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2 The Role of Health Literacy in Primary and Secondary Prevention RADM Penelope Slade-Sawyer, P.T., M.S.W. Deputy Assistant Secretary for Health Office of Disease Prevention and Health Promotion The Office of Disease Prevention and Health Promotion (ODPHP) within the U.S. Department of Health and Human Services (HHS) is the office responsible for coordinating key public health initiatives, including the Dietary Guidelines for Americans, the 2008 Physical Activity Guide - lines for Americans and Healthy People 2010, which is the nation’s set of 10-year health goals. Rear Admiral (RADM) Penny Slade-Sawyer has worked to promote the inclusion of health literacy in Healthy People 2020, as well as within other prevention work within the ODPHP, and across other HHS agencies. While many resources are devoted to create information and recommendations, advantage is not always taken of opportunities to improve health literacy by advancing prevention efforts. One example of such an opportunity, Slade-Sawyer said, is the provi- sion of easy-to-understand actionable health information that addresses people’s health concerns and also takes into account the fact that many health consumers must focus attention on other areas such as jobs and families. The focus of public health professionals needs to shift from tell - ing the public what they ought to do, Slade-Sawyer said, to emphasizing the tangible benefits of prevention now and in the future. The Health Literacy Work Group at HHS has worked to develop a National Action Plan to Improve Health Literacy1 which will provide a blueprint for how health professionals can do a better job of communicating with the public about prevention, and explain benefits clearly and in motivational terms. 1 The National Action Plan to Improve Health Literacy was released in April 2010. 3
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4 PROMOTING HEALTH LITERACY As part of its efforts to carry out this mission, ODPHP has developed Healthfinder.gov, a website that provides vetted, easily accessed informa - tion to the general public. According to Slade-Sawyer, ODPHP has con - ducted research for the past four years on how to better address the health information needs of populations with limited health literacy. Health - finder.gov is one example of ODPHP’s attempts to translate research into information that is easy-to-use for vulnerable populations. Another example is the incorporation of health literacy principles into the 2008 Physical Activity Guidelines, a booklet that describes the types and amounts of physical activity required for health benefits (http:// www.health.gov/paguidelines/). Slade-Sawyer pointed out that by examining the public’s needs and desires it is possible to identify multiple opportunities for the advancement of health literacy. Surveys have shown that individuals want to obtain their health care and prevention informa - tion from their own health care providers, but are not currently given advice they can understand and act on. In order to deliver prevention information that is easy to understand and use, the National Action Plan calls on clinicians and health care providers to make clear communication with patients a fundamental skill and priority. There are additional overlooked opportunities in the education sys- tem to prepare people to be smart consumers of health information and services, Slade-Sawyer said. Currently, about one-third of the American adult population struggles to understand health information because of literacy barriers, while two-thirds struggle with the complexity of the health care system. The National Action Plan calls on the education sys - tem to ensure that children graduate with the health literacy skills that will help them lead healthy adult lives. The National Action Plan also addresses the research opportunities at the intersections of prevention and health literacy by identifying research on factors of health literacy and by evaluating interventions. Health liter- acy, which involves the ability to seek out and interpret health information, is crucial to primary and secondary prevention efforts. The purposes of providing health information to people include helping them to pay atten- tion to recommendations, teaching them about risk factors, and making it more likely that they will obtain appropriate health screenings and take other preventive measures such as getting a flu shot. It is critical to carry out research on which aspects of prevention people pay attention to and on what factors, including health literacy, affect their attention. Research can also reveal the factors that determine how prevention information and services are organized and used. Slade-Sawyer concluded her presentation with an invitation to attend the Health Literacy Annual Research Conference which is held annu-
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5 THE ROLE OF HEALTH LITERACY ally and which in 20092 was cosponsored by the National Institutes of Health and the Agency for Healthcare Research and Quality (AHRQ). She said that the National Action Plan calls for a multi-sector response to improve health literacy, and that everyone will need to work together in a linked and coordinated manner to improve access to accurate and action- able health information and usable health services. By working together, she said, there is potential to improve the health and quality of lives for millions of Americans, she said. 2 The Health Literacy Annual Research Conference was held in 2009 and 2010. At the time of this report, the 2011 conference is scheduled for October.
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