Exam 2 Osborne Readings

strategies, ideas, and suggestions for talking with patients about what they learn from the media

1. pay attention to the news 2. pay attention to the ads 3. pay attention to the shows 4. pay attention to spikes in phone calls *important to stay current and keep up with news

3 ways to create an environment conducive to learning

1. post large, readable signs that clearly inform people where they are 2. provide well-lit rooms, halls, and quiet spaces in which to meet and talk 3. dont rely just on color to help people navigate the environment, as color-coded arrows may be of no use to people who are color-blind or visually impaired

pay attention to spikes in phone calls

about certain topics or specific health stories front-desk staff and nurses are usually the first to speak with patients

ways to gauge humor

by noting how the person reacts to funny pictures in the room or silly pins you are wearing try to notice the other person's style, such as whether she or he enjoys visual cartoons or prefers word play such as puns and quips

how else to engage children in conversation example

by talking about their favorite TV character or pop singer and trying to play games or use puppets as part of an exam (provider gets what they want and the child has fun) i.e. when listening to a child's breathing, you can ask a child to blow on a pinwheel or pretend to blow out candles on a birthday cake

explaining the metaphor

by themselves, their seldom sufficient; you need to follow up with a fuller explanation and include limitations

what is the best way to present translated materials in ways readers can understand and relate to

by working collaboratively with those who represent the intended audience this includes working together to develop ideas, deciding about word choice and illustrations, and then testing drafts along the way

helping patients feel welcome

create a feeling of welcome by greeting patients in their native tongue or using ASL to sign "hello" even if you magnet pronunciation, it is still evident that at least you care enough to try

translators

do essentially the same, but with the written word; this can include translating discharge instructions, patient's rights, informed consent documents, medical bills, and even signs or maps that help newcomers find their way around unfamiliar places

metaphors, similes, and analogies

figures of speech used to help people understand unfamiliar words and concepts by comparing new information to that which people already know metaphor is saying what something IS simile is saying that something is LIKE or AS analogy compares to things based on similarities

who is health literacy a factor for in youth

for children, their parents or other caregivers, and pediatric health care providers (what's distinct and complex about pediatric health literacy is that it must be considered in terms of parents' or caregivers' health literacy as well as the children's own health literacy)

what can emailing bring concerns for

for privacy and security- people can share computers and access messages intended for others, and employers can legally read messages their employees send from work *make sure it is not to be used for emergencies not everyone uses it or feels comfortable using it

when should you use metaphors example

for those times when you are teaching something that is unfamiliar or hard to understand; don't use for a well-understood condition like the common cold i.e. when explaining a new diagnosis like congestive heart failure

example of medical jargon

in health care the term "unremarkable" generally means "you're fine" while the term "positive" may mean you're not

what is one way to help remember true information

in positive rather than negative ways also emphasize what's true rather than what's false- don't start with misinformation even if you intend to correct it if you must repeat false information, put it in the middle of a document and not at the beginning or end, which are places where people tend to pay most attention

write out full directions rather than abbreviations: what is this most important for/how should you do it

particularly important for dosing instructions: clearly explain what to do, giving instructions like "take this pill two times a day- one pill at breakfast and one pill at dinner time"- giving a specific time can help too

what does this mean for patients and providers

patients may see media stories on medical or health findings before providers have reviewed the research

set a tone of partnership

patients need to feel safe admitting that they don't understand invite patients to be partners

why is emailing in healthcare useful

people may respond at their convenience, messages can be printed and saved, and hyperlinks can be added so people need only to click of more information

idioms

phrases that mean something quite different from their actual words

what do visuals include

pictographs (simple line drawings), photographs, anatomic diagrams, comics, and other images that convey actions or ideas

when to use: pie charts bar graphs line graphs scatter plots

pie charts to show proportion bar graphs to make comparisons line graphs that communicate trends scatter plots that show variability

prepare a standard office response example

prepare a script for staff to give in response to calls about hot topics "Yes, the study came out yesterday and we know it is in the news. While the journal article is not yet widely available, Dr. Jones is confident that (something from the study that the doctor thinks patients should know now). Let us make an appointment for you to speak with her in the next week after she has reviewed the article"

