Health Literacy Month 2009
“It Matters…Your Pharmacist Wants to Help”
Iowa MedCard Initiative
FREE printable MedCard online
Ask Me 3
Health Literacy Resources
“It Matters…Your Pharmacist Wants to Help”
The Pharmacy Health Literacy
Improvement Program was developed by the Iowa Pharmacy Association
with funding from the NCSPAE/Merck Grant Program. The goal of the
program is to stimulate positive actions by the pharmacy profession
to minimize negative health outcomes associated with low health
literacy. The program’s objectives include increasing the pharmacy
profession’s awareness of low health literacy’s impact on
healthcare, particularly medication use problems; providing
pharmacists with tools and strategies to overcome barriers caused by
low health literacy; and establishing a framework to facilitate
multidisciplinary approaches to improving health literacy. To meet
these objectives, a packet containing health literacy educational
and training materials was created and distributed for use by state
pharmacy associations and their members.
The “It Matters…Your Pharmacist
Wants to Help” program also includes materials and practical tools
to assist pharmacists in assessing their patients’ health literacy
and educational aids to increase patient understanding of pharmacist
consultations. These materials and tools in the “It Matters” kit
are specifically related to over-the-counter (OTC) medication use.
OTC therapy presents a unique pharmacy niche where patients’ ability
to self-care must often be balanced with professional care. “It
Matters” focuses on health literacy and the pharmacist’s niche in
helping patients effectively use OTC medications. It acknowledges
the difficulty patients experience when making OTC selections and
promotes the pharmacist’s role in aiding patients when making these
important decisions. Specific materials were developed to promote
understanding and appropriate use of the following:
The educational materials in the
“It Matters” kit were developed through focus groups consisting of
patients, new readers (adults recently overcoming illiteracy),
pharmacists, and health literacy experts. These materials are
designed to be a helpful tool to assist pharmacists when providing
quality patient care. “It Matters” kits are available through IPA.
If interested, please contact Anthony Pudlo, at
Iowa MedCard Initiative
IT. SHOW IT. TELL IT.
“Know It. Show
It. Tell It.” is a state-wide campaign to provide MedCards to all
Iowans and improve health literacy by promoting communication
between patients and healthcare providers regarding appropriate
from The Wellmark Foundation, the Iowa Healthcare Collaborative,
Iowa Foundation for Medical Care, Iowa Hospital Association, Iowa
Medical Society, and the Iowa Pharmacy Association have partnered to
help improve Iowans’ health literacy by promoting the use of
MedCards and educating patients and healthcare providers to use
MedCards during every interaction to discuss appropriate medication
information, or to get involved,
It. Show It. Tell It.” poster
Create FREE printable MedCard online
is an online tool that can be used to create pocket-sized printable
MedCards as well as medication handouts complete with dosing
information, directions, and even pictures of the pills—all free of
charge. The MedCards and handouts include the name, strength,
and picture of each drug as well as specific dosing instructions for
each medication. They may be printed in large, easy-to-read
font as well as in Spanish.
To create a personalized MedCard or medication
handout, go to
http://www.MyMedSchedule.com and click
Register Now to create a
free MedCard or medication handout that can be printed upon
Ask Me 3
is a quick, effective tool designed to improve health communication
between patients and providers.
patient and provider education materials developed by leading health
literacy experts Ask Me 3 promotes three simple but essential
questions that patients should ask their providers in every health
care interaction. Providers should always encourage their patients
to understand the answers to:
What is my main problem?
What do I need to do?
Why is it important for me to do
Health care providers and patients can visit
for information on the Ask Me 3 program.
Iowa Literacy Resource Center
The Center is operated under grant
authorization from the Iowa Department of Education and is jointly
administered by the
Northeast Iowa Library Service Area [NEILSA], Hawkeye
Community College [HCC], Northeast Iowa Community College [NICC],
Waterloo Public Library [WPL]
where the main collection is located. The Center
provides a link to resource materials in Iowa and at a regional and
national level for adult literacy practitioners and students. These
resources are available in many formats; including print, audio,
video and online. The Center operates a toll-free
literacy support telephone line providing referral to appropriate
resource and persons involved in community literacy programs.
1-800-772-2023. For more information, visit there
Annual New Readers Of Iowa
Conference is held each year to bring together health care
professionals, educators, and new readers. This Coalition
Conference is a learning opportunity for all who attend. For more
information visit the Iowa Literacy Resource Center website above.
