Special Halloween Edition: Attribute 4

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.

In honor of this scary day, we learned from New York City Poison Control’s Director of Public Education Lauren Schwartz about why you should never be frightened of engaging the people you serve.

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).

Say Ah!’s Back to School Tips

We wanted to pass along these tips to help parents make their kids’ back-to-school check-ups better,  simpler, and safer. Please feel free to share these tips with friends, family members and colleagues!

1. Get your forms in order! Have all the school, daycare, and athletic health forms you need for each child. Make a list of which doctors to see and the paperwork need signed.

2. Call ahead to schedule the appointments.  If weekdays are a problem for you, find out if the doctor is available on weekends.

3. Make a list of important information and bring it with you.  This includes:

• What medicines your child is taking. Include prescription and over-the-counter medications, vitamins, herbs, and supplements (such as protein drinks).
• Important facts about your child’s health. Include allergies, chronic illnesses, any past surgeries, broken bones, etc.
• Questions or concerns that you – or your child – may have about his or her health.
Make three copies of this list: One for you, one for your doctor, and one to give the front desk for your child’s file.

4. Prepare your child for the visit.  Depending on the age and readiness of your children, let them know what to expect from the visit and what is expected of them. If they are old enough to speak to the doctor on their own, encourage them to do so.

5. Make sure your child is comfortable during the visit.  This should be a positive experience in every way for your child. Talk with your child about anything that is bothering him or her (physically or emotionally), and help resolve the problem or concern.

6. Check that your child’s records are correct and up to date. The lists you just made should square with what is in your the doctor’s file for your child.  This is especially important if your child sees more than one doctor or has been to a hospital or an emergency department.

7. Communicate with your child’s doctor!  Speak up when you have something to say — you are your child’s advocate!  Ask questions whenever you don’t understand something, whether it is a medical term or medication directions.

8. Take notes so you don’t forget what your doctor tells you.

9. Make sure you (and your child if s/he is old enough) understand important information such as medication directions, how to use an inhaler or other medical devices, or what to do if your child is referred to another doctor.

• Ask your doctor to repeat instructions if you don’t get them the first time.
• Check your understanding by saying, “Okay. Let me make sure I’ve got this right,” and repeat back to your doctor what s/he just said in your own words.
• If you go home and realize you have a question, contact your doctor immediately and ask for clarification.

10. Get your child’s weight and height.  This is great information to have as many medications are often given by weight.  NOTE: these numbers can change throughout the year, so use them only as guidelines.

Bonus Tip: Finally – don’t forget to get those school, daycare, and athletic forms signed!

Say Ah! Hosts Webinar October 16th!

You are Invited to Say Ah!’s Health Literacy Webinar: Strategies to Improve Patient/Client Health Literacy. October 16th, 10am.

Hosted by the Bureau of Cultural Competence, New York State Office of Mental Health. Reserve Now! Space is Limited.Click here for link to register.

Health literacy is the ability to access, understand, and act on health and medical information and services, and is “a stronger predictor of a person’s health than age, income, employment status, education level, and race” (JAMA). Although low health literacy has emerged as one of the most pressing public health issues of our time, few professionals receive the vital training needed to recognize or “diagnose” and improve the health literacy of patients or clients. This webinar provides strategies and skills to integrate into your work as a means to increase patient-client health literacy and enhance their health and mental health outcomes. Led by Say Ah! co-founders Anna Allen and Helene Eisman Fisher, the Webinar provides an overview of health literacy and its nuances; strategies to effectively communicate with patients/clients (including Teach Back and Plain Language skills), how to recognize low health literacy, cultural competency, and more.

Space is limited.
Reserve your Webinar seat now at:

Title: Say Ah!’s Health Literacy Webinar: Strategies to Improve Patient/Client Health Literacy
Date: Tuesday, October 16, 2012
Time: 10:00 AM – 12:00 PM EDT

After registering you will receive a confirmation email containing information about joining the Webinar.