Research has shown that health care professionals often underestimate the challenges associated with health literacy.
It is even harder to recognise people’s health literacy as sometimes people are too polite or feel embarrassed to tell their health professional that they haven’t understood. While this is particularly common in those who have difficulty reading, writing or using numbers, it can affect anyone.
It is worth bearing in mind that:
- You cannot tell someone's literacy level just by looking at them. A person may speak well and appear to understand what is going on, however this does not mean that they truly do.
- The language and terminology used in health services is often not commonly used in everyday life and even those with good educational backgrounds may not understand what their diagnosis means or what is being asked of them.
- Even someone who normally manages health information well may have increased difficulty when they feel anxious, or overwhelmed with too much information, they may not be able to understand or use health information as well as normal.
Adapting how you communicate with people can help everyone, not only those with low health literacy. There are several evidence-based health literacy interventions that can help:
- Literacy awareness: routinely ask people if they would like help in filling out forms.
- Use simple language: avoid jargon and use language that is easy for the person in front of you to understand, both when you speak to them and in any written information you provide.
- Limit information (3 to 5 key points). Think about what you want the patient to remember and focus on those.
- Use the ‘Teach-back’ type techniques: check that you have explained everything in ways people understand, by asking them to explain in their own words the information you have given. For example, you might say ‘I want to make sure that I have explained your medicine clearly. Can you tell me how you will take your medicine?’
- Chunk and check: break what you need to discuss into small chunks, and check understanding using teach-back before continuing.
- Use pictures: draw or show a picture to help convey a complex concept or body part.
- Check confidence for following agreed treatment/activities? For example you might say ‘On a scale of one to ten, how confident do you feel about doing what we have discussed?’
- Provide written or other forms of information covered in consultation – like leaflets etc. – providing they are easy to understand.
The article Teaching about Health Literacy and Clear Communication provides a clear and helpful exploration of the challenges facing health professionals and some approaches to addressing these.