Community-Based Health Literacy Interventions Proceedings of a Workshop (2018) / Chapter Skim
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3 Examples of Community-Based Health Literacy Programs
3 Examples of Community-Based Health Literacy Programs
Pages 15-48
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From page 15... ...
. Marisa New, board member of the Oklahoma Health Equity Network and chair of the Southwest Regional Health Equity Council, and Leslie Gelders, health literacy coordinator at the Oklahoma Department of Libraries, discussed community-based health literacy interventions in Oklahoma and included an example of a program focused on public l ibraries.
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From page 16... ...
HEALTH LITERACY IN PUBLIC LIBRARIES1 The Oklahoma Health Equity Campaign, which launched in 2008 and enhanced its focus on health literacy in 2011, is a grassroots coalition that aims to address the fact that Oklahoma has consistently been at the bottom of national health rankings, said Marisa New. In 2016, the United Health Foundation ranked Oklahoma as the 46th healthiest state, and the 2014 State of the State Health Report Card showed failing grades in the state's mortality rate, prevalence of diabetes, consumption of fresh fruits and vegetables, and physical activity.
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From page 17... ...
The coalition's steering committee decided to forge ahead as a nonprofit organization and has since engaged with the Southwest Regional Health Equity Network, which serves Arkansas, Louisiana, New Mexico, Oklahoma, and Texas. In 2015, this network developed a blueprint for enhancing individual and community health, with the objective of launching a health literacy campaign that would align with the Robert Wood Johnson Foundation's Culture of Health framework and the National Action Plan to Improve Health Literacy, explained New.
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From page 18... ...
Libraries, through their many connections in communities, can help promote health literacy efforts through their networks. Libraries may offer free space for health literacy programs, and they may have access to state or federal funds they can use for health literacy programming, said Gelders.
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From page 19... ...
A family and consumer sciences educator led the project, which had the children work in one of the gardens built between the public library and the county health department. Another project, based in Elk City, Oklahoma, created a virtual Route 66 walk-a-thon, where individuals and teams were challenged to walk the distance between Chicago and Santa Monica, California, and record their virtual journey on a map in the library.
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From page 20... ...
For the past 4 years, the Cover Missouri Coalition has been working with O'Leary and her colleagues on health insurance literacy. This effort has three goals: promoting quality health coverage for every Missourian; improving the health insurance literacy of Missourians; and lowering the rate of uninsured Missourians to 5 percent by the end of 2018.
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From page 21... ...
To enable that effort the Missouri Foundation for Health funded a pilot program to support four communities' knowledge about health and health care in whatever manner those communities wanted that help. The pilot program, said O'Leary, aims to engage the community around health and health insurance through strategies that lower barriers to health, and in doing so, help people make informed choices for their family's health.
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From page 22... ...
NOTE: CC = Community Catalyst; CMC = Cover Missouri Coalition; FH = FleishmanHillard; HSHC = Healthy Schools Healthy Communities; MFH = Missouri Foundation for Health; SCRx = StratCommRx; WashU = Washington University in St. Louis.
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From page 23... ...
access those resources easily, the coalition identified communities in which 16 percent or more of the residents were uninsured and 18 percent or more had incomes below the Federal Poverty Level. Two other selection criteria were that the community included Missouri Foundation for Health priority populations and that there were some preexisting relationships with the community.
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With regard to what Health Literacy Media and the Cover Missouri Coalition provided to the chosen communities, O'Leary listed the following activities: • Met with and interviewed partners in each community to hear their opinions on the health of their community;
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Discussing the key findings from the pilot programs, she said that community members in Hannibal reported a lack of community awareness about existing health resources even among health professionals, a lack of coordination of health and social services resources, and little knowledge about health insurance and the insurance marketplace. They also noted that health care organizations in Hannibal were using unclear materials, such as discharge instructions, and that there was a significant problem with mental health in the community, particularly among teenagers.
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From page 26... ...
"We started with 4 people at the first walk, but by the end we were getting 40 people at every walk" O'Leary said. Other activities involved connecting with the local farmer's market, setting up a health insurance booth to provide the community with information, and providing health insurance literacy training for the Monett school district and EFCO, one of the region's major employers.
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From page 27... ...