3 concerns that social media brings

privacy, payment, and time

who are the best source of help between the two why

professional medical interpreters are the best source of help, as they not only are trained medical vocabulary but are also instructed in how to maintain neutrality, adhere to confidentiality, and not impose personal views

what do patients vs. providers need to describe; what do they both need to do

providers need to present information about new diagnoses, treatment options, and self-care instructions; patients need to describe their symptoms, ask questions, and express opinions about treatment and care; they both need to listen closely, respond thoughtfully, and remember clearly what each other just said

pay attention to the news

providers should stay up to date with health reports by periodically checking the news throughout the day (media stories are often aired the same day that studies are published)

how to teach in ways that children and their parents or caregivers can learn

putting unfamiliar concepts into context, as for a new diagnosis or medication also means using familiar wording like a "stuffy, runny nose"

recover when humor backfires what if you take something offensively

quickly apologize and let the other person know that you are not trying to be hurtful in turn, when someone tells you a joke that you find offensive, don't overreact; you might say something like "that's a creative way of looking at things" and then change the subject

research the research

read the peer-reviewed research and investigates the quality of journalism

abbreviations, acronyms, and initialisms

refer to shortened ways of referring to longer, more complicated terms

using words, terms, and examples that people know

tailor it to their experience

medical jargon

technical terms and phrases or words used in special, idiosyncratic ways

what is one good source to consult in this situation and what does it consist of

the Foundation for Informed Medical Decision Making's Web site, run by the School of Journalism and Mass Communication at the University of Minnesota, this site uses stringent criteria to grade health stories on a scale of 1 to 5

in the teach-back technique, what happens if the patient does not understand a concept correctly or completely

then the provider restates or tailors the message to make it more accessible then, the provider again assesses the patient's comprehension and continues this process until it is clear that the patient understands

what should you do after this

then, ask open-ended questions about new concepts such as "now that we've talked about adding fiber to you diet, what will you look for the next time you buy cereal"

payment

there is little to no third-party reimbursement for the extra time you spend communicating through social media

example of how to tailor the phrase "exercise more"

use an example familiar to each patient so, if the person likes to swim, you might say "instead of swimming just once a week like you have been doing, try to swim three times a week for at least half an hour"

preparing the child for medical procedures example

use humor and real-life examples to help prepare the child for the procedure ie letting the child look and feel what a throat swab looks like before using it or letting them use it on a doll

what do you need to show when using visuals

use pictures of entirety especially when discussing body parts (can be used as a road map) include the most important elements (so they can see it in relation and understand how it works)

what must you first do if you want to change materials that are not in the public domain

you must get permission to do so from the content author (just about everyone is very willing to have their materials customized to be more useful of local settings and appreciates hearing that their resources are helpful)

look at and speak directly to the patient, not the interpreter

you not only show respect this way but also can notice a patient's nonverbal cues with an ASL interpreter, the interpreter should sit a little behind and to the side of the health provider

how should you begin to set a tone of partnership

"I want to make sure that you and I are on the same page" place the onus of misunderstanding on the clinician or educator by adding "I just want to make sure I explained things well, When you go home and your husband asks what the doctor suggested about your medication, what will you tell him?"

what question should you not ask why

"do you understand?" because whether or not they understand, most simply respond by nodding and smiling

strategies, ideas, and suggestions for knowing your audience with children and youth

*1. talk to the child about health 2. prepare the child for medical procedures (humor and real-life examples) 3. encourage laughter (TV characters or pop singers) 4. teach in ways that children and their parents or caregivers can learn (play games or use peppers as part of an exam)

results of using media for health care

* unrealistic expectations and DTC (direct-to-consumer) advertising

2 strategies, ideas, and suggestions for an older audience

*1. CONFIRM, CONFIRM, CONFIRM UNDERSTANDING WITH FEEDBACK 2. ensure materials are readable: asses reading ability informally with red flags

strategies for communicating when patients feel scared, sick, and overwhelmed why do patients fear asking questions

*1. appreciate why communication can be hard for patients (patents feel providers won't like them if they ask questions 2. help patients learn more many fear if they ask too many questions the providers will not like them so they don't ask them and they feel ashamed to admit not understanding certain medical terms or concepts

what to do when confronted with news in the media

*1. confirm what is true especially if the information pertains to DTC advertising 2. write a message that you will provide to everyone who calls with concerns about the information; ensures everyone obtain the same information

7 strategies, ideas, and suggestions

*1. invite, or even INSIST, on questions 2. elicit questions with open-ended phrasing (not yes or no) 3. offer reassurance 4. ask as well as answer 5. prepare commonly asked questions 6. encourage patients to write down their questions (provide pen and paper) 7. consider the expense of not asking questions

