Health Literacy: Techniques

On this page you will find tips for utilizing health literacy techniques, including:

• Universal precautions
• Teach back
• Open ended questions
• Risk communication
• Limiting information
• Plain language
• Plain language resources

Experts recommend you should assume that everyone may have difficulty understanding health information and recommend creating an environment where all patients can thrive. Universal precautions should be taken to address health literacy because providers can't always know which patients are challenged by health care information or tasks at any given time. By adopting a universal precautions approach, health care providers communicate with all patients in clear and actionable ways.

Health literacy universal precautions are aimed at:

• Making the health care system easier to navigate
• Simplifying communication with and confirming comprehension for all patients, so that the risk of miscommunication is minimized
• Standardized Standardizing the approach to communicating clearly about vaccines with every patient and family.

Use teach back for medical encounters to ensure understanding and improve safety. Correct any misunderstandings and be ready to try teach-back again. Give positive and encouraging feedback. Ask open ended questions.

Teach back examples:

• “I want to make sure that I did a good job explaining this ...
• “Please tell me in your own words why it’s important for you to…”
• “What questions do you have about this?”

1. Start with “how” or “what” questions
2. Address all patient concerns about the encounter
3. Adopt a “patient-centered” approach

Open ended question examples:

• Assure patients and families that there are no “bad or stupid” questions.
• “I have given you a lot of information today, what would you like to review again?” “Tell me what comfort measures you can use at home with your child after getting this vaccine? “
• “What questions do you have for me?
• Normalize questions “Most people ask a lot of questions when ___”

• Marry words and numbers Emphasize numbers rather than words such as “rare,” “low risk,” or “common.” Best practice is to use both words and numbers
• Do the math Perform calculations for your patients. Tell them what their risk is for getting a vaccine preventable illness over 10 years rather than have them calculate it
• Limit numbers Focus on just a few concepts and highlight key information
• Use everyday words Say, “about half” instead of “49 percent” and round to whole numbers
• Consider cultural differences Would they prefer U.S. Standard or Metric system
• Stay consistent Keep denominators and time frames the same when you compare numbers
• Elaborate by providing estimated numbers. Avoid explaining risks in purely descriptive terms such as “low risk”

Health Literacy Written Materials Principles

When creating, using, or assessing handouts:

• Use color to create contrast of risks or numbers Use action colors (example: Red, yellow, green)
• Be visual- Combine numbers, words, and visuals to explain risk People better understand probabilities when presented with words and visuals
• Choose data display type wisely Remember the why, use the display type that emphasizes the important point:

• Icon arrays = ratios or risk
• Pie graphs = ratios
• Bar graphs = compare numbers
• Line graph = change over time

Limiting information can be done through Chunk and Check and Ask Me 3®. Chunk and Check is the practice of grouping related information together and then assessing comprehension. Ask Me 3® is trademarked didactic concept consisting of three questions aimed at summarizing important health-related information.

• What is my main problem?
• What do I need to do?
• Why is it important for me to do this?

MedSpeak

This list of medical words decoded into plain language was developed by the Medical Library Association to help patients understand their healthcare provider. Healthcare professionals can use it to help translate medical terminology into simple language in order to improve patient communication.

Plain language principles include:

Using simple, easy-to-understand words and numbers

• Include “you” and other pronouns
• Define medical and insurance terminology

Keeping it short by sticking to 1-3 ideas

• Remove words you don’t need
• Use short sentences
• Have singular, clear statements about each concept

Identify who is doing what and use an active voice

• Keep the subject up front by saying the most important points first
• Write and speak in a friendly tone

Plain language examples:

• Focus Your Communication Know your audience and purpose before you begin. Always open your communication with the most important messages
• Be Concise Too much information may overwhelm or intimidate patient and caregivers. Try to limit each communication to three key messages. This helps everyone to focus on the details that matter most
• Speak/Write at a Grade 6 Level Many people with low health literacy won’t clearly understand information shared at a higher level. Sharing information at a Grade 6 level allows you to communicate clearly with the greatest number of advisors
• Avoid Using Jargon Choose words and numbers your audience knows. Words with fewer syllables are easier for people with low health literacy to understand. Avoid health system acronyms. If you must use acronyms, have a conversation with patients and families about what they mean and when you plan to use them (Health Quality Ontario; Kimble, 2002)
• Use Bullet Points This makes documents easier to read and reference and highlights key facts or instructions that need to be followed. Providing information in bullets instead of paragraphs also helps to break up text and add white space, which is a best practice in plain language communication
• Use Images Evidence shows that health info-graphics and other images are a great way to help patient and caregiver advisors visualize and understand key information

• Plain Language Medical Dictionary

  A project of the University of Michigan Taubman Health Sciences Library. To use, click on the drop down menu to browse the list of high-level medical terms. Once a word or phrase is selected, the plain language translation will appear in the box.

• Plain Language Thesaurus

  From the CDC's National Center for Health Marketing, this thesaurus offers plain language equivalents to medical terms, phrases, and references.

• Assessing and Developing Health Materials

  Tips to consider when creating educational materials. From Harvard T.H. Chan School of Public Health.

• Plain Language.gov

  Contains guidelines for creating plain language materials, as well as an overview of the plain language movement and tools for trainers.

• SMOG (Simple Measure of Goobledygook)

  This online tool calculates the grade level of written materials.

• Toolkit for Making Written Material Clear and Effective

  Provides a detailed and comprehensive set of tools to help make written material easier for people to read, understand, and use.

• Usability.gov

  One-stop source for web designers to learn how to make websites more usable, useful, and accessible.