Enhancing health literacy in adults with chronic disease: A systems approach

A sizable proportion of Americans are estimated to have poor health literacy. Health literacy is commonly associated with an individual's educational level, not focused on systems-level influences that may hinder or facilitate the acquisition of pertinent health information. The goal of this initiative, located in Tarrant County, Texas, is to use a systems approach to enhance connections between healthcare providers, public libraries, and existing resources that promote self-management of chronic disabling conditions. Our approach includes (1) enhancing the current referral system for the local United Way's (UW) evidence-based chronic disease self-management programs; and (2) training public librarians. We are working to integrate referral systems for patients with chronic disabling conditions from health care systems to UW's community-based programs. Through trainings conducted by our outreach librarian, we are enhancing librarians' capacity to link their patrons with valid sources of health information and to refer to the UW programs. We are currently measuring the impact of our librarian training with surveys assessing their capacity to direct patrons to relevant information as well as health-related circulation statistics. To assess systems change, we are measuring referral streams to UW programs and assessment of strengths/barriers of existing referral mechanisms to UW programs. The next step for this initiative will be to assess its impact on changes in health literacy for the target population. Systems change has the potential to make a significant impact on the self-management of persons with chronic disabling conditions, which has important implications given the Affordable Care Act.