5 ways on how to use understandable words

*1. use common one-or-two syllable words 2. define unfamiliar, yet necessary, words and terms (pronunciation and example) 3. be consistent, using the exact same wording each time (one term) 4. be cautious when using contractions like "don't and you'll" (can be confusing) 5. be sensitive to concept, category, and value judgment words (rarely and moderate because they have different meanings)

what can images help people to do what do you need to balance between

*take in information faster and more accurately, and remember it better balance between words and visuals (combine pictures and text)

8 strategies, ideas, and suggestions for visuals

1. 1. acquire the artwork you need 2. show sensitivity and respect (realistic and show people at their best) 3. select visuals appropriate to the subject matter 4. show people in their entirety, not just body parts (road map for patients) 5. combine pictures and text (improve understanding) 6. appreciate that symbols are not always understood (select to interpretation) 7. consider the needs of those with visual or cognitive disabilities (make them easy to see by having a lot of contrast and avoid decorative backgrounds) 8. confirm understanding

what do findings specifically show about health numeracy

1. 22% of the adults in the US have below basic quantitative skills 2. 33% of the same population has basic quantitative skills 3. 33% has intermediate quantitative skills 4. 13% has proficient quantitative skills

what 4 traits are health numeracy skills

1. basic 2. computational 3. analytical 4. statistical

9 strategies, ideas, and suggestions for plain language

1. build a team 2. identify project goals 3. organize content in ways that make sense to your readers 4. use understandable words 5. write succinct sentences 6. use engaging tone 7. consider format and layout 8. use graphics wisely 9. confirm comprehension

concept words category words value judgement words

1. describe general or abstract ideas like "wellness and health status" 2. incude overall groupings such as "poultry" rather than "chicken or turkey" 3. refer to amounts of thresholds that readers must determine, such as "rarely and moderate"

strategies, ideas, and suggestions

1. determine when to use a metaphor 2. use words, terms, and examples that people know 3. explain the metaphor 4. move beyond the metaphor 5. confirm understanding

strategies, ideas, and suggestions for translators

1. develop and test materials with intended readers 2. simplify your message before translation 3. inform patients about translations 4. decide whether to put two languages in one document 5. use meaningful examples and illustrations

5 ways to make number-based concepts easier to understand

1. patients are much more interested in what will happen to them (rather than comparing them to a population) 2. make clear what the risk is about 3. state risk as absolute, not relative 4. frame results as positive, not negative 5. compare unfamiliar concept sot something known

what additional steps does Elyse Barbell recommend on top of the teach-back

1. pay attention not just to peoples' words but also their body language, eye contact, and tone of voice 2. don't be satisfied when a patient's teach-back is just "pretty good" instead listen for what the patient didn't say (what wasn't said can reflect gaps in understanding) 3. respond specifically to patients' teach-back (add at least one more sentence) 4. reinforce lessons that patients learned well 5. teach key content again when you notice discrepancies 6. supplement teaching with good take-home (written) instructions; choose materials that have informative illustrations, simply stated step-by-step, and vocabulary matching your spoken word 7. continue teaching and asking for teach-back until you are assured that patients fully understand

Dr. Apter's 3 examples of number-based problems she sees in practice

1. figuring out measurements (milligrams in pills) 2. reading and tracking numbers (like when using flow meters) 3. understanding risk and other mathematic components

strategies, ideas, and suggestions for humor and healing

1. gauge the other person's sense of humor 2. show humor 3. bridge from humor to teaching 4. if in doubt, don't say it 5. recover when humor backfires

3 strategies, ideas, and suggestions for social media

1. get your social media feet wet, so to speak 2. appreciate the value of social media to your and your patients 3. address concerns

strategies, ideas, and suggestions for interpreters

1. help patients feel welcome 2. allow sufficient time 3. look at and speak directly to the patient, not the interpreter 4. provide translated tools of basic phrases 5. communicate your message in alternative ways 6. appreciate differences in body language 7. notice signs of difficulty 8. verify understanding

3 was to organize content in ways that make sense to your readers

1. identify one primary message and support it with a limited number of (usually three to five) key points (prioritize the need-to-know skills/behaviors rather than nice-to-know) 2. organize key points in ways that make sense to readers (the concept WIIFM: what's in it for me- about why people should read this information) and then summarize key points and include non-print resources as well as written 3. have ways for readers to interact with written materials: check-off boxes, quizzes, etc.

