Health Literacy, Health Communication Barriers, and Helping Employees Understand Their Options

Transcription

1 Health Literacy, Health Communication Barriers, and Helping Employees Understand Their Options Beccah Rothschild, MPA Senior Outreach Leader, Consumer Reports

2 Today s Agenda 1. Introducing Consumer Reports 2. Two problems in our healthcare system: Health literacy and overuse/waste 3. Employee engagement 4. Questions 5. Lunch!

3 Introducing Consumer Reports:

4 Meet the Consumer Reports Team

5

6 Consumer Reports and Health Early days: 1936: Alka-Seltzer 1938: Dangers of smoking 1939: Universal healthcare 1971: Home exercise machines And more Today: Best Buy Drugs Cancer Screening Tests Choosing Wisely Hospital Safety Surprise Medical Bills Sunscreens Insect repellants (Zika advice) Bike helmets Blood Glucose Meters Blood Pressure monitors And more.

7 Two problems in our current healthcare system are: 1.Low Health Literacy Skills 2.Overuse and Waste

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9 Definitions General Literacy: Using printed and written information to function in society, to achieve one s goals, and to develop one s knowledge and potential. -National Assessment of Adult Literacy, 2003 Health Literacy: The degree to which individuals have the capacity to obtain, process, understand, and act on basic health information and services needed to make appropriate health decisions. -Healthy People

10 U.S. Reading Levels The average American adult reads between the 7th - 9th grade level; Most adults read 3 grade levels below the highest grade they completed; and Most health information is written above the 10th grade level. Over 90 million adults in the U.S. have trouble understanding and acting on health information. 10

11 What Is It Like? I bought cough medicine at the drugstore and couldn t read the label on it. I overdosed and fainted. I didn t know it would make me sick. I thought it was safe. -California adult literacy student I just have to trust the doctor; I put a huge amount of trust in the medical staff. I just sign forms without really understanding them. -California adult literacy student 11

12 How Well Do People Understand How to Take Their Medicine?

13 How Well Do People Understand Health Insurance Paperwork?

14 How Well Do People Understand Diabetes Meal Plan Instructions?

15 15 How Well Do Parents Understand Pediatric Dosing Instructions?

16 How Well Do New Yorkers Understand Parking Instructions?

17 How Well Do Bathroom Users Understand Flushing Instructions?

18 How Well Do Ice Cream Eaters Understand How Much Fat Is In 1 Cup?

19 Problem #2: Overuse and Waste Approximately 30% of healthcare costs (more than $750 billion annually) are spent on wasted care. -American College of Physicians What are the causes?

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21 Patients are requesting tests, treatments, & procedures that they don t need

22 Providers are performing services that are unnecessary and may be harmful In today s health marketplace, being a compliant patient isn t good enough any more

23 Cultural norms and misleading advertising can lead to inappropriate care TV Doctors

24 What are the common communication challenges and barriers, in addition to limited health literacy skills?

25 5 Communication Barriers The message is: 1. Too general 2. Unfamiliar 3. Contradictory 4. Unclear 5. Passive Resources Review of cognitive psychology research report on healthcare communication from U.S. Institute of Medicine. CR surveys and focus group studies. 80 years of health reporting

26 Lack of perceived relevance The message is: 1. Too general 2. Unfamiliar 3. Contradictory 4. Unclear 5. Passive

27 It s not my problem! The overuse of preventive screening May harm thousands of patients NATIONWIDE. May harm YOU and YOUR FAMILY. Wastes billions of healthcare $ NATIONWIDE. Means the NATION S healthcare system is not delivering the right care. May waste $ YOU spend on healthcare. Means that YOU and YOUR FAMILY are not getting the right healthcare. Heath Ratings Center Impact Benefit Screening Tests, Consumer Reports National Research Center, Feb. 17, 2012.

28 People prefer the status quo The message is: 1. Too general 2. Unfamiliar 3. Contradictory 4. Unclear 5. Passive Survey of more than 8,000 CR subscribers, ages 40-60, with no history of heart disease: Half had already had an EKG. Two-thirds said that they would have a complete battery of tests if it was free. Nearly all agreed it was better to have a scare that turned out to be nothing than to not get tested.

