[BEGIN_TRANSCRIPT]
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Welcome to this edition of AMC.

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Tell you how I got better. I'm glad to be

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here, but a mission

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to. Well, I think that we're, we're talking, we're gonna

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talk about everybody's Arkansas is

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the 2nd highest prescriber.

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Welcome to AFMCTV. I'm Robin Ledbetter.

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Thank you for joining us. Today I have with me Katie

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Leith, and she is the director of the UAMS

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Center for Health Literacy.

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Katie, thanks for being here today.

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Thanks for having me, Robin. This is great.

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So tell us exactly what is health literacy

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and why is it important?

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Yeah, so actually there are two

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technical definitions of

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health literacy, and one is,

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um, focuses on somebody's personal

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health literacy or their individual

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skills,

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um, skills that people need to find,

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understand and use health informations

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to make health decisions for themselves and the people

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that they care for.

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And then another definition

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is more focused on

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organizational health literacy. So

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that is what

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us health and healthcare

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organizations like UAMS and AFMC,

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what we do,

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um, that enables the people

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that we serve to be able to

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find and understand and use our

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services and information to,

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again, improve their health or care.

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Um, for others. So there's a little bit, there's

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two sides of, of health

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literacy, and it's really important because

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it's linked to if and

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how well someone can, you know, take

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care of their health and make

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good decisions about their health. Um,

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and if we think about like

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all the different like specialties out there

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and all the kinds of different health

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problems and body systems and

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everything. There's lots of stuff to

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know and if we think about

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the complexities of the healthcare system

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and how

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You know, hard it can be to navigate and

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use your insurance or get

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insurance even.

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Um, that takes a lot of, of

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skills to be able to

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manage all of that. And we,

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unfortunately, the healthcare system is

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we just don't make it easy for,

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for people,

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um, and that hurts their ability to be

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able to take care of themselves, so.

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So it's like low health literacy,

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it really does affect

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individuals' lives like in communities

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every day.

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Yeah, absolutely, it affects individuals

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every day.

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And what are some of the biggest barriers people

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face when trying to understand health

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information?

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Um, I think that there,

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there are 22 things

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to highlight. There maybe, maybe more,

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but two important things to highlight.

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One is like just the way that information

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is communicated,

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and that is pretty

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broad, right? So that's not

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just

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Um,

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that's not just using plain language and making

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sure, you know, people can read it and understand it

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and use it, but it's just like, does it meet

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the audience's needs? Does it,

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can they, can they access it? Is

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it in a format that, you

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know, they prefer and like, like some people

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like me, I like,

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um, I like print written things because

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I can like scan it real easy, but I know that,

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you know,

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some younger generations really prefer

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a video where I don't really want.

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a video. So it's, it's, you know,

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the, the way we communicate,

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um,

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affects people's ability to use

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information.

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Um, and then

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we have to also, you know, I think now more

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than ever,

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think about information literacy

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and

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how people's ability, their

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skills to, um,

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find accurate,

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trustworthy, high quality

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information,

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um.

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Because there's just a lot of information out there and

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information is not all equal,

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not all good.

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How does health literacy intersect

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with social determinants of health, like education,

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income, or race?

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Um, so according to, um,

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US, um, DHHS

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Department of Health and Human Services,

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social determinants of health are,

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um, grouped into five main

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domains, economic stability,

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social, and community contexts, neighborhoods,

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and, and built environment,

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educational access and quality, and then healthcare

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access and quality.

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And health literacy is very specifically

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listed,

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um, in that healthcare

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access and quality, but I'd

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say it's kind of ingrained throughout all

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five of, um, those

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domains. So like in that

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economic stability, health literacy

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impacts an individual's ability to navigate

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insurance and use it appropriately

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and access health programs like

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Medicaid and SNAP or WI

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or anything.

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Like that, when people don't understand, you

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know, how to fill out the forms,

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um, how to use the programs, um,

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it affects their not only their healthcare

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access, but it also leads to unnecessary

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costs probably on their part. And

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so that affects their economic stability.

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Um, limited health literacy is also

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directly linked to educational attainment.

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Schools play a vital role in

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teaching, you know, foundational literacy

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and some other health literacy skills

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that last a lifetime and really

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shape somebody's ability to access and

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use health information.

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And then,

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as it relates, um,

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to that neighborhood and built environment,

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there's not maybe a strong,

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that's probably like the weakest link,

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but when people don't understand like environmental

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risks or,

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um, they, they really just can't make good choices

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about, you know, how to care

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for the health of their families.

