# Presentation: 089012

## National Prevention Summit: 
Prevention, Preparedness, and Promotion
October 27, 2006

***Prevention, Preparedness, and Promotion***
***October 27, 2006***

## The Scope of the Problem is Vast Many Patients are at Risk for Not Understanding

- The Scope of the Problem is Vast Many Patients are at Risk for Not Understanding

- 93 million adults can only perform basic literacy skills1
- 11 million adults are non-literate in English1
- 7.8 million seniors can only perform the most simple and concrete literacy skills1 (Below Basic)

*More than 89 Million Consumers are Impacted by Low Health Literacy – **the Ability to Read, Understand, and Act on Health Information*

- 1**2003 National Assessment of Adult Literacy (NAAL)**

**Notes:**
Talking Points:
50 percent of the adult population in the United States reads at or below the 8th grade reading level.

20 percent of the adult population reads at or below the 5th grade reading level.  

Among elderly and certain ethnic minority populations, the statistics are even more alarming – 50 percent of seniors and African Americans read at the 5th grade level or below.

We are going to watch a short video today that drives this issue home (Amy – those on by Web Ex will have already watched the video. It is about 6 minutes long)

## Low Health Literacy Negatively Impacts Health Outcomes 

- Adults with low ***health*** literacy:
- Are often less likely to comply with prescribed treatment andself-care regimens1
- Make more medication or treatment errors1
- Fail to seek preventive care1
- Are at a higher risk for hospitalization than people with adequateliteracy skills2
- Remain in hospital nearly 2 days longer3
- Lack the skills needed to negotiate the health care system1
- People with low health literacy ***AND*** diabetes:
- Were found to be less likely to have effective glycemic control4
- Were more likely to report vision problems caused by their diabetes4

- 1	Weiss, BD. *20 Common Problems in Primary Care*. McGraw Hill. December 1999
- 2 	Baker DW, Parker RM, Williams MV, Clark WS. Health Literacy and the Risk of Hospital Admission. *Journal of General Internal Medicine*. 1998; (13): 791–798
- 3 	Kirsch IS, Jugebut A, Jenkins L, Kolstad A. Adult Literacy in America: A First Look at the Results of the National Adult Literacy Survey. Washington, DC: Department of Education 1993
- 4 	Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, Palacios J, Sullivan GD, Bindman AB. Association of Health Literacy With Diabetes Outcomes. *JAMA*. July 24/31 2002 (288) No 4

## Low Health Literacy Impacts Resource Utilization 

- Adults with low literacy:
- Averaged 6% more hospital visits1*
- Stayed in the hospital nearly 2 days longer than adults with higher literacy skills1*
- Had fewer doctor visits, but used significantly more hospital resources2
- Had annual health care costs 4 times higher than those with higher health literacy3

- *	Among adults who stayed overnight in a hospital
- 1	Kirsch IS, Jugebut A, Jenkins L, Kolstad A. Adult Literacy in America: A First Look at the Results of the National Adult Literacy Survey. Washington, DC: Department of Education 1993
- 2	Baker DW, Parker RM, Williams MV, Clark WS. Health Literacy and the Risk of Hospital Admission. *Journal of General Internal Medicine*. 1998; (13): 791-798
- 3	Weiss, BD. 20 Common Problems in Primary Care. McGraw Hill. December 1999

## The Creation of the Partnership for Clear Health Communication

- 	The **Partnership for Clear Health Communication (PCHC) is a national, non-profit coalition of over 400 organizations working to build awareness and advance solutions to improve health literacy and positively impact health outcomes. **

## Partnership for Clear Health Communication

**Who** – Nationally recognized organizations with local membership experienced in building and leading coalitions, representing a broad range of constituencies
**What** – Develop and execute a prioritized and coordinated Action Agenda

***Shared Interest in ******Improving Health Outcomes***

- Partnership for Clear Health Communication

## Action Agenda

***Increase awareness ***of the importance of clear health communication

- Provide ***training, targeted education, coaching and materials ***to people who have the most patient interface

- Advocate for clear health communication and ***increased health literacy resources  ***

**Notes:**
Today the Partnership announces an ambitious, four-pronged action agenda to improve clear health communication between patients and providers. 
Our agenda is a national call-to-action – a road map to guide our public health officials, policymakers, health industry leaders, consumer advocates, literacy groups.  It will take the collective efforts of those gathered here today to enhance health outcomes through improved health literacy.
KS ADDING MORE NOTES TO HIGHLIGHT ACTION AGENDA ITEMS