29 Watch your language! Positive framing Advantage, appropriate, benefit, careful, prevent, protect Negative framing Adverse effects, lack of benefit, loss, risk More effective for reinforcing a health action i.e. getting a flu shot More effective for convincing people NOT to act i.e. avoiding taking antibiotics long term for back pain. Sprenger, A., Kane, J., Schuler-Adair, E. Health actions not to do: lessons for consumer decision-making, prepared by Consumer Reports Health Ratings Center for AHRQ, Feb

30 Misinformation The message is: 1. Too general 2. Unfamiliar 3. Contradictory 4. Unclear 5. Passive

31 Misinformation

32 Tell the Whole Story Before reading <16% interested in topics After reading Half interested in receiving more info Two-thirds said they would talk to their doctor about the topic 43% changed their mind about a topic Choosing Wisely pamphlet evaluation, Consumer Insight, Consumer Reports, Jan

33 Information is Complex The message is: 1. Too general 2. Unfamiliar 3. Contradictory 4. Unclear 5. Passive

34 Use Simple Terms and Resources

35 Use Social Media and Videos Choosing Wisely Wednesday Choosing Wisely Video

36 No Substitute Actions The message is: 1. Too general 2. Unfamiliar 3. Contradictory 4. Unclear 5. Passive

37 Give Clear Advice

38 Employee Engagement: A case study on the appropriate use of healthcare

39 From , we tried Too long Too boring Too much All about CW

40 Attitudinal Statements Toward Appropriate Care (2014) These four statements registered high agreement among more than 2/3 of respondents (n=3,000), with women agreeing more than men. Improved communication between you and your doctors leads to better clinical outcomes. (72%) When you actively participate in your healthcare, you make better healthcare decisions and get better healthcare. (71%) You should have full access to the notes your healthcare providers take during your medical visits. (71%) By talking with your doctor, asking questions and discussing your options, you will get better healthcare. (71%) The common themes are communication, participation, and access to information.

41 From , we tried again: Short & Clear Engaging Categorized CW - PSA

42 And We Landed Here Making Healthy Choices

43 Making Healthy Choices: The issue and the solution The Issue: Patients are faced with many healthcare choices. Employers are interested in helping their employees make smart healthcare decisions. Note: IBM initiated the project The Solution: Consumer Reports created Making Healthy Choices, a toolset including a video series, mobile app, and website utilizing Choosing Wisely materials a med at helping employees understand how to make the right healthcare choices and what questions to ask. ConsumerHealthChoices.org/Healthy

44 Preliminary Integration Methods IBM: Hosted on health intranet site and employee wellness tools; offered incentives including CR subscriptions Case Western Reserve: Included in university-wide newsletter and wellness intranet site; distributed posters and wallet cards at campus wide summer-event; offered $100 Visa gift cards via lottery system Bath Iron Works: Included in employee newsletter and announcements to employees at staff meetings; offered ipad Air 2 via lottery system

45 That it is ok to ask your doctor the reason for specific treatments. I think the patient can feel at a disadvantage in these situations and it's good to have the background to ask "why" questions. Making Healthy Choices: Lessons Learned from Employees That some tests or procedures could actually have a negative impact on the patient. Antibiotics should not be used for viral infections. Sometimes the best treatment is no treatment. To not rely on one source of information. I'll review those questions before going to my doctor appointment next time. We (generationally) over-depend on the ever expanding technology and decrease the use of common sense. These MHC series are making us more aware of common sense practices that need to be revitalized.

46 Employee Feedback After using the Making Healthy Choices tools: 92% reported that they would ask their doctor questions before agreeing to a test, treatment, or procedure. 55% will request fewer medical tests/medicines. 73% will return to Making Healthy Choices in the future to seek out specific information of interest. 93% will recommend it to family/friends.

47 Offer an incentive Making Healthy Choices: Lessons Learned from Employers Make the content easily accessible Be clear that: Participation / use is optional Making Healthy Choices is a free tool offered by a trusted nonprofit organization Making Healthy Choices is not affiliated with your health insurance plan

48 Lessons Learned From Consumer Reports About Employee Engagement Employees don t necessarily trust the messenger They might not trust you Some people will never be engaged Practice what you preach It s about the conversation Measurement is hard Clinical, economic, behavioral Behavior change interventions Cultural relevance Be cognizant of communication barriers & health literacy Be patient with culture change Experiment

49 The problem with communication is the assumption that it has occurred. -GB Shaw

50 Questions? Choosing Wisely: ConsumerHealthChoices.org/Choosing Getting Started with Making Healthy Choices: ConsumerHealthChoices.org/Starting Implementation Guide: ConsumerHealthChoices.org/Implementation Vimeo: Beccah Rothschild,