Elegantly Simple Evaluation: Talking to Health Care Providers about Patient Health Literacy

Posted by nnlmneo on October 9th, 2014 Posted in: Blog

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By Yawar Ali and Cindy Olney

As the child of a physician living in South Texas, I’ve witnessed a deficiency of health literacy in patients. I volunteered in my dad’s clinic over spring break. I also participated on a medical relief trip with my father to a nonprofit charitable hospital in Pakistan. At both places, I witnessed difficulty in patient health literacy. – Yawar Ali

 In June 2014, Yawar Ali, a rising junior from the South Texas High School for Health Professions, taught physicians and physician assistants in his father’s medical clinics about patient health literacy. He also introduced them to MedlinePlus as an important tool for their patients. Yawar evaluated his project and discovered valuable insight that helped him improve the impact of his project.

Yawar conducted this health information outreach project as an internship offered through the  ¡VIVA! (Vital Information for a Virtual Age) project.  ¡VIVA! is a high school-based initiative in which students are trained to promote MedlinePlus to their classmates, teachers, families, and community members.  It is a student organization led by librarians of the South Texas Independent School District, located in the Lower Rio Grande Valley. The National Library of Medicine (NLM) funds the project.

He developed his presentation using health literacy materials available through the Medical Library Association and presented to three doctors and three PAs.  He taught them seven steps for addressing low patient health literacy and introduced them to MedlinePlus.

Yawar incorporated elegantly simple evaluation techniques into his project. Right after the presentation, he asked participants to complete a short evaluation form, asking them how likely they were to use the steps and promote MedlinePlus to patients.  They all responded positively, indicating good intentions.

Two weeks after the training, Yawar visited all of the health care providers to conduct brief semi-structured interviews. He asked if they had tried the steps and collected their feedback on the techniques. He also checked to see if they had promoted MedlinePlus to their patients. With some persistence, he was able to conduct a complete interview with each participant.

The feedback he received is of interest to anyone hoping to initiate health information outreach in partnership with primary care clinics, particularly in medically underserved areas:

• The majority of Yawar’s participants tried teach-back, open-ended questions, and other techniques with their patients; but they were conflicted because such techniques added time to patient appointments. This interfered with their ability to stick to their busy schedules.
• The health care providers were impressed with MedlinePlus, but they had convenient access to print materials from a database (Healthwise) that was integrated with the clinic’s Electronic Health Records (EHR) system. Furthermore, it was easier to document that they were adhering to the meaningful use requirements of the Medicare and Medicaid EHR Incentive Programs when they got patient information from Healthwise.
• While the Healthwise database was more convenient for the providers, they recognized that the print information they were providing was limited. They believed their patients could get more comprehensive information from MedlinePlus, but the clinicians did not have a convenient way to promote the resource.

Their feedback prompted a speedy response. The project team secured MedlinePlus brochures from NLM that Yawar delivered to the clinics. The fix was relatively simple, but critical. The team may have never known about this necessary adjustment without Yawar’s elegantly simple evaluation.

Credit:  Yawar and Cindy would like to thank ¡VIVA! project team members Lucy Hansen, Sara Reibman, and Ann Vickman, for their help on this project.

The ¡VIVA! project has been funded in whole or in part with federal funds from the National Library of Medicine, National Institute of Health, under Contract No. HHSN-276-2011-0007-C with the Houston Academy of Medicine-Texas Medical Center Library.