It can be very frustrating when preparing patient education pieces for some physicians, actually, though, it can be any one.  But in the past I have had various encounters in trying to exchange easier more understood terms for the actual medical term.  It was interesting, however, as a medical illustrator I was asked from time to time to prepare artwork for medical students as well as cohort physicians that portrayed a complex body process into simpler, more understandable "terms," via the artwork.  Somewhat of a double-standard!

One of my concerns is:  how is it determined who is "at risk"?  If it is on a form that asks education level, it may not be the most accurate.  I use my father, as an example (also, see October 9th story of Health Literacy Month!), who had only an 8th grade education, but he was an intelligent man. However, if his education level had been circled/checked on a form and his level was seen, he may have been labeled "at risk"   . . . not very fair or accurate.  And, I know, he would have insulted to have had to have taken a reading test to see where he ranked (see Archie's e-mail).

Therefore, yes, all materials should be prepared at understandable levels.  If there is any item that is not, it needs to be reviewed one-on-one with the client/patient (but, that still is not the answer).  I don't believe there is any health topic that can not be reduced to a very basic level of understanding and that which will help that individual's life.

In my mind, there is no health professional who should be saying, "well, they just need to understand."  That is our charge:  increase the belief (until everyone understands and says it is the only way) in the need for health literacy and, thus, acceptance of the efforts of those of us working in the area.  More research in the area may help.

Linda
---------------------------------------------
Linda L. Rohret, M.A., R.H.Ed.
Special Projects Coordinator
North Carolina Comprehensive Cancer Program DHHS--Division of Public Health
1922 Mail Service Center
Raleigh, NC  27699-1922
Tele:   919 707-5331
Fax:    919 870-4811
Note new address:  linda.rohret at dhhs.nc.gov


-----Original Message-----
From: healthliteracy-bounces at nifl.gov [mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Marshall, Caroline D.
Sent: Wednesday, November 04, 2009 8:19 AM
To: The Health and Literacy Discussion List
Subject: [HealthLiteracy 3681] Re: Labeling "at risk" people? Orlabelingpoor communication?

I like that angle.  I had not thought of it that way before. The
healthcare environment is a new and unfamiliar place for many people, so
materials should be written in plain language.  However when I did a
presentation to our Surgery dept I showed a paragraph of our Informed
consent  document, one paragraph came out at a college reading level but
one surgeon got so bent out of shape when I suggested making it more
readable, or putting in a space for the patient to write in what he
thought the procedure was and its side effects etc. .  The consensus was
that this document had been reworked and was considered the best that
could be done.  Really by who? the patients. Unfortunately there was not
enough time to discuss it further.  I am told surgeons are a "different
lot"


Caroline

-----Original Message-----
From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Helen Osborne
Sent: Tuesday, November 03, 2009 4:00 PM
To: The Health and Literacy Discussion List
Subject: [HealthLiteracy 3679] Re: Labeling "at risk" people?
Orlabelingpoor communication?

Hi NIFL-Health,

[I am sending this message on behalf of Archie Willard who, for some
reason,
had trouble getting his email through to you. ~Helen Osborne] Here is
what
Archie wrote:

This subject keeps coming back. Testing people for literacy skills in a
doctor's office or a clinic was something The New Readers of Iowa at
their 2d Health Literacy Conference said in a statement "a doctors
office is no place for a reading test because it brought back the times
when they had to take tests in school and they failed'. There were over
one hundred new readers at this conference from 9 different states.

The Question: Do you understand putting all the responsibility on our
shoulders. What about the person who writes the material or who is
talking to us? Are you a good communicator? Are you clear? Are you using
everyday words? Are you giving us directions or information in a logical
order? Are you helping us take action? Please don't test our literacy
skills. Look in the mirror and test your communication skills

I have been to some health literacy conferences the past year. At these
conferences it has been said "that people who come for medical help have
the right to have materials written that they can understand and they
need to be talked to in everyday words

Archie Willard
Adult Learner
Health Literacy Advocate
URL - http://www.readiowa.org/archiew.html

----- Original Message -----
From: Audrey Riffenburgh
To: 'The Health and Literacy Discussion List'
Sent: Tuesday, November 03, 2009 12:26 PM
Subject: [HealthLiteracy 3673] Re: Labeling "at risk" people? Or
labelingpoor communication?


Greetings, all,

Fran, I DO say "this makes sense for everyone" and it's true. If you
look at
the NAAL health literacy data, you'll see that "only 12% of the
population
is proficient" in the tasks required for health literacy. But I think we

need to turn that on its head and say "the health, medical, and
insurance
industries have built systems that do not work for 88% of their intended

audiences." I think we ought to start using that kind of labeling.

As we make the case, we don't have to point out any specific "at risk"
populations because 88% of us are at risk of not being able to handle
the
systems that we're forced to use to get our health care, learn about
healthy
choices, etc. We need to make the case for change from that perspective
and
challenge the institutions, corporations, agencies, etc. to recreate
systems
and processes that work for everyone, no matter their educational,
literacy,
or language skills. That is their responsibility, I believe! In
communication, whether patient education, technical writing, social
marketing, or advertising, the writers'/speakers' first task is to know
their audience and customize to the audience's needs and interests. That

means one does not use methods that reach only 12% of your audience!
Let's
put the responsibility where it should be.

Audrey Riffenburgh, M.A., President
Plain Language Works, LLC
Specialists in Plain Language & Health Literacy since 1994
Based Albuquerque, New Mexico, USA
Phone: (505) 345-1107   E-mail: ar at plainlanguageworks.com
========================================
Principal and Founding Member, www.clearlanguagegroup.com
Co-founder and former Faculty, www.healthliteracyinstitute.net
Ph.D. Student in Health Communication, Univ. of New Mexico

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