gary L.

Article Type: Research Article

Abstract: This paper examines the importance of health literacy to the design and use of mobile digital health information technology (mHealth) applications. Over the past two decades mHealth has evolved to become a major health communication channel for delivering health care, promoting health, and tracking health behaviors. Yet, there are serious communication challenges that must be addressed concerning the best way to design and utilize mHealth application to achieve key health promotion goals, including assuring the appropriateness and effectiveness of mHealth messaging for audiences with different communication competencies, styles, and health literacy levels, to ensure that mHealth applications are truly effective …tools for health promotion. Health literacy is one of the major communication issues relevant to the effective use of mHealth. To be effective, mhealth applications need to match the messages conveyed via these mobile media to the specific health communication needs, orientations, and competencies of intended audience members. Unfortunately, current evidence suggests that many mHealth applications are difficult for audiences to utilize because they provide health information that is not easy for many consumers to understand and apply. Health literacy refers to the ability of participants within the health care system to accurately interpret and utilize relevant health information and resources to achieve their health goals. Evidence suggests that many consumers possess limited levels of health literacy to adequately understand health information, especially when they are feeling ill, since health literacy is both a trait (limited education, language facility, etc.), and a state condition (based on how their current physical and mental states influence their abilities to communicate effectively). Therefore, it is incumbent upon mHealth developers to design and utilize message systems. Strategies for designing and implementing mHealth applications to meet the health literacy levels of different audiences are described in this article. Show more

Keywords: mHealth, health literacy, health communication, applications, health promotion

DOI: 10.3233/ISU-170828

Citation: Information Services & Use, vol. 37, no. 2, pp. 123-130, 2017

Authors: Levin-Zamir, Diane | Leung, Angela Yee Man | Dodson, Sarity | Rowlands, Gillian

Article Type: Research Article

Abstract: International and cultural perspectives of health literacy help deepen the understanding of the global context within which health literacy plays an important role. Throughout this article, we explore the significance of health literacy initiatives, interventions, practices, and research for addressing health challenges on a variety of levels in the international and global context. More specifically, the notion of health literacy as a dynamic construct is introduced, after which we examine health literacy throughout the life course, emphasizing the impact of health literacy among children and the elderly in their families and in the community. Cultural norms and family interpersonal relations, …and values influence health literacy and need to be considered when closing the health literacy disparities. Global trends of migration and immigration bring to the forefront the need for unravelling the complexity of health systems, for which health literacy plays a central role; health literacy initiatives address cultural differences between providers and patients to help narrow the communication gap. The importance of cultural competency among health care providers exemplifies how capacity building in health literacy is critical for maximizing the benefits to the public of the health care system. Health literacy provides a conceptual foundation for community participatory research, involving members of the public to take part in the planning, execution and evaluation of health education interventions. Selected case studies and picture boxes from around the globe, exemplify aforementioned topics of interest. Practical recommendations for policy makers, practitioners and research are offered based on the studies conducted in the international context. Show more

Keywords: Health literacy, cultural competency, patient-provider communication, digital health literacy, media health literacy

DOI: 10.3233/ISU-170834

Citation: Information Services & Use, vol. 37, no. 2, pp. 131-151, 2017

Authors: Neuhauser, Linda

Article Type: Research Article

Abstract: Health communication is an essential health promotion strategy to convert scientific findings into actionable, empowering information for the public. Health communication interventions have shown positive outcomes, but many efforts have been disappointing. A key weakness is that expert-designed health communication is often overly generic and not adequately aligned with the abilities, preferences and life situations of specific audiences. The emergence of the field of health literacy is providing powerful theoretical guidance and practice strategies. Health literacy, in concert with other determinants of health, has greatly advanced understanding of factors that facilitate or hinder health promotion at individual, organizational and community settings. …However, health literacy models are incomplete and interventions have shown only modest success to date. A challenge is to move beyond the current focus on individual comprehension and address deeper factors of motivation, self-efficacy and empowerment, as well as socio-environmental influences, and their impact to improve health outcomes and reduce health disparities. Integrating participatory design theory and methods drawn from social sciences and design sciences can significantly improve health literacy models and interventions. Likewise, researchers and practitioners using participatory design can greatly benefit from incorporating health literacy principles into their efforts. Such interventions at multiple levels are showing positive health outcomes and reduction of health disparities, but this approach is complex and not yet widespread. This article focuses on research findings about health literacy and participatory design to improve health promotion, and practical guidance and case examples for researchers, practitioners and policymakers. Show more

