Skilled for Health The Story So Far

1
Skilled for HealthThe Story So Far

• Jonathan Berry
• Executive Director, Health Improvement
• ContinYou

2
A new definition of health literacy

• Health Literacy is the ability to make sound
  health decisions in the context of every day
  life
• at home
• in the community
• at the workplace
• the health care system
• the market place
• the political arena.
• It is a critical empowerment strategy to increase
  peoples control over their health, their ability
  to seek out information and their ability to take
  responsibility
• Ilona Kickbusch 20 Oct 2005 UK Presidency
  Conference on Health Inequalities

3
What do we know about Health Literacy?

• different social groups vary in the degree of
  uptake and action resulting from health education
  and information campaigns, and differences in
  health literacy contribute to variations in
  behaviour and health inequalities
• people with low literacy levels have less
  knowledge of their medical conditions and
  self-care instructions than their more literate
  counterparts
• low health literacy can have an impact on
  peoples ability to navigate the healthcare
  system, talk to healthcare providers effectively
  and get the most out of healthcare services.

4
Evidence from health literacy research (USA)

• A study of functional health literacy in America,
  found
• 42 of patients could not understand directions
  for taking medication on an empty stomach
• 26 were unable to understand information on an
  appointment slip
• 43 did not understand the rights and
  responsibilities section of a Medicaid
  application and
• 60 did not understand a standard informed
  consent form.
• A 2-year follow-up study found patients with
  inadequate literacy were nearly twice as likely
  to have been hospitalized during the previous
  year (31.5 vs 14.9)
• Ref Baker, D W et al (1998)
• Health literacy and the risk of hospital
  admission
• Journal of General Internal Medicine, 13, 791-798

5
Recent UK research 1

• Women with poor numeracy tend to
• Be out of the labour market in full-time home
  caring roles
• Live in non working households
• Not vote or have any political interest
• Have poor physical health be depressed and
• Feel they lack control over their own lives
• National Research and Development Centre for
  adult literacy and
• numeracyThree years on what the research is
  saying 2005

6
Recent Research 2 Are those who flourished at
school healthier adults?

• When comparing those who were disengaged at
  school and had no O level equivalents with those
  who did the odds, of
• smoking at 33 are 4.7 times higher for women and
  3.5 times for men
• drinking heavily at age 33 are 1.5 times higher
• taking exercise less than once a week are 1.5
  times higher
• having depression are 2.4 times higher for women
  and 2.0 times higher for men
• having back pain are 1.3 times higher in men and
• of having migraines 1.3 times higher for women
• Centre for Research on the Wider Benefits of
  Learning Feb 2006

7
Skilled for Health

• What is Skilled for Health?

8
Skilled for Health

• Launched January 2003 by public health and adult
  learning ministers
• Links the Skills for Life Strategy (Dept for
  Education and Skills) with Choosing Health and
  Health Inequalities priorities (Department of
  Health) National Voluntary Sector Partner
  (ContinYou)
• Embeds language, literacy and numeracy (LLN) in
  health learning
• The projects initial aims were to improve
  health literacy and basic skills among specific
  groups with common health issues, and to build
  awareness among NHS staff of the links between
  poor basic skills and health outcomes.

9
Locations of first 8 projects

• Yorkshire Humberside
• Older people in Care

• East of England
• Young parents
• Parents with
• young children
• Older people

• West Midlands
• Mental Health

• East Midlands
• Older people
• Black and Minority
• Ethnic groups

• London
• Diabetes among
• Bangladeshis

10
First Tranche - 8 Skilled for Health projects

• Harlow- young parents attending an All Day
  Breakfast Club
• Thurrock- community mothers trained as basic
  skills tutors
• Norfolk Age Concern- older people with arthritis
  in rural communities
• Calderdale Age Concern- older people in care
  settings
• Camden Primary Care Trust- older Bengali-speaking
  people with diabetes
• Leicester Primary Care Trust- Somali refugees
  access to primary care
• Derbyshire Sport Active- keeping well and fit for
  the over 50s
• Shropshire- supported living for people with
  mental health problems

11
Lessons from the first phase

• Learners with medical conditions can have
  difficulty attending regular learning
• Not all learners want equally to improve their
  skills and learn about health issues about
  assessment
• Some health materials are pitched too low not
  challenging enough
• Local LSC priorities are not always helpful for
  some groups over 50s
• Attaining level 1 and level 2 qualifications is
  not always easy

12
Outcomes

• Some learners in all projects reported changes in
  behaviour including
• improved diet
• improved understanding of dietary information
• improved parenting skills
• increased levels of exercise
• weight loss
• changes in how learners used NHS services
• learners requesting medication reviews.

13
Adult Learning

• In one project
• 7 of 9 learners improved reading skills by at
  least one level (at entry level)
• 5 of 6 learners progressed writing skills by at
  least one level (at entry level)
• 1 of 2 learners improved numeracy skills by at
  least one level (at entry level)
• On another project
• 31 of 45 learners achieved 80 or more of their
  individual learning plan.

14
Skilled for Health Key Strategic Lessons

• Lead-in Time Crucial
• NHS/LLN Strategic Commitment Champions
• Shared Understanding- Skills for Life
  Approaches- NHS Inequalities Agenda- Planning
  and Funding
• Outcomes- Health Gains- Skills Improvement

15
Initial Products from the Demonstration Sites

• A training pack for health and social care staff
• Guidance/resource pack for other LLN tutors
• The Virtual Doctor
• Resources for use in mental health programmes
• Health workers were trained and worked with ESOL
  tutors to deliver messages about self-care to
  older people with diabetes
• A file of learning resources on Family Health

16
Skilled for HealthCore National Materials

• Developed from preliminary materials
• Topics covered- making decisions about healthy
  eating- giving up smoking- understanding
  appointment systems- what to do in emergencies

17
Skilled for HealthMaking the Case

• Making the Case Document
• Strategic Power Point
• Operational Power Point
• DVD

18
Skilled for HealthWhere next?

• Greater Numbers of Learners
• Higher Confidence Levels
• In-depth Evaluation

19
Skilled for Health Phase 2

• National Sector Sites
• Local Authority Workforce
• Army
• Prison Service
• Commercial Business
• NHS Workforce

20
Skilled for Health Phase 2

• Early Adopter Sites to be identified
• Based on Government office area
• Implement Phase 1 lessons
• Support from Steering Group

21
Skilled for Health Phase 2

• Purpose
• Provide more impact evidence- health outcomes-
  LLN outcomes
• Develop local delivery models and strategies

22
Skilled for Health Further Information

• Please Contact
• Jonathan Berry
• Email jonathan.berry_at_continyou.org.ukTelephone
  024 76 58 8461