Patient and Health Literacy

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Health literacy plays a significant role in patient compliance, patient outcomes, patient satisfaction, and health care costs. Health literacy encompasses many factors from understanding and deciding on health care plans to calculating blood sugar levels and understanding nutrition labels. In addition, one must have some knowledge of the human body and disease process in order to make informed decisions. As medicine continues to progress, it is not hard to comprehend how health information can be overwhelming to an individual, even those who are proficient at understanding health literacy.

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The Patient Protection and Affordable Care Act of 2010, Title V, defines health literacy as the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions ('What is Health Literacy?', 2016). One small but vital area of health literacy is knowing how to read nutrition labels (label literacy). Understanding the information provided on food packages is key to helping the individual make wise choices when buying goods.

Knowing how to interpret the information on a food label also helps the individual determine if particular foods fit in to their diets. Label literacy gives an individual knowledge to make healthier food choices, maintain a healthier weight, consume more essential nutrients and less fats, and contribute to their overall health and well-being. Targeting adults and holding them accountable for understanding health literacy will hopefully create a trend for them to teach the younger generation. Being aware of the potential effects an unhealthy diet can have on the body is crucial.

Because child obesity rates have steadily increased over the years, it is important that adults learn about health literacy so they can teach and lead by example.

The brochure attached focuses on providing facts as to why reading and understanding nutrition labels is so important. In addition, it provides an example of a label that is numbered with corresponding explanations that are color coded and numbered to match the provided label. Providing accurate, easy-to-understand information is key when trying to reach a specific target audience. Because there is so much information made available now, the brochure was created with that in mind. One page of the brochure includes the importance of nutrition. The goal of this is to inform the audience on why they should be more conscious of their diet. Knowing the benefits of a healthier diet will hopefully spark the urge to make a change. Another page includes a list of diseases that can be managed or avoided with better nutrition. These specific diseases were chosen as examples because they are the most common among the American population. According to the CDC (Centers for Disease Control), heart disease is the leading cause of death for both men and women. Hypertension, hyperlipidemia and smoking are three key risk factors with “about half of Americans (47%) having at least one of these three” (Fryar, Chen, Li, 2012). Cancer, heart disease and diabetes are among the CDC’s top 12 causes of death in the United States, accounting for more than 75% of all deaths ('12 Leading Causes of Death in the United States'). Because there are numerous diseases that fit the criteria for inclusion, only the leading diseases that are a major problem in the United States are listed.

Creating an educational brochure has its challenges. Because there are endless amounts of topics, the biggest hurdle was picking one that is relevant to today’s society. When doing research, the same diseases kept appearing; all of them in some way could be affected by diet. This helped with making the final choice for the brochure. Once the topic selection was made, the next hurdle was including enough pertinent information in a limited amount of space to be beneficial. Researching other brochure examples and topic information made it easier to decide what information should be included and how to present it. Many brochures included small paragraphs, bullet points and illustrations. Bullet points are a great way to provide information; the information stands out, is easy to read and is less wordy. Pictures are also beneficial, providing examples without words. Working with a brochure template is not easy for a person that has never created one. The information has to be inserted so that when the final brochure is printed and folded, the information reads in the correct order. Because no instructions could be found that guided the insertion order of information, this was strictly a trial and error task. A mock brochure was made, each page of information numbered and then properly inserted so it would read appropriately.

Literature suggests that the general rule of thumb is to aim materials for a 6th-grade reading level or lower. Yet another challenge to creating the brochure was making sure that the reading material fit the criteria. A SMOG (Simple Measure of Gobbledygook) scale was used to calculate the reading level. “The SMOG is considered to be the most rigorous of the reading assessment tools because it focuses on the length of words and sentences rather than on words alone” (Rudd). To calculate the reading level using the SMOG, first identify 30 sentences in the text (10 from the beginning, 10 in the middle, and 10 at the end of the text); count the syllables in every word. Count the total number of words that have 3 syllables or more within the 30 sentences. Input this information into the SMOG formula to calculate the reading level. The formula can be found on many websites and will automatically calculate the reading level when the information is plugged in. Because the attached brochure only had 25 sentences total, every one was used. Initially, there were 83 words with three or more syllables, resulting in an 11th grade reading level score, according to the SMOG formula. After changing many words using synonyms, the reading score was calculated again. The readability consensus, based on 8 readability formulas, scored the text at a 5th grade level, reading level was easy to read, and reader’s age was 4th-5th graders (Text Readability Consensus Calculator). The SMOG index was 4.8.

The topic of understanding how to read nutrition labels was chosen because it is something that is simple to learn, it is easy to implement into a daily routine, and it can make an enormous impact in a person’s health status. It is often assumed that individuals have a certain level of knowledge to understand and utilize health information and services. Personal knowledge and skills, past experiences and other demographic, cultural, and environmental factors all influence the way a person perceives and/or chooses to use health information for their benefit. “Data from the 1992 National Adult Literacy Survey (NALS), 2003 National Assessment of Adult Literacy (NAAL), and the 2012 Program for the International Assessment of Adult Competencies (PIAAC) show that adult literacy skills change relatively little over time. According to the PIAAC, only 12% percent of adults showed the highest proficiency level on literacy tasks, and even less, 9%, showed proficient numeracy skills. These results are the same as a decade earlier when the NAAL demonstrated that only 12% of adults have proficient health literacy skills. This information indicates that there are broad-based, population-level challenges that demand comparably broad, population-level solutions” (CDC Health Literacy).

“Individuals that have limited health literacy are associated with lower health outcomes, increased rates of hospitalization, decreased use of preventative services, poor health management, and higher costs” (Quick Guide to Health Literacy Fact Sheet). It is the responsibility of health care professionals to ensure that individuals are informed and are provided with the essential information needed to make sound decisions about their health choices. Whether a person is being health conscious for preventative measures, trying to maintain a healthy weight, or managing an existing disease, health literacy can make a difference in health outcomes. Understanding the information on nutrition labels is a simple but important factor to this. There are federal laws in place to govern what information is included on each food label, which makes it a trustworthy and valuable resource for healthy eating. Individuals should be provided knowledge regarding their diets and should realize that consuming a healthy diet that contains less processed foods and more nutrient-rich foods are rich can increase life expectancy.