Strategies for implementing and evaluating SEPA-reads (Southeastern Pennsylvania Regional Education Addressing Disconnects in Cardiovascular Communication)

The association of low health literacy and poor health and economic outcomes is well documented. Data reflect high cardiovascular-related morbidity and mortality rates among adults ≥ 50, disproportionately in Southeastern Pennsylvania, compared to national and state rates. Recognizing the need for seniors to appropriately self-manage cardiovascular conditions, the Pennsylvania Department of Health funded an innovative, three-year multifaceted, health literacy project to improve cardiovascular outcomes. The Healthcare Improvement Foundation and an urban Academic Health Center created a multidisciplinary, multi-institutional regional Cardiovascular Health Literacy Coalition to design, implement and evaluate this initiative. The health literacy objectives and interventions focused on three constituent populations: healthcare systems staff and providers, local senior serving community organizations, and consumers, with input from Professional and Community Advisory groups. This presentation describes the Coalition's comprehensive evaluation of the implementation, effectiveness, and impact of the interventions. Qualitative and quantitative analyses of project components were conducted with respective constituent groups. Baseline assessments of health systems include patient demographics; status of health literacy principles in policies, education and signage; and cardiac readmissions, ER use and patient satisfaction data. Findings informed the selection of evidenced-based health literacy interventions for professionals, community organizations and consumers, incorporating ‘Train the Trainer', 'Teach Back', ‘Ask Me 3' and 'Peer Activation' models. Since 2011, >1400 hospital staff, 15 facilitators, 51 peer educators and 181 consumers received training; hospital forms, signage and resources have been adopted and a shared website has been launched. Evaluation results, key learnings, sustainability and scaling up plans at constituent and project levels presented.