We are thrilled to share a special Halloween installment of our series on the Ten Attributes of Health Literate Health Care Organizations in celebration of National Health Literacy Month.
This series is meant both to inform and spark discussion. Please feel free to comment, ask questions, and contribute. Thank you!
Attribute 4: A health literate health care organization includes populations served in the design, implementation, and evaluation of health information and services.
Say Ah!: Poison Control has been an early adopter of health literacy best practices. The Health Education Literacy Program was one of the first initiatives to engage a broader audience in both health literacy and medication safety. How did you engage target audiences in developing these materials?
Lauren: We were fortunate to collaborate with Literacy Partners on the Health Education Literacy Program (HELP). We developed the materials together and were able to field-test all of the curriculum components with their adult learners to ensure that the materials were engaging and understood by our target populations. This included the brochures and the lessons. In addition, we were able to observe a number of adult education instructors at the Queens Public Library use the materials with their English as a Second Language (ESL) students. Working with the adult education students, we were able to incorporate the feedback from focus groups. We then showed them the revised version of the materials. The students were able to again give feedback and stated how much the materials had improved and how much of their own suggestions they saw incorporated into the new versions.
Say Ah!: Your written materials are great models of plain language writing. Thank you. How do you handle and resolve conflicts of opinion when they arise between what professionals want to communicate and what patients and consumers want and need from the materials?
Lauren: I always sit down with the content experts at the Poison Control Center when beginning materials development to help establish the key messages and ensure that the content is rooted in clinical evidence. Materials are then field tested using a discussion guide that incorporates CeCi Doak and Len Doak’s Learner Verification and Revision technique, which asks questions of the target audience to ensure that the material is understood and allows any concerns or questions to be addressed before the piece is printed. See Chapter 10 (chapters 8, 9 and 10 appear in this link).
Say Ah!: Do you have different models for evaluating information and services based on the many unique populations? If so, can you tell us about some and to what populations they apply? And if not, can you tell your process for evaluating the health literacy of the health information and services you design and implement?
Lauren: Any new program is piloted with a sample of the target population we are aiming to reach. For example, when we developed the medicine safety for parents program in English, Spanish and Chinese, our health educators piloted it with these audiences. We collected a pre-test from participants and then conducted follow-up calls two weeks after the session to obtain their feedback about the program and gather information about changes in knowledge, attitudes and behaviors. Building knowledge, attitude and behavior change questions into the assessments helps to evaluate outcomes. Knowledge based questions assess using a dosing instrument rather than a kitchen spoon and knowing the active ingredient; attitude is often measured through comfort calling the Poison Control Center after the workshop; and behavior often asks about using the medication management tools and saving the Poison Center number in the cell phone.
Say Ah!: In the many years you have been doing this, what are the top 3 three lessons you have learned to better engage and empower populations served in the development of consumer-facing materials and services.
Lauren: First and foremost, always listen to the needs and feedback of those communities you are trying to reach. Ask about any barriers for accessing a service or engaging in a health behavior change. Focus groups conducted with parents at WIC showed that barriers for calling the Poison Control Center included a preference for 911, a fear of being reported to child welfare, and low self-efficacy when presented with a child’s poisoning. This led to creating programs that addressed these issues with caregivers (read more here). Second, field test all new programs and materials developed in every language to ensure that the messages are understood and address any concerns. Third, be open to change and continue the learning process.
About Lauren Schwartz, MPH
Ms. Schwartz is the Director of Public Education at the New York City Poison Center, where she has worked since 1999. In her role, she coordinates the community education and outreach efforts for New York City and Nassau, Suffolk and Westchester counties. Ms. Schwartz is responsible for all aspects of the multilingual health education programs created to raise awareness about prevention of unintentional poisonings, medicine safety and utilization of the NYC Poison Control Center. She is also an Assistant Professor of Emergency Medicine at New York University School of Medicine. She received a master’s degree in Public Health from Hunter College.
The NYC Poison Control Center is available 24 hours a day, 7 days a week for treatment advice about exposures to poisons or questions about medicine safety. Pharmacists and nurses certified in poison information are there to give advice. All calls are free and confidential. Translator services are provided in more than 150 languages. Call any time at 1-800-222-1222 or 212-POISONS (212-764-7667).