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Um, so adequate health literacy

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helps keep people safer,

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makes healthier choices that impact

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them. Individually and then all of

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us really collectively.

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Um, so that health literacy really

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can foster,

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um, good engagement and,

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um, and empowerment in our communities

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that it improves trust and strengthens

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the health system and the health of, of

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communities too.

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And what can healthcare providers do to communicate

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more clearly and improve understanding for

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patients?

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So there are specific strategies

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that health providers, um,

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can use like using plain language, but

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this is so much easier said than done.

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Um,

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you know, doctors and, and other

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providers, they have spent

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years, right,

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learned in in school, like in the classroom,

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in clinical rotations and

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everything. And during that time, they've really

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learned like this very special,

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um, Lingo,

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right? Like,

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so they, and, and

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I think, and I was even guilty

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of this when I kind of started in

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this work because

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I took for granted all of the things I

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learned in in my education and forgot

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that not everybody's had the benefit

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of that type of education and it's hard to kind

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of move yourself out of that,

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I think, and, and take a step back and think, oh,

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well, not everybody might understand,

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you know, this word,

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um.

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And so,

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you know, our plain language writers, um,

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on our team spend probably more

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than 50 hours

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training, and then it really can take them

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a year before they're really good.

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Um, at that plain language writing. So

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I say, you know, providers

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should use plain language when they communicate

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with patients, but that's actually just

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a little bit harder,

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um, to achieve. It's, it's

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easier said than done.

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What role do schools and public

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institutions play in promoting the literacy? Is,

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does that start at an early age?

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I think, um, schools play a really

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important role in equipping their

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students, um, with all the

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skills that they need.

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Um, to be able to find appropriate health

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information, understand it, and then

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use it to make decisions about their

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health. And some of those skills are really

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covered in regular coursework, like,

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of course, you need to learn how, you need to know how to

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read,

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to be able to, you know, read

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the information that you find about

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or that you're given about, uh, you know, a

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health problem. You have to be able to interpret

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numbers and risks, that's kind of a harder

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skill, math, you know.

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I often like to

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ask in like our plain language trainings, how many

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of you, you know, really like math and nobody

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hardly raises their hand, you know, but it's

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still an important skill cause if you don't

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understand, you know, what your

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risk of lung cancer is if you've

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been, you know, a long time

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smoker or something, then you

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can't make good decisions. It affects your ability

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to make decisions about, you know, what

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you're gonna do. And then also like in school, I

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think we learn basic.

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Social and communication skills, which are useful.

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Um, but there are some skills that I

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think are really specific to healthcare that

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should also be addressed. And, um,

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we did a,

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a little

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study about how they're addressed in,

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um, health education competencies in

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K to 12 education a couple of years

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ago with some Clinton students

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and, um,

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And, you know,

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they kind of vary about how

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those competencies are addressed, but some,

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you know, things just like navigating the healthcare

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system, you know, how do you use your

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insurance? How do you make an appointment? What's

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a referral,

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um, why is that needed, you know, how to get

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prescriptions filled. I mean, these are things that

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a lot of us, I think, take for granted.

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We, you know, I know myself, I've

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had health insurance most of my

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life.

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Um,

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my, I, I have a You know, a

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mom that kind of taught

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me, led by example,

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trained me, but not everybody has the benefit

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of, you know, having health insurance

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their entire life and

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um understanding that, so,

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you know, when they don't, like we have to help them

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along the way when they are new

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or or just learning to access the

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health system. I think that public

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institutions also play

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an important role in how they enable

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those that they serve,

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um, to find and understand and use

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that information and services,

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um, and, or like how they like

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incorporate these attributes of a health

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literate health organization. So

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that's kind of related to that organizational health

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literacy.

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Um, definition, when we make

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it hard for people, um,

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everybody could really struggle, but if we

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make it easy, then more people are likely

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to succeed, and that really just

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saves time and lowers costs,

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improves overall satisfaction

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in,

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in your care.

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And are there effective tools or programs that

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you've seen that really help improve health literacy

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in in a lasting way?

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So, I wouldn't say that, you

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know, there's like one thing

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to, to do, you know, like I think there's

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lots of different strategies. I

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think, you know,

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providers, health organizations,

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um,

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You know,

[00:11:12.710]
really should

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focus on using plain language

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with, you know, patients in the public when they're

[00:11:18.908]
communicating,

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you know, ensuring that their messages are readable,

[00:11:22.859]
understandable, and action, actionable.