Keywords: Health communication, health literacy, participatory design, design sciences, health promotion, participatory action research, determinants of heath, health disparities

DOI: 10.3233/ISU-170829

Citation: Information Services & Use, vol. 37, no. 2, pp. 153-176, 2017

Authors: Roberts, Michelle | Callahan, Lizz | O’Leary, Catina

Article Type: Research Article

Abstract: Social media – websites and other online tools called social networks – serve as a tool to connect people and organizations around topics of common interest. Social media platforms offer tremendous opportunity to engage quickly and sometimes in depth with many and diverse stakeholders as people have the ability to communicate back-and-forth from anywhere in the world. As increasing numbers of people receive their news and health information online, it is important to ensure content delivered through online resources is accessible to diverse target audiences. This article discusses a mid-sized health literacy nonprofit organizations’ social media philosophy and tactics during the past …10 years, as both social media and health literacy strategies evolved continuously. The integration of social media in health literacy program content depends on the use with best evidence health literacy strategies, such as the use of plain language techniques. Strategy and technical considerations for the implementation and integration of social media within a health literate health communications model are discussed. Show more

Keywords: Health literacy, social media, communication

DOI: 10.3233/ISU-170836

Citation: Information Services & Use, vol. 37, no. 2, pp. 177-187, 2017

Authors: Nguyen, Tam H. | Paasche-Orlow, Michael K. | McCormack, Lauren A.

Article Type: Research Article

Abstract: Advancing health literacy (HL) research requires high-quality HL measures. This article provides an overview of the state of the science of HL measurement at the level of the individual: where the field started, currently is, and should be going. It is divided into eight key sections looking at (1) the history of HL measurement, (2) the relationship between HL definitions and measurement, (3) the HL conceptual domains most and least frequently measured, (4) the methods used to validate HL measures, (5) the characteristics of the participants in the measurement validation studies, (6) the practical considerations related to administering HL measures, …(7) the advantages and disadvantages of using objective versus subjective HL measures, and (8) future directions for HL measurement. Based on the material presented in this article, the following conclusions can be drawn. First, there is an enormous proliferation of HL measures and this growth presents both opportunities and challenges for the field. Second, to move the field forward, there is an urgent need to better align HL measurement with definitions of HL. Third, some HL domains, such as numeracy, are measured more often than others, such as speaking and listening. Consequently, it is important to think about novel mechanisms to measure HL domains that are rarely measured. Fourth, HL measures are most often developed, validated, and refined using classical measurement approaches. However, strong empirical and practical rationales suggest making an assertive shift toward using modern measurement approaches. Fifth, most HL measures are not well validated for use in minority populations; consequently, future validation studies should be mindful of validation samples. Sixth, HL measures can be administered using multiple modes, most frequently via paper-and-pencil surveys. Identifying which mode of administration is most suitable requires reflecting on the underlying measurement purpose and the characteristics of the participants being measured. These considerations should also be made when deciding between a subjective versus objective HL measure. Cumulatively, this article provides tools to help readers select and use the most appropriate measures of HL for their needs. It also provides rationale and strategies for moving the science of HL measurement forward. Show more

Keywords: Health literacy, measurement, conceptual domains, validation, psychometrics

DOI: 10.3233/ISU-170827

Citation: Information Services & Use, vol. 37, no. 2, pp. 189-203, 2017

Authors: Hesse, Bradford W. | Greenberg, Alexandra J. | Peterson, Emily B. | Chou, Wen-Ying Sylvia

