D406

equity:

unbiased treatment, fairness, and justice for all people that considers systemic inequalities to ensure that everyone has access to the same opportunities and outcomes

healthcare rights:

universal rights concerning healthcare guaranteed to all people and protected by federal and state laws

plain language:

using language that is free of medical jargon and not complex

organizational health literacy:

the responsibility of organizations and HHS professionals to implement practices to improve health literacy

social justice:

the view that everyone deserves equal economic, political, and social rights and opportunities

health literacy:

the degree to which people can find, understand, and use information and services to inform health-related decisions and actions for themselves and others

demand side:

the expectations and demands the healthcare system requires from its clients

populations most impacted by issues related to health literacy include:

-Adults over the age of 65 -Non-native English speakers or those with limited English proficiency -People with incomes at or below the poverty level -People with less than a high school degree or a General -Educational Development (GED) credential -People with a compromised health status -Racial and ethnic groups other than white

Seven Action Steps to Help Clients Improve Personal Health Literacy:

1. Be prepared to share your medical history, health status, medications, and lifestyle choices. 2. Identify a goal for all encounters with a healthcare professional and set a plan before the visit. 3. Write down a list of questions and concerns and consider bringing a relative or friend to all appointments. 4. Restate what your doctor told you before you leave to confirm your understanding of the information and instructions provided. 5. Request a list of credible sources of health information you can research online. 6. Learn to access your personal medical record online. 7. Educate yourself about health and wellness, and make positive lifestyle choices to prevent disease and illness.

The Action Plan provides seven goals with suggested strategies organizations and healthcare professionals can implement to achieve the goal of helping more people attain health literacy:

-Develop and disseminate health and safety information that is accurate, accessible, and actionable. -Promote changes in the healthcare system that improve health information, communication, informed decision-making, and access to health services. -Incorporate accurate, standards-based, and developmentally appropriate health and science information and curricula in childcare and education through the university level. -Support and expand local efforts to provide adult education, -English language instruction, and culturally and linguistically appropriate health information services in the community. -Build partnerships, develop guidance, and change policies. -Increase basic research and the development, implementation, and evaluation of practices and interventions to improve health literacy. -Increase the dissemination and use of evidence-based health literacy practices and interventions.

five key principles of self-advocacy:

-Empowerment: All people should be empowered to make decisions, take risks, and ask for help when needed. -Equal opportunity: All people have equal opportunity to be supported as full members of their community. -Learning and living together: All people have the right to participate in their community and attend school. -Institutions are bad for people: As an advocate, you must not allow yourself or others to be controlled by institutions. -Non-labeling: All people have the right to be recognized without labels or stereotypes.

Action Plan was established with two core principles in mind:

-First, all people have the right to health information that can help them make informed decisions about their health and healthcare -Second, health services should be provided in a simple way that is easy to understand with a focus on improving health outcomes.

Specific examples of how a client's cultural beliefs and customs can influence the advice a healthcare professional might provide include:

-Health beliefs: Some cultures believe discussing the possibility of a poor health outcome will make the outcome occur. -Health customs: The role of family members in decision-making about a client's health varies widely among different cultures. -Ethnic customs: There are many cultural differences related to the role men and women play in making healthcare decisions. -Religious beliefs: The influence of religion and spiritual beliefs on seeking healthcare and accepting treatment options varies. -Dietary customs: Food or dietary restrictions or cooking preferences may impact adherence to disease-related treatment and advice. -Interpersonal customs: Cultural beliefs about the appropriateness of eye contact or physical touch will impact health encounters

Advocates may work to:

-Improve access to healthcare services -Promote healthy behaviors -Address social determinants of health -Improve health education -Strengthen public health infrastructure -Foster collaboration among stakeholders

Health disparities can be reduced through various strategies, including:

-Providing tailored health education materials and resources for disadvantaged individuals, presenting health information in an accessible and understandable manner -Building patient-provider partnerships that include members of the community and support networks -Providing culturally appropriate care to ensure that health information is tailored to an individual's cultural needs, allowing patients to make informed decisions about their care -Promoting self-management skills essential for underserved individuals to care for their health and educating and empowering individuals to make informed decisions about their health; for example, providing braille literature for individuals with special needs and writing materials in two different languages -Creating partnerships between patients and providers that include members of the community and support networks

Five ways to improve self-advocacy are:

-Read about and research health topics that are important to you. -Ask questions of healthcare professionals. -Participate in activities and programs that are designed to increase health literacy. -Share your knowledge and experiences with others. -Utilize available resources, such as health libraries and online health websites.