3 ways that Reach Out and Reach accomplishes this goal

1. in the exam room, doctors and nurses speak with parents about the importance of reading aloud to their young children every day, and offer age-appropriate tips and encouragement 2. the pediatric primary care provider gives every child 6 months through 5 years old a new, developmentally appropriate book to take home and keep 3. in the waiting room, displays, information, and books create a literacy-rich environment; where possible, volunteers read to the children, modeling for parents the pleasures-and techniques-of reading aloud

2 reasons why people struggle so much with numbers

1. it can relate to the anxiety of being a patient 2. be due to a person's math education numbers do not necessarily relate to overall intelligence

8 strategies, ideas, and suggestions for health numeracy

1. know why are you using numbers 2. help opal make meaning of numbers 3. help people measure correctly 4. make calculations easier 5. give context for number-based concepts 6. recognize that words and symbols sometimes serve as shorthand for numbers and calculations 7. use charts, graphs, and other visual tools 8. confirm understanding

4 things to do when emailing

1. make it clear that email is not to be used for medical emergencies 2. use plain language 3. let patients know when to expect replies from you (and create an auto responder) 4. consider the most appropriate way to respond (bad news=encouraging a meeting/appointment)

communicate your message in alternative ways

1. make simple drawings 2. use an anatomic model to demonstrate how to do a self-care activity 3. use visuals to rate pain 4. provide health information in audio, web-video, and other formats

strategies, ideas, and suggestions about choosing the right words

1. make sure the meanings of acronyms are clear 2. be aware of pronunciation 3. write out full directions rather than abbreviations 4. avoid gobbledygook

4 ways to help people measure correctly

1. mark how high to fill a drinking cup or use a divided plate to show proper proportions of vegetables, fruits, protein, and grains 2. compare quantity to known amounts (4 ounces of meat is about the size of a deck of playing cards) 3. use familiar measurement units such as ounces or grams, cups or liters 4. demonstrate fractions

tabs for keeping your own medical record

1. medical reports: copies of paperwork 2. doctors: photo, contact info, and directions 3. questions 4. medication lists, healthcare proxies, and other important papers (to give to each provider instead of telling them each time) 5. zippered pouch (business cards, etc.)

social media as a food pyramid

1. micro-blogging is the base (tweets) 2. social networking is the next level (Facebook and LinkedIn) 3. multimedia makes up the third level (audio podcasts and videos) 4. blogs are at the pyramid's peak (they provide in-depth information on a narrow topic)

4 things to do when texting

1. offer the option of text messaging 2. obtain consent 3. designate someone to send daily messages 4. make the message clear, but brief (no slang or shorthand)

*what are stories powerful for what do they typically have what does it take to be good at telling them what should you ensure about the story

1. powerful health communication tools: increases awareness and brings connection to the situation through facts and emotions 2. stories typically have a beginning, middle, and end 3. takes practice to be good at 4. ensure the story is relevant to the situation

what is recommended when spikes occur

1. prepare a standard office response 2. research the research 3. refer patients to resources you trust

5 ways to use graphics

1. select graphics that are informative and not just decorative 2. use recognizable images rather tan abstract symbols that might be misunderstood 3. show and tell readers the correct way to perform tasks by having pictures and simple written captions beneath them 4. select pictures that are culturally relevant and appropriate to your audience 5. draw internal body parts in context of the entire body

what are some helpful strategies for the teach-back technique

1. set a tone of partnership 2. tailor your message to be more consistent with what the patient says (their frame of understanding) 3. consider why the message is not understood *body language, eye contact, and tone of voice are also important

2 ways to appreciate the value of social media to you and your patients know what patient blogs help*

1. social media as an adjunct to patient education- you can use social media to inform and teach, such as tweeting about the latest health news or posting up-to-date research about a certain disease or condition **2. patient blogs as an expression of illness

5 strategies, ideas, and suggestions for patients when communicating while they feel scared, sick, and overwhelmed

1. take note of your symptoms (when they started, how often they occur, and how long+describe them) 2. invite family members or friends to act as advocates (they can take notes, voice concerns, and remember what was said) 3. overcome communication barriers (bring hearing aids or eyeglasses, tell provider if they're speaking too softly, if the print size is too small, or if you don't understand) 4. learn only as much as you want to know 5. create your own medical record

5 strategies, ideas, and suggestions about telling stories

1. tell stories (relevant and true and don't violate privacy) 2. encourage patients to share stories (find out strengths, concerns, and points of view) 3. help patients focus on the point of a story 4. listen for what's missing in a story (may differ from other versions) 5. decide whether to share stories from your own experience