Article Type: Research Article

Abstract: The contemporary healthcare system can help improve health literacy outcomes in two ways: first, by nurturing the skills and motivations needed for patients to be actively engaged in their own health and healthcare decisions; and, second, by creating a prepared and proactive healthcare system that adapts to patients’ capacities and needs in efficacious ways. In 2001, the National Cancer Institute launched the Health Information National Trends Survey (HINTS) as a way for researchers and planners to understand how the public is interacting with a rapidly changing health information environment. Original iterations of the HINTS national probability sampling strategies took place …on a biennial basis, but in subsequent years the protocol moved to a yearly administration. This yields a rich resource of cross-sectional, national surveillance data to evaluate for trends across and within vulnerable populations. Sixteen studies are presented from the published literature to illustrate how HINTS data were used to explore constructs of direct interest to health literacy researchers. Suggestions are given for how this ongoing public surveillance mechanism can be used: (a) to provide a sentinel view of how the public is interacting with information in the environment to address their health needs; (b) to generate research questions and hypotheses for further exploration using complementary methodologies; and (c) to explore the diffusion of new health communication channels within and between segments of the national population. Show more

Keywords: Health communication, patient engagement, surveillance

DOI: 10.3233/ISU-170830

Citation: Information Services & Use, vol. 37, no. 2, pp. 205-218, 2017

Authors: Kurtz-Rossi, Sabrina | Rikard, R.V. | McKinney, Julie

Article Type: Research Article

Abstract: This study assesses the content of email messages posted to the Health Literacy Discussion List (HLDL) during a two-year period. The study identifies issues of concern to list subscribers, describes the purposes the list serves for health professionals, and contributes to the health literacy literature by providing an email listserv as a research corpus. The authors conducted an inductive qualitative analysis of email posts to the HLDL from October 2013 to October 2015. Using an iterative process, the authors identified descriptive categories for types of posts and topics of posts. The first (SKR) and third (JM) authors reviewed subject lines …of all 2,036 posts and brainstormed type and topic categories, independently read and sorted a random sample of 200 posts into those categories, and then discussed discrepancies. Based on the latter experience, the authors combined, added, or excluded certain categories and jointly created a detailed description for each type and topic category. We then sorted another random sample of 200 posts and generated a list of key words relating emails to topic categories. A Cohen’s kappa reliability coefficient was calculated to establish intercoder reliability. The second author (RVR) then conducted key word searches for sorting the remaining 1,836 email posts. The existence and frequency of email clusters and the content of emails in these clusters were used to identify and explore in greater detail the “hot topics” of interest to the field. Our analysis suggests the utility of the HLDL as a platform for sharing information and resources, announcements and calls for action, technical assistance and professional discourse. Show more

Keywords: Health literacy, email listserv, professional development, community of practice, content analysis

DOI: 10.3233/ISU-170831

Citation: Information Services & Use, vol. 37, no. 2, pp. 219-234, 2017

Authors: Smith, Sandra A. | Carroll, Lauren N.

Article Type: Research Article

Abstract: Scientific discovery and global health policy are moving health literacy promotion and maternal-child health from the fringes of research and public health to the forefront of healthcare reform [Matern Child Health J. 18 (2014 ), 344–365]. In 2011 the United Nations General Assembly adopted the Shanghai Declaration [Lancet 378 (2011 ), 566–567]. The Declaration highlights new understanding of the origins of health and disease in early development. It calls on all nations to apply this knowledge to reduce the burdens of chronic disease and related disparities worldwide. The Declaration recommends a specific intervention strategy: promote health literacy …across the life course, particularly in parents and children, and empower women . This article explores findings and implications of the Life Skills Progression Maternal Health Literacy studies. These LSP-MHL studies evaluated implementations of an intervention designed to promote health literacy in parents and empower women in the U.S. First, the article reports findings of the most recent of five published LSP-MHL studies with discussion of its implications for future work in this line of inquiry. A postscript highlights two of many implications of the LSP-MHL intervention studies for health literacy research in the third era of modern healthcare. Show more

Keywords: Health literacy, maternal health literacy, empowerment, Life Skills Progression, health promotion, home visitation, Shanghai Declaration

DOI: 10.3233/ISU-170832

Citation: Information Services & Use, vol. 37, no. 2, pp. 235-252, 2017