Individuals and communities also have specific healthcare rights:

-The right to access healthcare: Individuals have the right to receive healthcare services when they need them, regardless of their ability to pay. -The right to quality healthcare: Individuals have the right to receive good-quality healthcare services that meet their needs. -The right to informed consent: Individuals have the right to be fully informed about their healthcare options and to make decisions based on that information. -The right to privacy: Individuals have the right to confidentiality in their healthcare matters and the protection of their personal health information. -The right to nondiscrimination: Individuals have the right to receive healthcare without discrimination based on factors such as race, ethnicity, religion, gender, sexual orientation, or disability.

At the personal level, steps that can be taken to improve health outcomes. Help your clients or patients to take these steps, including:

1. Assess their personal levels of health literacy, and honestly acknowledge their strengths and weaknesses. 2. Build their digital health literacy and numeracy skills; encourage them not to hesitate to ask for help when needed. 3. Complete all preventive care services and take precautions to avoid illnesses that lead to expensive visits to the emergency room or long hospital stays.

At the organizational level, steps that can be taken to improve health outcomes include:

1. Assume all people have low health literacy and provide accurate information and support to improve their health, including notes and instructions provided after each doctor visit, a follow-up phone call, and appointment and preventive care reminders; provide all health information and patient materials in the patient's preferred language. 2. Make changes to the health system to improve access to care, including preventive care services. 3. Invest in health and human service professionals to connect patients to resources in a different way. 4. Focus more on diversifying the healthcare workforce to resemble the diverse patient populations they serve.

Policies and Programs to Improve Health Outcomes for Diverse Populations

1. Congress created the Office of Minority Health, which is dedicated to improving the health of racial and ethnic minority populations by developing health policies and programs to help eliminate health disparities. 2. The National Center on Minority Health and Health Disparities was established to lead scientific research to improve minority health and reduce health disparities. 3. The National Institute of Aging developed and adopted the NIA Health Disparities Research Framework to study health disparities related to aging. 4. The Centers for Disease Control and Prevention (CDC) established the Division of Human Development and Disability to promote health and reduce health inequities for people with disabilities.

There are at least five ways to encourage clients to engage in health literacy self-advocacy:

1. Create easy-to-read materials and write content in plain language that a person can understand and put into action; for example, use infographics or pictures to clarify instructions or concepts. 2. Display information clearly on a webpage, pamphlet, or document; for example, make sure the text is large enough and web pages are easy to navigate. 3. Share best practices with people and organize content to make it easy to find, read, and use; for example, use large print buttons and provide an overview of how to find materials. 4. Engage the person and deliver healthcare information from the client's perspective; for example, provide first-person narratives (that is, your own experiences) or relevant, real-world experiences. 5. Train providers on how to use materials and testing materials on people with limited literacy skills; for example, use focus groups to determine how user-friendly materials are before sharing them with clients.

At the social level, steps that can be taken to improve health outcomes include:

1. Investing in public health education with a focus on the health disparities in diverse populations. 2. Minimizing the impact of social determinants of health by implementing policies and programs to help individuals find housing and secure jobs, provide access to healthy food, education, and transportation, and address other social factors affecting their ability to care for their own health. For instance, communities can invest in organizations that help arrange transportation for seniors to a doctor's appointment or the grocery store. 3. Creating system-wide accountability for achieving goals and metrics related to health outcomes for diverse populations.

Action Steps to Improve Organizational Health Literacy:

1. Make health information easier to access and understand for all individuals and include all relevant information in their medical record. 2. Make changes to simplify how patients navigate the healthcare system to address the effects of low health literacy. 3. Train HHS professionals to identify patients at higher risk for poor health outcomes, address health literacy issues, and measure progress to make necessary adjustments.