Health Literacy Information
literacy is the ability to
read, understand, and act on health information. This widespread but
hidden health challenge is both a warning and a call to action.
Understanding health information is everyone’s right; improving
clear health communication is everyone’s responsibility.
million Americans—39% of adults in the U.S.—are limited in their
ability to read and understand health information.
38% of adult
Iowans read below high school level.
Health information can be confusing for
anyone. Clear health communication is an important part of a
patient’s ability to understand and act on health information.
This can include following instructions after a physician visit,
managing a chronic illness, or taking medications properly. For
health care providers, clear health communication guides which
words are used, how directions are given, and what materials are
presented when communicating with patients
literacy is one of the least recognized yet most widespread
challenges to achieving better health outcomes and lowering health
care costs in the United States.
The 2004 Institute of
Medicine Report, Health Literacy: A Prescription to End
Confusion, found that health literacy “…is
fundamental to quality care…” and relates to three of the six aims
in the Quality Chasm report: safety, patient-centered care,
and equitable treatment.
In Priority Areas
for National Action: Transforming Health Care Quality, the IOM
identified self-management and health literacy as cross-cutting
priorities for improving health care quality and disease prevention
in the U.S.
The 2007 Joint
Commission report, “What Did the Doctor Say?:” Improving Health
Literacy to Protect Patient Safety, reported that health
literacy issues and ineffective communications place patients at
greater risk of preventable adverse events, and that among the key
systems for which leaders of health care organizations must provide
stewardship is communications. It recommended the following:
communications an organizational priority to protect the safety of
communication needs across the continuum of care.
Pursue policy changes
that promote improved practitioner-patient communications.
involves more than a measurement of reading skills. It also relates
to listening, speaking, and conceptual knowledge. Low health
literacy can affect any population segment, regardless of
age, race, education or income. It can affect anyone, in the
context of illness, worry, pain, fear, anxiety, medications,
unfamiliar settings, or preoccupation with other concerns.
Those with limited
health literacy cannot:
Circle the date of a medical
appointment on a hospital appointment slip.
Identify how often a person should
have a specified medical test, based on information in a clearly
Identify what it is permissible to
drink before a medical test, based on a set of short instructions
Explain why it is difficult for
people to know if they have a specific chronic medical condition,
based on information in a one-page article about the medical
Give two reasons a person with no
symptoms of a specific disease should be tested for the disease,
based on information in a clearly written pamphlet.
Low health literacy
affects everyone, but some more than others.
Almost one-third of adults over
the age of 65 have very poor health literacy skills. Only 10.4
million seniors nationwide can perform the most simple and
concrete literacy skills. Adults who receive Medicare or
Medicaid, and those with no insurance, have lower than average
Among Hispanic adults, 41% have
poor health literacy skills, and among Black adults, 24% have poor
health literacy skills.
Adults with low health
Are less likely to comply with
prescribed treatment and self-care regimens
Make more medication or treatment
Fail to seek preventive care
Are at higher risk for
hospitalization than people with adequate literacy skills
Remain in hospital nearly 2 days longer
the skills needed to navigate the health care system.
Estimates by the
Georgetown University Center on an Aging Society indicate that
additional health care expenditures due to low health literacy
skills are about $73 billion in 1998 health care dollars.
Strategies can be used to improve
patients and families:
Encourage all patients to maintain
an accurate MedCard, and use the MedCard as a tool to talk with
patients about appropriate medication use.
Create a welcoming, supportive
environment that offers help proactively and encourages questions.
Ensure all staff can recognize signs
that patients may not understand or not read well--red flags for
low health literacy--and respond appropriately.
Ensure all staff--including
physicians and those not involved in direct patient care—are aware
of health literacy, its prevalence, the adverse health impact of
low health literacy, and strategies to address it.
Help patients remember instructions
with the “teach-back” method— asking them to repeat in their own
words what they need to do when they leave. This allows providers
to check patients' understanding of their health instructions.
Use Plain Language principles in
interpersonal and written communications
2. Use everyday words and analogies.
3. Limit information to the 2-3 most important concepts.
Use visual aids and illustrations
Use principles for reader-friendly print materials for all materials
intended for use by patients, including forms and signs.
Check reading level (ideal 5th-6th grade)
Show or draw simple pictures
Focus only on key points
Emphasize what the patient should do
Minimize information about anatomy & physiology
Simple words (1-2 syllables)
Short sentences (4-6 words)
Short paragraphs (2-3 sentences)
No medical jargon
Headings and bullets
Lots of white space
Highlight or circle key information
Simplify & avoid duplicative paperwork
Offer to read aloud & explain
HRSA's health literacy activities assist the Agency in accomplishing
its mission: to improve and expand access to quality health care for
all. HRSA's health care delivery sites, along with training and
education programs, work to reach out to those with low health
literacy skills to improve their quality of life.