##  Sample of PCHC Members

- American Academy of Family Physicians Foundation
- American Academy of Pediatrics
- American Academy of Physician Assistants
- American Cancer Society
- American Diabetes Association
- American Geriatrics Society Foundation for Health in Aging
- National Council of La Raza
- National Health Council

- American College of Nurse Practitioners
- American Public Health Association
- National Council on the Aging
- National Association of Community Health Centers
- Pfizer
- March of Dimes
- American Pharmacist Association
- Aetna Health

***PCHC has expanded to include over 400 members***

## Moving from Medical Model to Patient-Centered Model

**Moving from Medical Model ****to Patient-Centered Model**

- Focuses onthe disease,symptoms, treatment
- Appropriate for physicians
- Not appropriate for *most* consumers

- Focuses on the patient’s perspective
- Covers what patientswant and need to know
- Acknowledgestheir readinessto learn

***The Medical Model***

***A Patient-Centered Model***

## The Partnership for Clear HealthCommunication’s First Solution

- The Partnership for Clear HealthCommunication’s First Solution

- Addresses the highest priority Action Agenda items
- Awareness, targeted education and materials
- Creates a compelling solution and ***Call to Action*** for patients and providers
- Is designed to promote clear communication between patients and providers to improve health outcomes
- Was developed with health literacy experts, then tested and validated

**Notes:**
We said that we wanted to emphasize solutions at this luncheon, and I’d like to share that first initiative to come from the Partnership’s Action Agenda.  And while this initiative is also clearly linked with the education component of the Action Agenda, it should be noted that education about health literacy issues is imperative if we are going to make progress in any other areas.

## What Is Ask Me 3?

- Promotes three simple, but essential, questions and answers for every healthcare interaction:

**Notes:**
Ask Me 3 is a new patient education program designed to promote communication between health care providers and patients, in order to improve health outcomes. 

The program promotes these three questions that patients should ask their providers in every health care interaction and that providers should always encourage their patients to understand the answers to. 

## Ask Me 3 – Creates Shared Responsibility for Clear Health Communication

*Ask Me 3 *– Creates Shared Responsibility for Clear Health Communication

**Patient**

**Provider**

**De-stigmatize and****Reduce Embarrassment****of Low Health Literacy**

**Recognize****Patient Coping Mechanisms**

**Notes:**
Ask Me 3 is a new patient education program designed to promote communication between health care providers and patients, in order to improve health outcomes. 

The program promotes these three questions that patients should ask their providers in every health care interaction and that providers should always encourage their patients to understand the answers to. 

## Ask Me 3 – Program Materials Available in English and Spanish

**Patient Brochure**

**Organizational Brochure**

**Website**

**Posters**

**Provider Brochure**

## Ask Me 3 Dissemination

**Lynchburg Family Practice**
**Winnoski Family Health**
**Lechtworth Family Medicine**
**HCH Family Practice**
**Ronald A. Cole, MD**
**Robert T. Hartman, MD**

**Hospitals & Community Health**
**E. Boston Health Center**
**All Saints HealthCare**
**Jackson Health System**
**Boston Medical Center**
**Prince George’s County Health Department**

**Advocacy/**
**VHA Groups**
**American Diabetes Association**
**American Cancer Society**
**Catholic Charities**
**The Senior Alliance**
**American Geriatrics Society**

**Academia**
**New Mexico State University**
**Arizona Department of Education**
**Ohio State University**
**Texas Tech**
**Duke**
**UW Medical School**

**Pharmacy**
**Medicine Shoppe **
**Student National Pharmaceutical Association**
**MCPHS School of Pharmacy**
**Bause’s Super Drug Store**
**Kmart Pharmacy**
**Anchor Pharmacy**

***Ask Me 3***** Dissemination**

**Sample of Organizations Who Have Received Materials**

**MATERIALS DISSEMINATED SINCE 2003: **
**Over 1 Million**

## More Information on PCHC

- To find out more about PCHC, our programs, resources and members, please visit
- 		_[www.p4chc.org](http://www.p4chc.org/)__ and_
- 		_[www.AskMe3.org](http://www.askme3.org/)_