Plain Language: Tools and Techniques

Peggy Sissel-Phelan, Ed.D.
Best Practices Working Group
Health Literacy Section
Arkansas Public Health Association
Annual Conference
May 12, 2011

Introduction of Concepts
• Health Literacy
• Best Practices
• Plain Language

Rationale for Plain Language

Skill Building Resources

Resources

Definition ~

Need ~

Scope ~
Definition ~
Health literacy is the use of a wide range of skills that
improve the ability of people to act on information in
order to live healthier lives.
These skills include reading, writing, listening,
speaking, numeracy, and critical analysis, as well as
communication and interaction skills.
Health literacy allows the public and personnel working
in all health-related contexts to find, understand,
evaluate, communicate, and use information.
(Calgary Charter on Health Literacy, 2008)

Need ~
• 97 million adults in U.S. struggle with literacy
• That’s one third of the U.S. population . . .
• Half of all adults 16+




Cannot
Find which foods contain a specific vitamin
Identify a specific location on a map
Use fractions
Interpret a growth chart or table
Need ~
Health Care Disparities
• Race
• Poverty
• Class
• Age
• Ethnicity
• Gender
• Education
• Cultural beliefs
• Isolation
• Language
Need ~
Health Care Complexity
• Primary Care
• Specialties
• Prevention
• Prognosis
• Access
• Insurance
• Diagnosis
• Medication
• Treatment
• Compliance
Need ~
NAAL results for Below Basic Group
 37%
have a HS or some college education
 52% speak English as birth language
 54% have no physical or mental disabilities
Kutner M et al, Nat Center for Educ Statistics 2005

Definition ~
Understanding + Actions = Outcomes

Need ~
Widespread + Immediate

Scope ~
The Public
+
The personnel in all
health-related areas
•
Practitioner’s role
- give best possible care
- communicate about the care
•
Practitioner’s goal
- best possible outcome
- patient understanding
•
Practitioner’s responsibility
- culturally competent
- assume that everyone may have
difficulty understanding
- have knowledge of barriers to care
- create environment that helps
all patients understand
•
Patients have the right to understand healthcare information that is necessary for them to
safely care for themselves, and to choose among
available alternatives.
•
Healthcare providers have a duty to provide
information in simple, clear, and plain language
and to check that patients have understood the
information before ending the conversation.
The 2005 White House Conference on Aging;
Mini-Conference on Health Literacy and Health Disparities.
•
is clear and simple
•
the goal - patients are better able to:
-
Locate
Form Questions
Understand
Act
•
Plain language guidelines have common
set of principles
•
Provider should:
- identify the audience
- adapt to their needs and abilities
- have clear communication objective.
Shohet & Renaud
Critical Analysis on Best Practices in Health Literacy
CANADIAN JOURNAL OF PUBLIC HEALTH
Volume 97 (S2) pp. S10 - 13 2006
COMPLEX
PLAIN
Passive sentences
Active sentences
Long paragraphs
Short paragraphs
Poly-syllable words
Mono or bi-syllable
Clinical language
Colloquial language
Past/mixed tense
Present tense
3rd person (they, s/he)
2nd or 1st person (you, I)
Health language/ Word Choice
- No jargon and technical language
- Use lay terms about health concepts
- Terms clearly defined and explained
- No abbreviations, acronyms and statistics
It’ s Not Just Medical Terms . . .
We are disseminating information about….
We are giving out information about…
How do you administer the medication?
How do you give the medicine?
This product has an extensive list of symptoms that it treats…
This medicine can help with many things like
fever, or pain, etc….
Signage
Intake forms
Medications
Treatment plan
Self care directives
Communication style
Adequate time
Feedback loop
Pictures
Sequence
Demonstrations
Video
Plain Writing Act of 2010 (Public Law No: 111-274)
•
Federal agencies must use “plain writing”
•
All “covered documents” issued to public
~ Letters, publications, forms, notices,
instructions
~ Anything relevant to federal benefits or
requirements
Alternative Words Using
Plain Language
Based on: Plain Language Alternatives for Patient Information and Consent Materials
Copyright © Sharon Nancekivell 2002-2007. All rights reserved. Electronic or print
redistribution of this work for nonprofit purposes is permitted, provided this notice is
attached in its entirety. All unauthorized, for-profit redistribution is prohibited.
Abdomen
Stomach /area around stomach
Abscess
Swollen area filled with a thick
yellow or green liquid called pus
Accompany
Go with
Aerosol
Spray
Biopsy
Taking a small bit of
tissue to test
Blood clot
Clump of blood
By mouth
Swallow it
Resources
1. Universal Precautions Tool Kit
http://www.ahrq.gov/qual/literacy/healthliteracytoolkit.pdf
2. National Action Plan to Improve Health
Literacy
http://www.health.gov/communication/hlactionplan/pdf/Health_Literacy_
Action_Plan.pdf
Universal Precautions Tool Kit
Resources
3. Plain Language Alternatives for Patient Information
and Consent Materials Copyright © Sharon Nancekivell
2002-2007.
http://healthcare.partners.org/phsirb/consfrm_files/Plain_Language_Alternative
s_for_Patient_Information_and_Consent_Materials.pdf
4. Pfizer Clear Health Communication Initiative
http://www.pfizerhealthliteracy.com
5. NYU Patient and Family Resource Center
http://www.nyupatientlibrary.org/medcenter/build-skills
Resources
6. Center for Health Care Strategies Health Literacy Fact
Sheets
http://www.chcs.org/publications3960/publications_show.htm?doc_
id=291711
7. Institute for Healthcare Advancement
www.iha4health.org
Michael Villaire, MSLM
Director, Programs and Operations
[email protected]
(800) 434-4633 x202
8. American Medical Association
Health Literacy Program and Kit
www. ama-assn.org
Resources
9. Help Your Patients Understand.”
Video Available from AMA Foundation
http://www.ama-assn.org/ama/pub/category/8035.html
10.
http://www. plainlanguage.gov

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