Building a Health Literacy Curriculum
The University Of Virginia School Of Medicine has developed a Health
Literacy Curriculum. The guidelines include basic lectures and tools
to use in teaching the important skills of recognizing which
patients are unable to understand their medical needs and how to
help those patients reach that understanding.
Harvard School of Public Health Department of Health and Social
Behavior Health Literacy Studies
A research program of the National Center for the Study of Adult
Learning and Literacy.
HEALTH - University of Cincinnati
Located in the Area Health Education Center Program of the
University of Cincinnati. Robert E. Burket, Executive Director of
Health Learning Resource Center at the University of (HEALTH-UC)
compiled a list of the Center's health literacy materials. An
institution's library or health education coordinator can borrow
Literacy (CBM 2000-1)
National Library of Medicine: Current Bibliographies in Medicine
An annotated bibliography of print and Web-based health materials
for use with limited-literacy adults.
Health Literacy Month
Join with health literacy advocates around the world to promote the
need for understandable health information. Health Literacy Month is
a grassroots campaign. This means that individuals, organizations,
and communities can participate in whatever ways make sense for
Resources and Services Administration: Office of Minority Health
Study on Measuring Cultural Competence in Health Care Delivery
Settings: This study includes information on the cultural factors
affect the consumer-provider communication.
Medicine (IOM) Report: Priority Areas for National Action:
Transforming Health Care Quality
This report identifies 20 priority areas for quality improvement.
Two areas are identified as cross-cutting -care coordination and
self management/ health literacy- because these areas cut across
specific conditions and would benefit many patients.
Institute of Medicine (IOM) Health Literacy Study
"Health Literacy: A Prescription to End Confusion". Recommendations
to address the problem of health literacy within a public
health/public education framework
Everyone Participate (LEP.gov)
Promotes a positive and cooperative understanding of the importance
of language access to federal programs and federally assisted
Medical Association (NMA)
Focuses primarily on health issues related to African Americans and
medically underserved populations, however its principles, goals,
initiatives and philosophy encompasses all ethnic groups. Resource:
NMA Cultural Competence Primer
Partnership for Clear Health Communication
A coalition of national organizations that are working together to
promote awareness and solutions around the issue of low health
literacy and its effect on health. Site includes a patient education
program: Ask Me 3.
Language Action & Information Network
A government-wide group of volunteers working to improve
communications from the federal government to the public.
Strategies to Improve Communication Between
Pharmacists and Patients:
This AHRQ training program is designed
to introduce pharmacists to the problem of low health literacy in
patient populations and to identify the implications of this problem
for the delivery of health care services. The program also explains
techniques that pharmacy staff members can use to improve
communication with patients who may have limited health literacy
American Medical Association Foundation
Helping Your Patients Understand: health literacy toolkits, news and
The El Paso
Collaborative Health Literacy Curriculum
This curriculum includes lessons developed to meet the educational
and health needs of students attending El Paso Community
College/Community Education Program.
Lessons can serve as a guide and may be replicable in entirety in
certain communities. Note ideas for collaboration and online
resources on this site.
Institute for Healthcare Advancement
This California non-for profit, has published a "What to Do for
Health Series". The series is a set of books written at the 3rd-5th
grade reading level for pregnant women, parents, seniors and
caregivers. There is a link to a fact sheet on Research-Supported
Solutions under "Research Shows What to do for Health Series Works".
Assessment of Adult Literacy (NAAL)
These surveys are nationally representative and continuing
assessment of English language literacy skills of American adults.
Institute for Literacy (NIFL)
A federal organization that shares information about literacy and
supports the development of high-quality literacy services so all
Americans can develop essential basic skills.
Guide to Quality and Culture
A web resource designed to assist health care professionals in
providing quality culturally and linguistically appropriate services
to multicultural populations.
The State Official's Guide to Health Literacy
Reports the results of a 2002 national survey conducted to find out
what states are doing to improve health literacy or to make the
health care system easier to navigate. The Guide provides an
understanding of the problem, what can be done to improve health
literacy and access to health care.
New in Health Literacy Consulting
Consulting helps organizations communicate health information in
ways that people can understand. Resources available include
articles, free newsletters, and consulting options.