Health Literacy in British Columbia

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Health Literacy in British Columbia

• Dr. James Frankish, Senior Scholar
• Director, Institute of Health Promotion Research
• Associate Professor, Health Care Epidemiology
• College for Interdisciplinary Studies
• "You teach a child to read, and he or her will be
  able to pass a literacy test. George W. Bush,
  Feb. 21, 2001

IHPR Institute of Health Promotion Research
Partners in Community Heath Research-Training
Program
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Current Projects

• Research Training Program in Community
  Partnership Research
• Homelessness Poverty-Related Research
• Health Literacy, Literacy Health Research
• Health-System Reform Marginalized Groups
• Measuring the Health of Communities

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Why Measure Health Literacy?

• Helps us know if it is a problem
• Helps us know where the problem is located
• Helps us know what to do about it
• Existing measures are inadequate

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From Idea(s) to Measures

• The idea of health literacy
• Our idea of health literacy
• The ingredients of health literacy
• Measuring how much of the ingredients of
  health literacy are present
• Deciding how to define success in measuring
  health literacy

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Objectives of Research

• To develop a measure of health literacy
  appropriate to the Canadian context
• To test the application of this measure with
  specific population groups
• To further develop a conceptual framework for
  better understanding health literacy and its role
  in Canadian society
• To develop the foundation for a descriptive and
  predictive model of the role of health literacy
  in relation to use of health services,
  determinants of health and quality of life

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Construct/Convergent Validity

• What is a Construct?Abstract, hypothetical
  variables (our whole field) Mental states that
  cant be directly observed
• Operational DefinitionsIt must be representative
  of your construct of interest.Defined
  influenced by how you measure
• Construct Validity Defined - the conceptual basis
  (construct) underlying the effectthe degree to
  which the study measures and manipulates the
  construct

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Operational Definition of Health Literacy
The ability to access, understand, appraise, and
communicate information to engage with the
demands of health contexts to promote health
across the life-course.
(Health Literacy Research Team, Nov. 30, 2004)
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Data Analysis Some Questions

• What health information are seniors looking for?
• Where do seniors go to get health information?
• What are some difficulties seniors experience in
  trying to find and understand health information?

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Seniors Health Literacy

• Seniors in our sample tended to be fairly
  educated and exposed to Canadian culture, and
  perceived their health to be fairly good
• Respondents rated themselves to be fairly health
  literate on the self-perceived measures of health
  literacy
• Types of information sought by the respondents
  varied broadly
• Multiple sources of information were often used
  to find information on a specific topic, most
  commonly from GPs, specialists, books
  (non-library) and the Internet
• Self-perceived measures of health literacy were
  reported to be influenced by a broad range of
  variables (context)

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Seniors Health Literacy

• Respondents did fairly well on most of the
  task-oriented measures of health literacy (REALM,
  reading passages)
• Measures of self-perceived health literacy had
  good internal consistency (Cronbach's
  alpha0.852), and therefore a sum scale of these
  measures was created
• Self-perceived measures correlated with each
  other the task-oriented measures with each
  other, but there was little relation between
  self-perceived task-oriented measures
• Self-perceived measures of health literacy, REALM
  score, self-rated health, and demographic
  characteristics did not predict task-oriented
  measures of health literacy

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At-Risk Youth Health Literacy

• Youth saw health as inclusive of physical
  mental health. Youth identified smoking, drugs,
  alcohol, sexual health, mental health, nutrition,
  fitness and injuries.
• They were aware of harm of smoking but said
  negative comments by teachers and peers deterred
  quitting.
• Youth saw mental health as central. Friendships
  were seen as contributors to health. Theys
  described a lack of information for youth about
  mental health.

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At-Risk Youth Health Literacy

• Access to information depended on hours of
  service, transportation, availability of
  services, and the quality of the relationship
  between the youth and care providers.
• Youth were more likely to confide in doctors
  nurses trust information if they perceived that
  the professionals took the time understand their
  health issues.
• The majority said they trust and utilize family
  doctors for their health concerns, with the
  exception of sexual health.

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At-Risk Youth Health Literacy

• They endorsed youth health clinics, because of
  caring, knowledgeable staff, but were critical of
  restrictive hours.
• Youth looked at written materials in schools,
  youth centres and doctors offices when there was
  a sense of urgency about an issue or when
  directed by a trusted source.

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Contact Information

• Jim Frankish
• Institute of Health Promotion Research
• frankish_at_interchange.ubc.ca
• jimfrankish.com
• www.pchr.net