Understanding the Current State of Health Literacy

Health literacy is an important but often overlooked concept in the health care industry. October is Health Literacy Month and to address the importance of communication between physicians, therapists, clinicians, and their patients, the Institute for Healthcare Advancement recently held their Health Literacy Conference in Irvine, CA.

At the conference, Dr. Pauline Hamel, a professor at Boston University’s online Master of Science in Health Communication, presented her poster presentation “Health Literacy and Physical Therapists: Feedback from the Field.” The presentation focused on the meaning of health literacy, increasing the current levels of health literacy throughout the industry, and identifying the current standards in communication practice. The objective is to explore aspects of patient-provider communication, patient comprehension, and compliance in order to raise awareness and create better communication and treatment options.

View Dr. Pauline Hamel’s poster presentation from the IHA Health Literacy Conference.

The content from the poster presentation is listed below:

Background

With the increasing complexity and number of  medical errors in the delivery of health care today, the purpose of this research was to explore and identify gaps in the current knowledge of health literacy (within the broader scope of health communication), among physical therapists (PTs) and doctoral physical therapist (DPT) students. Within a patient-centered approach, this research explored current levels of knowledge and definitions of health literacy, as well as methods used by this target population.

Objectives

• To identify the “meaning of health literacy” among physical therapist clinicians and DPT students
• To identify relevant industry standards and recommendations regarding health literacy
• To explore aspects of patient-provider and provider-provider communication, patient comprehension, and compliance
• To identify communication methods currently used by physical therapists in academic and clinical settings

Description

Participants were selected and interviewed in academic, clinical practice, conference, and home settings. Research based  upon  interviews with physical therapists and DPT students, communications industry consultants, instructional designers, and a pilot module with 37 health science students.

Approach

Qualitative research methods that included literature/document review, interview, and pilot testing were used to assess current levels of knowledge of health literacy and communication methods and approaches used by PTs in academia & clinical practice.

Target Population

Practicing PTs and DPT students were interviewed for this qualitative research. Categories included 3 cohorts:
(a)  graduate DPT students
(b)  PTs 3-5 years post graduation
(c)  PTs > 5 years post-graduation in academic, practice, & homecare settings

Findings

Meaning of Health Literacy

Some participants admitted that they were unfamiliar with the term health literacy, and definitions were, in many cases, “educated guesses” based upon reflection and recall of the word “literacy.” “We touched on it a little bit [in school]…Um…Health literacy. . . well, it’s uh…”

Health Literacy in Physical Therapy

Participants frequently used the terms communication, health communication, and health literacy interchangeably.  However, some did express the opinion that health literacy would improve between health professionals and non-professionals if health communication improved. “The better the health communication is between the health professional and non-health professional, the better the health literacy would be.”

Patient-Client Comprehension

Participants expressed that sometimes they need to use alternative methods, such as demonstration, touch, teach-back, or interpreters to help their patients comprehend PT instructions. But many still ask their patients, “Do you have any questions?” “Sometimes we think others should understand, and we assume that they do when in fact they don’t. We need to ask them to repeat it back to make sure they get it.”

Patient/Client Adherence and Compliance

More experienced PTs stressed the importance of special equipment, visual aids and models, and providing rationale for treatment in order to ensure compliance.
“Patients are petrified when in fact they appear ‘disinterested,’ which we see as ‘non-compliant.’  Non-compliance is a health literacy issue.”

FINDINGS demonstrate:

• That gaps exist in PT awareness and knowledge of health literacy
• That though PTs see themselves as clinicians and educators, they do not  generally perceive themselves as health communicators
• The need for formal HL training in academic and clinical settings
• The need for ongoing HL research  and development of industry standards and competencies for future clinical practice and training purposes

Implications for the Future (Policy, Delivery, Practice)

This research illustrates:

• That health literacy can be a bridge between research and practice
• That health literacy does not  stand alone, as it is part of an inter-dependent relationship and larger health communication picture
• The growing need for comprehensive health communication programs that include coursework in health communication, health literacy, health education, and professional development to expand the scope and roles of practitioners and communications professionals alike in academic, clinical education, and practice settings
• The importance of collaboration  and partnerships between health providers and non-health disciplines, including policymakers, educators, communications experts, and instructional designers to promote effective health literacy methods and materials, increased awareness, improved competencies and standards, and professional commitment to these priorities in academic, clinical, and other practice settings
• The need for further interdisciplinary research to ascertain more comprehensive and effective curricula, methods, and approaches to teach and implement evidence-based health communication and  health literacy practices in academic, clinical, and workplace settings