HEALTH LITERACY FOR PARENTS OF YOUNG CHILDREN

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HEALTH LITERACY FOR PARENTS OF YOUNG CHILDREN

• Kansas Early Childhood Comprehensive Systems
• Planning Meeting
• August 9, 2007
• Robin Gingerich
• Project Coordinator

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• This project was sponsored by the
• Kansas Head Start Association
• with funding provided by
• United Methodist
• Health Ministries Fund
• and
• Kansas Health Policy Authority
• (Medicaid match)

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• PAST
• SUCCESS!

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Head Start YEAR 1
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Head Start Year 2
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HEAD START YEAR 2
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PROJECT GOAL

• To empower parents to care for their childrens
  minor illnesses and injuries, reducing
  unnecessary utilization and decreasing costs of
  emergency room, doctor and clinic visits.

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PROJECT ACTIVITIES

• Develop a training curriculum
• Provide training for parents
• Pilot the project in 5 health settings
• Plan to replicate project statewide

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ACTIVITY 1

• DEVELOP
• A
• TRAINING CURRICULUM
• for
• PRACTITIONERS

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A PRACTITIONERS TRAINING GUIDE for What To Do
When Your Child Gets Sick
By Robin Gingerich and Kathryn Schartz Edits
by Noelle Kurth and Melinda McKnight
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Contents

• Section1 Background Information for
  Practitioners
• A. Health Literacy
• B. Effective Instruction
• C. Cultural Considerations
• Section 2 Using the Book to Teach

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• Section I
• BACKGROUND
• INFORMATION
• FOR PRACTITIONERS

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A. Health Literacy
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Why not just hand out the book?

• Health literacy is an issue in all communities
• Health literacy involves more than just being
  able to read

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Health LiteracyWorking Definition

• The degree to which individuals have the
  capacity to obtain, process, and understand basic
  health information and services needed to make
  appropriate health decisions. Source
  Healthy People 2010,
• Institute of Medicine 2004

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Health LiteracyPredictive Value

• Literacy skills are a stronger predictor of
  health status than
• Age
• Income
• Employment status
• Education level
• Racial/ethnic group
• Source American Medical
  Association, 2003

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Impact ofLow Health Literacy
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Impact ofLow Health Literacy

• Difficulty navigating health care system
• Not understanding signed documents
• Inability to complete required forms
• Use of more expensive health services

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Impact ofLow Health Literacy

• Inability to read directions for prescriptions
• Misuse of medications
• Misunderstanding of self-care instructions
• Practice of less preventive health care

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Impact ofLow Health Literacy

• Annual health care costs for people with low
  health literacy are 4 times higher than those
  with higher health literacy skills
• (Source Weis, B.D., Ed. (1999). 20 Common
  Problems in Primary Care. New York McGraw Hill.)

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How Widespread isLow Health Literacy?
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How Widespread isLow Health Literacy?

• Nearly half of the adults in the U.S. cannot
  fully benefit from much that the health care
  system has to offer because they have difficulty
  reading and processing everyday health
  information.
• Source Institute of Medicine 2004

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How Widespread isLow Health Literacy?

• 36 of surveyed adults had only basic or below
  basic health literacy
• 65 of adults 16-24 years of age had only basic
  or below basic health literacy
• Source National Assessment of Adult Literacy,
  2003

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How Widespread isLow Health Literacy?

• A Kansas Head Start evaluation found that only 3
  of Head Start families had any type of health
  book in their home
• Source Kansas Head Start Association Health Care
  Institute, Final Report, July 2006

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What are Health Literacy Skills?

• Reading
• Writing
• Math
• Speaking
• Listening
• Understanding
• Adequate background information
• Ability to act appropriately to information
• Ability to advocate for ones health
• Source Institute of Medicine of the National
  Academies

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How Do Adults Obtain Health Information?

• The lower the health literacy level the less
  likely health information was received from
  health care professionals
• More adults with low health literacy use the
  radio and television for health information
• Source National Assessment of Adult Literacy,
  2003

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Identifying Low Literacy Parents

• The majority of low literacy individuals say they
  read well
• Low level readers often develop strategies to
  hide or compensate for lack of reading ability
• Literacy levels are approximately 3 to 5 grades
  below the highest grade completed
• Source Lee P.P. (1999). Why literacy
  matters links between reading ability and
  health. Arch Ophthalmology.

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Tips for Working with Low Literacy Parents

• Make sure they understand that you know they
• know their child the best
• are intelligent
• know some things about health issues

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B. Effective Instruction
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Effective Instruction with Parents
See yourself in partnership with parents Do not
make assumptions about what a parent does does
not know Learn what the parent knows by asking
open-ended questions, Tell me what you usually
do Slow down use living room language
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Effective Instruction with Parents

• Be clear about your goals, objectives
  expectations
• Break information skills into small, manageable
  parts
• Teach parts systematically in sequence
• Explain model concepts skills first before
  engaging parent in activity

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Effective Instruction with Parents

• The GOAL is for the parent to know how to use the
  book
• to find information about their childrens health
  and safety

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Importance of Vocabulary

• Understanding the vocabulary is essential to
  understanding the content.

