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Thursday, April 25, 2019

Health literacy: information literacy for life #lilac19

This is Sheila, and today I'll be joining Pam in livebloggong from the LILAC Conference. The day opens with a keynote from Ruth Carlyle (Head of Library & Knowledge Services and Technology Enhanced Learning, Midlands and the East of England) on Health literacy: information literacy for life. She started by identifying us as "the perfect audience" to hear about health literacy. Carlyle went on to talk about the multiple health problems that face populations globally, and the need for people to be able to help themselves in terms of their health problems.
She quoted the World Health Organization definition of health literacy, and noted that the emphasis now is not just on personal characteristics, but also the need for communities to work together to access, understand, appraise etc. haelth related information. There is a WHO health literacy site here https://www.who.int/healthpromotion/health-literacy/en/ She also cited research by Gill Rowlands which identified that there was a UK national average of 43% of the population not understanding textual information, with a larger percentage unable to understand a combination of information types. Gill Rowlands' eprint archive is here. There are similar findings from studies in other countries. The obvious implications are that people may not be able to self-medicate effectively nor make informed decisions about health.
Carlyle cited Nutbeam's 3 types of health literacy: functional, interactive (including being able to "balance information from different sources") and critical ("analyse and gain control"). She also talked about when you are in a stressful situation, e.g. having just been diagnosed, this will affect your health literacy. Thus (using a framework by Carlyle herself) the Situation, your Skills and the Setting (e.g. a hospital) will all affect your health literacy, so you can be encouraged, empowered and enabled.
Carlyle tried an experiment with us, showing us some notes of music and asking us to decode it, whilst continuing to talk to us, to demonstrate how frustrating and difficult it can be to decode information where you don't know what the code is. She then talked about some techniques that could be used to improve communication. An example was "teach back", asking the patient to explain in their own words, re-explain if needed, and asking again until everyone's happy. There was also "chunk and check" to check after each small chunk of information. In terms of written communication there were "common sense" guidelines such as using active verbs, using short sentences (although these common sense guidelines were not always followed in health materials).
Health literacy friendly services will comply in terms of written communication, spoken communication (so support is evident and open), stock (e.g. up to date material in a range of formats), signage, training and policy ("policies for the services reflect the health literacy needs of staff and service users" and "HL policy for the service"). Training is provided to NHS librarians, so that they can support colleagues and they have a strategic framework "Knowledge for Healthcare" (I think this). The recent Topol Review (Preparing the healthcare workforce to deliver the digital future) stressed the need for digital literacy and e-health literacy, which (to us) relates to information literacy.
There was an interesting question session afterwards raising a variety of issues, including misinformation, findability of the NHS website, the extent to which clinicians are willing tp respect/involve librarians, and the scariness of actual medical situations that effects our judgement.

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