The Missouri Experience

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2 The Missouri Experience Arthur J. Culbert PhD President & CEO Health Literacy Missouri November 30, 2010

3 Retirement

4 HLM history Missouri Foundation for Health (MFH) discovered health literacy components in previous requests for funding ( ) Awarded $2.1 million in 2007 as part of 5 years funding Health Literacy Missouri (HLM) opens in 2009

5 HLM mission and vision Improve the health of all Missourians Become a national leader in health literacy

6 HLM video

7 Missouri health indicators 12 th worst in obesity (29.3% adults) (BRFSS, ) 21 st worst in diabetes (8.4% adults) (BRFSS, ) 13 th worst in hypertension (29.1% adults) (BRFSS, ) 5 th worst in smoking (25% adults) (BRFSS, ) Lowest cigarette tax in the nation at 17 (National Conference of State Legislatures, 2010) Missouri ranks LAST in the U.S. in state funding for public health (CDC, FY 2009)

8 Missouri population 84% counties under 50K population 53% counties under 20K population 66% (approx 4 million) live in STL and KC Metro areas

9 Missouri broadband Home Broadband Availability

10 Health Care System

11 Health Literacy Care System

12 Collaborator and Connector

13 Philosophy DOES NOT BLAME VICTIM, but rather: Creates systematic change in provider patient encounters Offers educational resources that help providers communicate effectively with patients Provides access to plain language health care information

14 HLM partners HLM Partners HLM s New Home

15 Group genius

16 First steps Cost of low health literacy in MO Low Health Literacy in MO ACP Living with Diabetes Guide

17 National Action Plan to Improve Health Literacy Goal #1: Develop and disseminate health and safety information that is accurate, accessible, and actionable.

18 Our roadmap Speakers Bureau Local Media Communications Readability Services Field-testing of Translated Materials Community Engagement Education Building Capacity for Statewide Initiatives Library Program/Clinical Evaluation Training

19 Community engagement Pharmacies Libraries Churches Brown Bag

20 What we do Engage communities around health literacy

21 What we do Support and initiate grassroots activities

22 What we do Provide resources to improve patient provider communication Straight Talk with your Doc Practice Improvement Module Standardized Patient Encounter

23 What we do Rewrite materials in plain language for insurance companies Phone calls to United Healthcare 30% of calls were to clarify information contained in written communications. A 1% reduction of these calls would save the company approximately $24 million. -United Healthcare, 2009

24 What we do Assess hospital layout, signage, and patient navigation Rima E. Rudd, of Harvard University and a Health Literacy Missouri senior advisor, trains staff at Barnes-Jewish Hospital about how to make a healthcare facility literacy-friendly The HLM training was a huge benefit to us and amazingly helpful -Brenda Battle, director of Cultural Competence at Barnes-Jewish Hospital

25 What we do Educate the business community on costs of limited health literacy

26 What we do Gather Missouri stakeholders

27 What we do Effect policy change and inform stakeholders

28 What we do Create a nationwide network of state health literacy centers

29 What we do Educate on health literacy at the state and national level Missouri State Capital Missouri Governor Jay Nixon United States Capital

30 HLM Website

31

32

33 Strategic communications Targeted Health Stories Social Media Vimeo YouTube Delicious List serve Plain Talk Blog

34 Communications: Targeted health stories Health Literacy in the News * January October 2010

35 Communications: Targeted health stories Intervention to date (Oct. 28, 2009 present) 26 news releases disseminated 280 stories picked up 98 different newspapers in 70 counties Avg. circulation size 3,600+ Stories have reached more than 1 million readers 85% of hits were in rural areas (county population <50K)

36 Communications: Facebook 311 friends since created in February active users in October % of friends located outside St. Louis, international reach Variety of age groups:

37 Communications: Twitter Town Hall Statistics: 553 tweets during the 1.5-hour period 92 people joined the conversation 833 followers Top participant under the #healthlit hashtag Mentioned on several blogs and websites TweetLevel rating (by Edelman): 52.2, up from 19 this summer (Rating system looks at number of followers, updates, retweets, users following, engagement, etc.)

38 Lessons learned Health literacy cuts across party lines Growing field A lot going on at a grass roots level Form coalitions Find your focus nurture your niche Do not go at it alone Develop working relationship with your state Take advantage of what has been developed

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