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Importance of Comprehension

• The ultimate goal of reading is to understand
  make use of what has been read
• The ability to read words does not necessarily
  indicate understanding of what has been read
• Reading comprehension is the most important
  health literacy skill

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C. Cultural Considerations
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Cultural Considerations

• Practitioners must be culturally responsive
• Cultural responsiveness does not happen all at
  once, nor does learning about different cultures
  ever end
• Cultures change over time

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Section 1 Review

• A. Health Literacy
• An issue in ALL communities with over 1/2 of
  adults having difficulty with health information
• Encompasses a variety of skills, not the least of
  which is reading
• B. Effective Instruction
• Acknowledge what families know
• Be clear and systematic
• C. Cultural Considerations
• It is your professional responsibility to learn
  as much as you can about your families cultures.

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Section 2 Using the Book to Teach

• Review project goals
• Introduction to books format
• Planning for YOUR families

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• Introduction to the Books Format

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Planning for YOUR Families
Now that you know the books format, it time for
you to decide how you are going to use it with
your families.
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So Think About

• How might this fit into what we already do?
• Do we need to offer something new or can we
  incorporate the teaching of the book into a
  current service?
• How much time do we have to devote to effectively
  teaching this book?
• Is it best to teach it all at once or at
  different sessions?
• Should we try a group meeting, teach it
  one-on-one or use a combination?
• Do we have the qualified staff? And time to train
  them?
• What are the the needed resources and can we
  obtain them?

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What Others Have Done

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ACTIVITY 2

• TEACH PARENTS HOW TO USE THE BOOK

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HOW TO USE

• WHAT TO DO WHEN YOUR
• CHILD GETS SICK

By Kathryn Schartz and Robin Gingerich Edits
by Noelle Kurth and Melinda McKnight
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HEALTH CARE LITERACY

• Learn how to use this book and others
• Learn where to find good information
• Know whom to ask
• Learn what the words mean or where to look them up

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PARTICIPATE IN HEALTH CARE

• YOU are part of the team that includes your
  childs doctors and nurses
• YOU are the expert because you know your child
  best!

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BE SMART

• Know what works and what doesnt
• Dont believe everything you hear

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WHAT IS BAD INFORMATION?

• Be careful of information from
• Someone who wants you to buy something
• TV, radio, magazines, or the internet
• Friends, neighbors

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LETS SEE WHATS IN THE BOOK
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PUTTING YOUR INFORMATION IN THE BOOK

• Put important phone numbers in the front cover of
  the book
• Write down specific details about your child

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TO THE READERS OF THE BOOK

• On page iii
• A reminder of how this book can be helpful to
  you.

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WHEN TO CALL THE DOCTOR OR CLINIC

• Look at this very important section at the front
  of the book
• This is a short list of things that are
  emergencies
• If you see these things, call the doctor or
  clinic right away
• Sometimes you should call 911

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HOW TO FIND THINGS IN THE BOOK

• On pages vi and vii
• A Table of Contents that shows parts of a babys
  and childs body.
• You can locate the body part where there is a
  problem and go to that page in the book

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HOW TO FIND THINGS IN THE BOOK

• Three pages starting on viii
• This is a more traditional Table of Contents that
  shows each chapter of the book

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LETS LOOK AT A CHAPTER

• Each chapter of the book is put together in the
  same way
• Each chapter starts with a Notes page

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GENERAL FORMAT FOR EACH TOPIC

• What is it?
• What do I see?
• What can I do at home?
• When do I call the doctor or nurse?

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WHAT IS IT?

• How does it happen?
• When does it happen?
• What does it mean?

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WHAT DO I SEE?

• What are the symptoms?
• How do I know that my child has this?
• What does my child look like when this happens?
• What will my child act like when this happens?

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WHAT CAN I DO AT HOME?

• Things I can do
• Things I need to keep track of
• What do I need to have?

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WHEN DO I CALL THE DOCTOR OR NURSE?

• What does the doctor need to know?
• When should I call?
• Who do I call?
• What is an emergency?

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THE BOOK CAN HELP TOO

• On page 169-174 is a Word List you can use to
  look up vocabulary you might not understand

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HANDS-ON PRACTICE

• Your child is coughing
• Where do you find out about coughs?
• What is a cough?
• What do you do?
• When do you worry?
• Where else in the book does it talk about coughs?

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WHAT TO DO WHEN YOUR CHILD GETS SICK
Using Chapter 2 Taking Care of Your Sick Child
By Kathryn Schartz Edits by Robin Gingerich,
Noelle Kurth and Melinda McKnight
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Chapter 2Taking Care of Your Sick Child

• Vocabulary
• What is it?
• What do I see
• What can I do at home?
• When do I call the doctor or nurse?
• What else should I know?

• How to tell if your child has a fever
• Fever
• Infection
• Over the Counter Medicines

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ACTIVITY 3
Pilot materials in 5 health care settings
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Project Sites

• Healthy Options for Kansas Communities, Wichita
• Salina Saline County Health Department, Salina
• Shawnee County Health Agency, Topeka

• Silver City Health Center, Kansas City, Kansas
• United Methodist Mexican American Ministries,
  Garden City

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Activity 4

• Plan to replicate project
• state wide!