Self-advocacy is rooted in two core beliefs:

Every person is an individual with their own identity who must be listened to when they express themselves. All people have the right to make their own decisions and have those decisions understood and respected by others.

Heckler Report:

a landmark report published in 1985 by the U.S. Department of Health and Human Services highlighting health differences among racial and ethnic groups

cultural humility:

a process of reflection to understand one's biases and privileges and remain open to others in relation to the aspects of their cultural identity that are most important to them

cultural competence:

a provider's ability to recognize the cultural beliefs, values, attitudes, traditions, language preferences, and health practices of diverse populations and apply that knowledge to a positive health outcome

health literacy universal precautions:

a set of strategies that healthcare practices can use to ensure their patients have the necessary knowledge and skills to make informed decisions about their health and effectively navigate the healthcare system

National Standards for Culturally and Linguistically Appropriate Services (CLAS):

a strategy focused on providing health services that are responsive to the cultural health beliefs and practices, preferred languages, health literacy levels, and communication needs of diverse patients

self-advocacy:

ability to communicate one's own needs and interests

healthcare advocacy:

acting to ensure that practices and policies are implemented that result in better access to healthcare, reduced health disparities, and considering the impact of particular social and economic factors on a person's health

interactive health literacy:

advanced skills, including the ability to use and apply information under different circumstances or in different situations

health equity:

all people have an equal opportunity to attain their best health

Healthy People 2030:

an HHS initiative that sets data-driven national objectives to improve health with an overarching goal to eliminate health disparities, achieve health equity, and help more people attain health literacy to improve health outcomes

health literacy:

an individual's ability to access and use the necessary information to make decisions about their health and healthcare

personal health literacy:

an individual's ability to access, understand, and use information and services to inform health-related decisions

skill side:

an individual's skills, abilities, and capacity to respond to the expectations and demands of the healthcare system

National Action Plan to Improve Health Literacy:

an initiative launched by the ODPHP "to engage organizations, professionals, policymakers, communities, individuals, and families in a linked, multi-sector effort to improve health literacy"

self-advocacy:

any action that speaks in favor of, recommends, argues for a cause, supports or defends, or pleads on behalf of others

functional health literacy:

basic reading and writing skills to understand information and function in everyday situations

health literacy environment:

the information provided to clients represents the expectations, preferences, and skills of those providing the health information and services

critical health literacy:

developing new skills and being able to analyze and apply information to create change

National Health Education Standards:

establish, promote, and support health-enhancing behaviors, emphasizing that all individuals should be able to demonstrate the ability to advocate for personal, family, and community health using effective interpersonal communication, goal setting, and decision-making skills

teach-back method:

has the patient "teach-back" the information to check for recall, understanding, and their ability to use the information to make decisions about their health

teach-back method:

has the patient teach information back to check for recall, understanding, and their ability to use the information to make decisions about their health

digital health literacy:

having the skills and ability to use electronic sources to access health information

evidence-based information:

health information and resources that are credible and reliable because they are based on solid scientific evidence

situational determinants:

include both the health literacy environment of the healthcare organization and the skills and abilities of HHS professionals, including the messaging being used with clients

personal determinants:

include the knowledge and skills of the client to access and understand health information in addition to the influence of other personal characteristics, including age, gender, culture, language, education and income level, and their ability to interact with the healthcare system

disadvantaged individuals and groups:

individuals who are economically or socially disadvantaged, racial and ethnic minorities, immigrants, people with disabilities, seniors, low-income individuals, and people living in rural or underserved areas

health numeracy:

mathematical and problem-solving skills related to the use of data

social determinants of health (SDOH):

non-medical factors that influence an individual's health outcomes

active listening:

paying full attention to the other person without judgment and trying to summarize, share, and clarify the information that you hear

health disparities:

preventable differences in the rate of disease and illness experienced by diverse populations

Health Literacy Environment Activity Packet

resource that provides a thorough analysis of the facility from the patients perspective and identifies ways to eliminate carriers and increase access

cultural respect:

the practice of maintaining esteem for others' beliefs, practices, customs, and language needs