5 ways to help recognize that words and symbols sometimes serve as shorthand for numbers and calculations

1. to clarify important concepts, use both numbers and words 2. avoid vague words that are open to interpretation (adequate, moderate, some) 3. be sensitive to words with multiple meanings 4. know that not everyone understands mathematic symbols 5. be willing to bend the rules (saying half instead of 48%)

4 ways to write succinct sentences

1. vary sentence length and style (clear and simple but not boring) 2. have just one main idea and no more than about 15 rods in each sentence (bullet points) 3. identify who is doing the action 4. be sensitive to conditional if/then sentences

AskMe3's threes impel questions that patients are encouraged to ask and that providers should answer in every health care interaction why

1. what is my main problem 2. what do I need to do about it 3. why is it important for me to do this participants are very receptive to these questions and refer to them often, it is effective, and people usually do not need to ask more than this to get the information they need

6 ways to consider format and layout

1. write in a font size that is large enough to see (14 and 16 for older people) 2. use a combination of upper and lower case, rather than all capital letters 3. justify (line up) words on the left, not centered or on the right 4. allow adequate white space 5. have visual contrast between letters and background 6. use header to identify main topics

4 was to engage tone

1. write in a friendly and conversational tone, though not overly chatty or cute (tone should match content) 2. write as though you were talking, using personal pronouns like "you and your" 3. present information in as positive a manner as possible (write about what they can do instead of cannot, but be honest) 4. be clear and specific, not asking readers to guess or assume what they do

examples of using metaphors for explaining "why don't we use antibiotics for colds, acute bronchitis, and other viral illnesses?"

1. you don't use bug spray to kill weeds in your lawn 2. using antibiotics for viruses is like using a large net to catch minnows, they just go through the holes 3. using antibiotics for viruses is like putting gas in your gas tank if your batter is dead 4. treating a cold with antibiotics is like using an umbrella to stay warm in winter, it just doesn't work, and when it starts to rain, your umbrella might be worn out

how many key points should be taught at a time

3 or 4

how many people in the US speak a language other than English at home

55 million

what percent of older adults (65 and older) scored at a basic or below level of quantitative skills when percent of those with less than or some high school education were found to have only basic or below quantitative skills

71% 89%

pay attention to shows

TV shows can impact patients' perceptions of medical care- many of these create unrealistic expectations about access to care

what else might readers benefit from example

a clear explanation rather than the acronym spelled out ie IV, a needle that goes into your arm

Reach Out and Read

a non-profit initiative that promotes early literacy and school readiness in pediatric exam rooms nationwide

humor what can it enhance/demonstrate

a powerful tool that providers can use to enhance communication and demonstrate compassion and humanity tool to connect people in personal and positive ways, even during stressful and sad times

provide translated tools of basic phrases

a qualified interpret may not be available at the time, so tools (booklets, cards, and software or other electronic applications) with translations of basic phrases might help: "are you hungry? are you in pain?" etc.

who does it take to write a readable document what should this include

a team a plain-language writer who is skilled in plain language and an unceasing advocate for readers; one or more content experts who determine information that must stay or can go; and readers who represent your intended audience in terms of literacy level, language, age, culture, and interest in and familiarity with the subject matter

interpreters

convert the spoken word from one language into another, such as from English to Hindi or from spoken English to American Sign Language (ASL)

being aware of pronunciation example

acronyms and initials are pronounced differently it's friendly to provide guidance when pronunciation is not straightforward HIPAA vs. CHF

how to move beyond the metaphor

after confirming that a patient understands, transition to the correct medical terminology

tailoring

altering the message to fit each person's frame of understanding

verify understanding

ask patients to tell you, via interpreters, how they understand information and instructions ask questions that require more than simple yes and no answers; ask open-ended questions instead

example of finding age-appropriate ways for children to participate in health (Mary Ann Abrams) what does this help with

asking a 6 year old to put a mark on a chart for each time she eats fruits and vegetables to help the child acquire health literacy skills and models a way for parents and caregivers to engage the child in healthy actions

how to confirm comprehension

asking for feedback- ask your intended readers to review drafts of your written material

asking questions is what kind of skill

asking questions is a learned skill, not an innate ability

what is the teach-back technique (the interactive communication loop) a ways to assess

assesses and confirms whether patients truly understand the provider's spoken words assesses a patient's recall and comprehension of important concepts just discussed

