207968 Highlighting the aural exchange: Examining distinct types of literacy in chronic disease management

Tuesday, November 10, 2009: 11:30 AM

Lindsay E. Rosenfeld, SD, SM , Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA
Rima Rudd, MSPH, ScD , Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA
Karen M. Emmons, PhD , Department of Society, Human Development and Health/Division of Community-Based Research, Harvard School of Public Health/Dana-Farber Cancer Institute, Boston, MA
Dolores Acevedo-Garcia, PhD , School of Public Health, Harvard University, Boston, MA
Laurie Martin, ScD, MPH , RAND, Arlington, VA
Stephen L. Buka, ScD , Department of Community Health, Brown University, Providence, RI
Objectives: To examine the relationship between distinct types of literacy and chronic disease management.

Methods: Study participants, all of whom reported asthma, were drawn from the New England Family Study (NEFS), an examination of links between education and health. NEFS data included measures of reading, speaking, and listening skills (using the Woodcock-Johnson Achievement Tests®). Additional interviews with participants included queries related to asthma management and free listing related to asthma issues. We also administered the HALS (Health Assessment of Literacy Skills). (n=69)

Results: In this session, we will discuss study results, including how a) regardless of education or literacy skill level, participants reported similar themes related to asthma management, and b) participants with higher aural comprehension skills offered more diverse conceptual themes. In addition, we will describe free listing methods, the use of the Woodcock-Johnson to measure literacy, and the creation of conceptual themes. Further, we will highlight the administration of the HALS. In all, we will discuss the relationship of aural comprehension skills and patient-provider communication.

Conclusion: Higher aural comprehension skills may enhance disease management capabilities. Therefore, distinct types of literacy skills, beyond reading comprehension skills usually highlighted in the study of health and literacy, may be important to measure in research and consider in program and policy development. In addition, strategies for clear communication in disease management may also likely need to consider distinct literacy types for optimal patient health.

Learning Objectives:
1) By the end of the session, the participant will be able to explain the purpose and describe the technique of free listing. 2) By the end of the session, the participant will be able to differentiate between aural, oral and reading literacy. 3) By the end of the session, the participant will be able to define these individual measures of literacy and discuss why and how they might be separately related to health outcomes. 4) By the end of the session, the participant will be able to identify why it is important to explore different types of literacy in relationship to health, and to specifically name the type of literacy under study. 5) By the end of the session, the participant will be able to evaluate how different types of literacy are related to different communication tasks which are part of everyday provider-patient interactions.

Keywords: Health Literacy, Disease Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: EDUCATION November 2008 Harvard School of Public Health, Boston, MA SD: Society, Human Development, and Health; Conc: Health and Social Policy; Major: Urban Health and Social Policy; Minors: Program Planning and Evaluation, Health Communications; Certificate: Women, Gender, and Health Focus: traditionally “non-health” policies that impact health, e.g. urban planning and design, housing, neighborhoods, education, (im)migration, and health literacy Dissertation: “Exploring Disparities in Asthma at Multiple Levels: Individual, Building, and Neighborhood Issues” June 2004 Harvard School of Public Health, Boston, MA SM: Health and Social Behavior Awards: Albert Schweitzer Fellowship and Rappaport Public Policy Fellowship May 2000 Brown University, Providence, RI AB with honors: Women’s Studies, magna cum laude, overall GPA: 3.9 Honors Thesis: gender, ethnicity, and social class in human service program design Honors: Phi Beta Kappa Oct 2008-present Postdoctoral Fellow, Harvard School of Public Health, Boston, MA  Continue research work with New England Family Study.  Explore new possibilities of research within health literacy and place-based disparity issues (i.e. regional equity, residential segregation, built environment).  Examine methods to explore current and potential non-health policies and programs that impact health. EXAMPLES OF EXPERIENCE: Sept 2008-present Research Associate, Harvard Clinical and Translational Science Center, Harvard Medical School, Boston, MA  Develop web portals as part of interdisciplinary team to 1) promote collaboration among Harvard science community and 2) provide access to information about clinical research for the community-at-large.  Develop evaluation study to examine usability and content of web portal for community-at-large. Oct 2002-Aug 2008 Member, Health Literacy/Health Communications Working Group Harvard School of Public Health, Boston, MA  Discuss new health literacy research, critiquing and addressing members’ work. Sept 2006-Dec 2007 Coordinator of Health Literacy Studies Harvard School of Public Health, Boston, MA  Managed inquiries; organized and gave presentations; performed research; coordinated functions of Health Literacy/Health Communications working group. Jan-June 2004 Project Coordinator (Schweitzer Fellow) La Alianza Hispana, Inc., Boston, MA  Conducted a health literacy assessment for health-related programs to address issues of readability, comprehensibility, and layout; created new materials, redesigned materials in-use, and trained staff. SAMPLE OF PRESENTATIONS: May 2007/2008 Guest Lecturer, Harvard School of Public Health, Boston, MA “Psychosocial Theory in Practice – Case Study: College counseling for high school students in a poor, urban high school”, co-presenter with Cassandra Okechukwu  Presented case study written by myself and co-presenter.  Facilitated program critique employing psychosocial theories in the final class of a capstone doctoral level theories course. Nov 2007 135th American Public Health Association Meeting, Washington, DC “Puerto Ricans in the Bronx, NY: Sociocontextual influences on asthma – building and neighborhood type”  Presented orals session entitled: ‘Strategies to Reduce Asthma Disparities,’ participated in panel discussion. March 2007 Sixth Annual Qualitative Research Conference, University of Missouri-St. Louis, College of Education, St. Louis, MO “Freelisting: Beyond survey development”, co-presenter with Vanessa Watts  Presented full-session on the qualitative method of freelisting, leading interactive discussion on its use for a variety of research areas. Nov 2006 American College of Rheumatology Annual Meeting, Washington, DC “Health Literacy in America: Why and how to improve written and oral communication”, co-presenter with Victoria Gall  Presented full-session to health care researchers and providers concerning health literacy research; facilitated plain language materials discussion and assessment tools practice. Oct 2006 The New England Regional Advisory Committee Meeting: Health Literacy – The Language of Adolescents, Boston, MA “Applying the Principles of Health Literacy: Interactive discussion/critique of adolescent health brochures”  Presented health literacy concepts to regional practitioners and taught participants to use assessment tools such as the SMOG, SAM, and PMOSE/IKIRSCH.  Led practice of assessment tools, using materials from their field work. July 2006 Plain Language Institute, The Literacy Assistance Center, New York, New York co-presenter with Jennie Epstein Anderson  Presented day-long training to government and health officials, health insurance and direct service providers, and foundation employees concerning various aspects of plain language and health literacy, including research and the how-to. April 2006 Preventing Disasters and Minimizing their Consequences, American Academy of Arts and Sciences, Cambridge, MA co-presenter with Dr. Rima Rudd  Facilitated discussion group concerning the relationship of disaster prevention and message communication to health literacy, and presented the working group’s “next steps” to the larger conference. Served on presenters’ panel.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.