[00:11:25.629]
Um,

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There's other strategies too, like,

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um,

[00:11:31.509]
using teach back to confirm

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understanding, that is a good,

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um,

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tool, a good, it's a communication

[00:11:39.308]
technique that,

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um, where you're, when you teach something

[00:11:43.500]
to like a patient or program participant,

[00:11:46.629]
um, you confirm under that they

[00:11:48.950]
understand your instructions in a non-blaming,

[00:11:52.070]
non-shaming way. So it looks a little

[00:11:54.109]
bit of something like,

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um,

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You you like do an explicit invite

[00:11:59.918]
to ask them to teach back

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to you,

[00:12:02.879]
um, what they understood about your instructions.

[00:12:05.440]
So something like, hey, I wanna make

[00:12:07.440]
sure that I did a good job

[00:12:09.678]
communicating this with you.

[00:12:12.119]
What are you gonna tell your friend about your,

[00:12:14.359]
you know, new medicine or new treatment

[00:12:17.109]
today? Um, so that

[00:12:19.239]
really takes respons that makes the,

[00:12:21.308]
the provider take responsibility for

[00:12:23.320]
their own communication.

[00:12:25.320]
It's not judging somebody or blaming

[00:12:27.798]
them for

[00:12:29.460]
Um, you know, maybe not understanding,

[00:12:31.590]
and then you get to like check, like, oh

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yeah, you didn't, they didn't get that

[00:12:36.349]
part. I didn't do a good job explaining that. I got

[00:12:38.389]
to go back and and re-explain.

[00:12:40.570]
Um, at the Center for Health Literacy,

[00:12:42.940]
we have created a lot of different tools,

[00:12:45.820]
um, and programs that help improve

[00:12:47.820]
skills of individuals too. So, one,

[00:12:50.700]
is our how to talk to your doctor and

[00:12:52.820]
how to talk to your child's doctor booklets.

[00:12:55.678]
Um,

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they, they really cover kind of

[00:12:58.899]
some basics on how to

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prepare for those primary care, um,

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encounters.

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And then we also have a new, a newer,

[00:13:07.629]
um, digital health insurance

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module,

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um, that was really, it was

[00:13:14.019]
designed really for young adults

[00:13:16.178]
who are,

[00:13:17.178]
um, so what's different about health insurance

[00:13:19.219]
literacy is, um, another group

[00:13:21.460]
who's more likely to be at risk for,

[00:13:24.379]
um, inadequate health insurance literacy

[00:13:26.820]
is young adults,

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um, because they're new.

[00:13:29.979]
They've not, you know, they're probably relied on

[00:13:31.989]
their parents to

[00:13:33.759]
Um, navigate the health system for

[00:13:35.798]
them, and so they, they

[00:13:37.969]
can struggle to, to understand, you

[00:13:40.048]
know, how to use health insurance. So we designed a program

[00:13:42.250]
to kind of help,

[00:13:43.570]
um,

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Help them learn to use their

[00:13:47.399]
health insurance in an appropriate

[00:13:49.349]
way. So

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before we close,

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how,

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how do you access those resources? Is it through your

[00:13:56.479]
website and is it more general public

[00:13:58.639]
or if there's physicians that want to learn

[00:14:00.649]
more um and, and learn how

[00:14:02.759]
to, to communicate that

[00:14:05.038]
information

[00:14:05.918]
effectively that they can go to?

[00:14:08.048]
Yeah. So we have a website.

[00:14:10.369]
It's health literacy.UAS.edu.

[00:14:13.750]
Um, you can learn about our services,

[00:14:16.109]
um, there, you can learn about

[00:14:18.330]
the print and digital

[00:14:20.590]
resources that we have there,

[00:14:23.070]
um.

[00:14:24.058]
And then you can actually request

[00:14:26.469]
some of those things. We have like an

[00:14:28.469]
online services portal too called Plain

[00:14:30.548]
Pages, so you can request services

[00:14:32.869]
through that. You can also email

[00:14:34.928]
our, our email address, which is

[00:14:36.989]
health literacy at UAS.edu.

[00:14:39.469]
So, um, if you have specific questions,

[00:14:41.639]
we're happy to help, um,

[00:14:43.788]
try and point you in the right direction.

[00:14:46.229]
OK. Katie, thank you so much for talking

[00:14:48.320]
about this today. I appreciate you being here.

[00:14:50.629]
Yeah, thank you.

[00:14:51.940]
And that's it for AMCTV. Have a great

[00:14:53.940]
day and thanks for watching.
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