how can stories help a wide audience

audiences of all ages and cultures relate to stories because they help people bridge differences and find qualities they have in common- they're easy to understand for those who have trouble reading or paying attention because they're engaging and entertaining

what else can question-asking be influenced by

by emotions and culture- they might feel scared and overwhelmed, or fear asking a stupid question different culture may think that it is rude to question those in authority

why do media stories often air the same day that studies are published

because most medical journals send articles to news outlets ahead of their publication date, "embargoing" them for a defined period of time

what do older adults need to know more about and why

because they are more likely to be diagnosed with acute illnesses and chronic conditions, so them and their caretaker need to learn a lot about health and wellness, treatment and care, and emergency response

appreciate differences in body language

beyond words, some gestures and body language are not universally understood feelings of anger and happiness look alike around the world "yes and no" are sometimes communicated in different ways (nodding)

writing in plain language is both a ________ and _________

both a science and art

encourage laughter: what does laughing help to break down

breaks down communication barriers and can go a long way toward relaxing children and their parents

what are ways to overcome these factors

bringing in an interpreter, inviting a family member to join the conversation, or making an appointment focused solely on teaching

allow sufficient time

conversations may take 2-3 times longer when using interpreters allow sufficient time in your schedule to meet briefly with an interpreter before and after speaking with the patient

when can a dose of humor help

can help build rapport, facilitate learning, and improve understanding

plain language

communication designed to meet the needs of the intended audience, so people can understand information that is important to their lives

what can the use of jargon, acronyms, etc. complicate

complicates understanding of medical issues

what should you do after simplifying the message

confirm that the translated document is accurate by asking others to proof that this version is correct also, make sure that the typist is also familiar with the language being used because even well-translated documents can lose their meaning when important accent marks are omitted or misplaced

gauge the other person's sense of humor

consider the other person's learning style, age, culture, and gender when choosing which, if any, type of humor to use you can also encourage the patient to tell you funny stories

how to help patients participate

encourage them to bring lists of their concerns and questions discuss a partient's goals and confidence in managing her or his illness

the art part of plain language

has to do with putting information together in ways that are not only understandable but also inviting, appealing, useful, and relevant

the science part of plain language

has to two with following established guidelines and using proven strategies

today, what is the general public bombarded with

health and medical stories from TV, radio, Internet sites, newspapers, magazines, and other popular media

why is it harder for older adults to know this information

health information is inherently complex and filled with many new words, concepts, instructions, and devices **plus, older adults may have diseases or take medications that affect their seeing, hearing, alertness, or attention span- INTRODUCE ONE CEPT AT A TIME emotional issues also can make learning difficult

privacy example

healthcare professionals should create clear boundaries between their public and private use of social media i.e. using different names or identifiers and setting privacy controls

if an acronym is needed, what should you do to use it

help by explaining its meaning put either the acronym or full term in parentheses alongside the other (i.e. BP (blood pressure))

how to help people make meaning of numbers

help determine if the number means it's a good or bad result one way is to give additional information such as high and low parameters or what her cholesterol level was last year

what should you do about ads

help your patients appreciate the influence of ads

who does plain language help

helps everyone- not just readers who have limited literacy or limited English skills

why is question-asking so important

helps people learn new content, confirming they understand key concepts, and framing information within a more personal context

what does this script help to do

helps reassure patients that the situation is not an emergency and offer an acceptable follow-up plan

according to Izzy Gesell, what does humor help to do/what is it

humor isn't always about being funny; it's about seeing the world form the same perspective as someone else- people tend to feel more connected and less alone when laughing with others

if in doubt, don't say it: when to use humor

humor should be used in small doses and not detract from treatment and care; there are times when humor is not appropriate, such as when people hear bad news, are angry, or are struggling emotionally people may need to cry before they can laugh

example of how to bridge from humor to teaching

i.e. you might heighten teenagers' interest in proper nutrition by first showing them a special food chart for teens; when the teens see refined sugar, fat, caffeine, and salt listed as the four major food groups, they can laugh at how ridiculous this diet is and be more receptive to learning about healthy foods

what to do if the patient seems confused

if the patient seems confused or doesn't know the answer, offer an empathic statement such as, "many people have trouble figuring out which cereals are high in fiber"

what should you do if you sense that there is a problem with difficulty

if you sense that there is a problem, such as lengthy conversations between the interpreter and patient and only one-word answers to you, withdraw from the situation and speak privately with the interpreter to make sure the message is being communicated correctly

how might you show humor if you're not comfortable

if you're not comfortable telling jokes or being silly, you can show humor in quieter ways such as have amusing photos on the wall or display magazines with great cartoons or, if your dress code permits, you might show your sense of humor by what you were- such as colorful neckties, silly pins, or doodads on your stethoscope in print, you can include a dose of humor with clever illustrations or ridiculous examples

basic: what skills are needed

includes skills needed to identify numbers and make sense of quantitative data needed for tasks such as counting pills or knowing the time and date of appointments

computational: what skills are needed

includes skills to count, quantify, compute, and manipulate numbers totaling the number of carbohydrates from a nutritional label

what help to bridge language gaps

interpreters and translators

good and bad of these sources examples

it can bring beneficial "teaching moments" but it also creates some challenges ie patients may panic after reading a newspaper article about someone who has the same diagnosis they do or they may have unrealistic expectations about a certain treatment and insist they need a particular drug after watching direct-to-consumer (DTC) advertising

what does "might" mean in: "This treatment might help"

it can mean to scientist that there is no conclusive evidence, it can be interpreted as "this treatment will help" to a patient desperate for hope

what is common for many people regarding false information

it is common for people to recall false information as true

it is not about dumbing down the language but rather _____________________

it is not about dumbing down the language but rather providing information in ways that MOST everyone can understand

notice signs of difficulty

it is the health provider's responsibility to make sure that medical information is communicated accurately

time

it takes time- just like any other competing demand, you need to budget how much time you can reasonably allot

what does humor include

jokes, riddles, word play, visual gags, and silly objects or cartoons

what other factors could contribute to why the message was not understood

learning disabilities, hearing loss, cognitive impairments, depression, limited literacy or language skills, or cultural differences that are getting in the way

what else should you actively listen for

listen for what the patients do not say

what happens when onsite-trained medical interpreters aren't available

organizations might engage over-the-phone interpretation services like Language Line

how to inform patients about translations

make sure to translate such statements into the language of your readers: "Please let us know if you need this booklet in (x language)."

what types of tasks are numbers need for

making sense of risk data, selecting health foods by reading nutrition labels, estimating costs and figuring budgets, and rating satisfaction of pain on scales from 1 to10

problems of mental multitasking and fluid intelligence

mental multitasking: putting al to of pieces of information together fluid intelligence: process of reasoning they both can lead to frustration when older adults try to manage and recall many bits of information from short-term memory

avoiding gobbledygook: when are messages clearer?

messages are clearer when you avoid jargon or define terms in ways your intended audience can understand

who has problems with numbers

nearly all health numeracy studies conclude that the vast majority of the lay public struggle to understand and use numbers

statistical: what are these skills needed for

needed to critically analyze quantitative information to comprehend concepts such as risk and randomization or blind studies

analytical: what are these needed for to understand

needed to understand inference, estimation, proportion, percentage, and other high-level concept determining whether cholesterol numbers are within normal range, understanding basic graphs, and comparing insurance benefits

do all points in a story have to be factual

no

when do we use number-based concepts in health information

number-based concepts include risks, benefits, frequency, and probability

to understand most health information, people need a working knowledge of _______________

numbers

health numeracy

numbers-based tasks the degree to which individuals have the capacity to access, process, interpret, communicate, and act on numerical, quantitative, graphical, biostatistics, and probabilistic health information needed to make effective health decisions

how much of the information delivered in a clinical encounter do patients recall and comprehend

only about half *50% of what they're told in a health encounter is not remembered

abbreviations

shortened versions of longer words, such as "prep" for "preparation"

what should you do before translation

simplify your message

what should you do with idioms and why

since health materials are written for a general (not local) reading audience, try to avoid using idioms like "feeling blue" and "heads up"

how to make calculations easier

sit alongside each other and do calculations together; in writing, line up calculations, making clear how to handle decimals

__________ is as significant a milestone in communication as the invention of the printing press, radio, and TV it is being used in all aspects of our lives, including health communication

social media

how to speak in ways so that people can hear

speak slowly, clearly, and concisely, and introduce just one new concept at a time use everyday language with swords that older adults know and are comfortable with and pay attention to nonverbal communication pause periodically to confirm understanding

what does Mary Alice Gillispie suggest with very diverse populations

suggests partnering across organizations and with academic centers to help share the load and high cost of developing translated materials to reduce duplication of effort, she recommends tailoring or customizing already translated materials from trusted sources such as MedlinePlus

bilingual volunteers how can this lead to problems

there may be times when providers seek language help from bilingual volunteers, perhaps staff members or people in the patient's family this can lead to problems when an untrained interpreter inadvertently misinterprets a term or interjects his or her opinion; also there are concerns about violations of privacy and confidentiality children especially should not interpret for their parents or other family members

what is tricky about acronyms example how can you fix this

they can have different meanings depending on where and how they are used ie AAA can stand for the American Automobile Associated, the Area Agency on Aging, or an aortic abdominal aneurysm provide context to help readers determine which acronym you mean

how to confirm understanding

they can sometimes add to confusion, so you might need to explain it in another way

what do stories combine; what do they help to do

they combine emotions and facts and help people connect with health information in a very personal way

why are some providers reluctant to open the communication loop why are they wrong about this

they fear it will take too much time he has found the technique is both time-efficient and time-effective

what do people need to ask questions

they must be fluent in medical vocabulary, understand basic biology, and have enough confidence to speak up to respected health professionals

what do people need to remember information accurately

they need to recall both the "claim"- the core piece of information- and its "context"-the situation in which they heard it remembering the claim is the easy part

decide whether to put 2 languages in one document: layouts and challenges

this may mean to have one language at the top of a page and the other language on the bottom, or to have one language upside-down from the other these layouts can create challenges: 1. English is a tighter language than most (it takes up less space and the text may look crowded with 2 languages)

what types of acronyms and abbreviations should you use

those that benefit the other person, not just you make choices about acronyms based on what matters to the audience

how should you include meaningful examples and illustrations

translated documents usually include more than just works: make sure that the examples and illustrations you use are consistent with the culture, age, and interests of your readers i.e. using different foods for different cultures

develop and test materials with intended readers

translated materials must also be presented in ways readers can understand and relate to

what do blogs offer

tremendous potential for helping patients feel less alone and more in control of an illness or caregiving situation they provide in-depth information on a narrow topic

where may social media reach 2 new populations who are "jumping online"

underserved populations 1. non-college-eduated 18 to 30 year olds who are connecting via mobile phones rather than computers 2. older adults (60 and over) who are becoming more interested and comfortable with technology, especially computers

what should you use to gauge how confident the child, parent, or caregiver is in following through with an agreed-upon action example

using principles of motivations interviewing ie "on a scale of 1 to 10, how sure are you that you will eat yogurt instead of chips every time you have a snack?"-> if the answer is low, you should com up with a more realistic option that can result in success and build self-efficacy also use the teach-back technique to confirm that key messages are correctly understood

where do idioms get their meaning from

usually idioms have special meaning to people form a certain region or culture

acronyms and initialisms examples

usually take the first letters from each word in a phrase to create something new CAT for "computed/computerized axial tomography" or creating a new word like "ADL" which means "activities of daily living"

know why are you using numbers when should you use them

what message are you trying to convey and are numbers essential to making this point? if so, be mindful as your goal, such as using numbers to compare treatment options, encourage certain behaviors, or convey feelings of concern or relief

talking to the child about health: how does this help

when a child is an active participant in the exam, he or she is likely to be cooperative and to give honest information (parents should "chime" in when necessary)

what makes communication been more difficult

when patients and providers lack a common language

when can abbreviations, acronyms, and initialisms be efficient

when talking with peers or entering data into medical charts

bridge from humor to teaching

when teaching new concepts or treatment techniques, you might want to use humor in your introduction or as a way of keeping people interested and engaged

when does age-appropriate acquisition of health literacy skills begin what can school-age children start to do with guidance what about teenagers

when toddlers learn to name body parts and preschoolers start doing self-care tasks with supervision, such as applying sunscreen and brushing their teeth school-age children can begin to assume greater responsibility, such as reading nutrition labels or using an asthma inhaler teenagers then can participate even more independently as they transition form being pediatric to adult patients

when it is effective to use a sort of shorthand when is it not

with colleagues and coworkers not with patients and other outsiders, such specialized language may be unclear

"simple" words that aren't so simple when does this usually happen

words like "may," "might," and "suggest" are difficult to understand usually happens when describing risk

homonyms examples

words that sound alike and may or may not be spelled the same way, but have very different meanings- be sure to clarify with patients about the meanings Stool, gait, and dressing

how do you simplify your message

work with a professional translator or community team to make needed adaptions for linguistic and cultural differences (rather than insist on a literal work-for-word translation)