"This idea of health literacy is important here," she said in closing. "We want to teach them our words because maybe those words have some power for them, but we do not have to start in that place." HEALTH LITERACY IN HEAD START PROGRAMS5 For the past 27 years, Johnson & Johnson has provided funding to Ariella Herman and her collaborators to bring Head Start directors to the 5 This section is based on the presentation by Ariella Herman, research director at the Johnson & Johnson Health Care Institute and senior lecturer on decisions, operations, and technology management at the University of California, Los Angeles, Anderson School of Management, and the statements are not endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.
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From page 28... ...
In response, she and her collaborators founded the Health Care Institute (HCI) in 2001 with the mission of strengthening the managerial capacity of Head Start agencies so that they can provide health education and prevention programs that attract 80 percent of the families to outreach activities and provide culturally sensitive materials that family members can understand and use to take action to improve the health of their families.
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From page 29... ...
SOURCE: Adapted from a presentation by Ariella Herman at the Community-Based Health Literacy Interventions workshop on July 19, 2017.
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Herman's team has also found that training increases engagement of parents and staff in health decisions. "Working with Head Start communities, where it starts with pregnant moms and goes to parents of children ages 0–5, this is the perfect time to start engag
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FIGURE 3-4 Health Care Institute's five levels of evaluation. SOURCE: As presented by Ariella Herman at the Community-Based Health Literacy Interventions workshop on July 19, 2017.
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From page 32... ...
They also found that while the training focused on common childhood illnesses, many of the programs had adopted the model for a variety of health topics. With regard to sustainability, Herman and her collaborators surveyed 203 Head Start agencies from 50 states and found that 84 percent had sustained the Health Improvement Project activities beyond the initial year and 71 percent continued to provide this training annually without her team's help.
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From page 33... ...
Evaluations of policy change, Herman said, have documented changes at the system level in both Head Start grantees and the Office of Head Start Policies. Health literacy, for example, is now included in new Head Start performance standards released by the Department of Health and Human Services (see Figure 3-8)
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From page 34... ...
34 INPUTS OUTCOMES Multi‐Level Curriculum Short‐term Medium‐term Long‐term NUTRITION NUTRITION • Increased knowledge of • Adoption of o Healthy food choices o Healthy eating behaviors o Consequences of poor o Limited budget and available nutrition resources balance o Selection of affordable and • Adult‐Child synergy leads to STAFF healthy foods behavior change • Improved attitude regarding • Attain appropriate body weight • Decreased risk factors Children Parents healthy eating for nutrition‐related classroom Centered • Awareness of appropriate body health problems and education Education weight chronic diseases • Decreased development of EXERCISE EXERCISE chronic diseases • Increased knowledge of • Adoption of • Maintained healthy CHILDREN Family PARENTS body weight o Importance of physical activity o Appropriate level of routine Centered • Decreased health care o Health consequences of physical activity Education costs inadequate physical activity o Practice of balancing diet o Identifying appropriate level and exercise and types of physical activity o Increase in family physical • Improved attitudes regarding activity physical activity • Adult‐Child synergy leads to • Awareness of appropriate body behavior change weight • Attain appropriate body weight FIGURE 3-5 The Eat Healthy, Stay Active strategic implementation model. SOURCE: Adapted from a presentation by Ariella Herman at the Community-Based Health Literacy Interventions workshop on July 19, 2017.
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NOTE: n = 497. SOURCE: As presented by Ariella Herman at the Community-Based Health Literacy Interventions workshop on July 19, 2017.
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36 FIGURE 3-7 Sample outcomes for children who participated in Eat Healthy, Stay Active pilot training. SOURCE: As presented by Ariella Herman at the Community-Based Health Literacy Interventions workshop on July 19, 2017.
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SOURCE: As presented by Ariella Herman at the Community-Based Health Literacy Interventions workshop on July 19, 2017.
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From page 38... ...
We can help set entire families and communities on a better health trajectory." MODERATED PANEL DISCUSSION6 To start the discussion, Earnestine Willis asked the panelists to elaborate on how they set priorities for action when it comes to addressing the 6 This section is based on the comments by Marisa New, board member of the Okla homa Health Equity Network and chair of the Southwest Regional Health Equity Council; L eslie Gelders, health literacy coordinator at the Oklahoma Department of Libraries; Catina O'Leary, president and chief executive officer of Health Literacy Media; and Ariella Herman, research director at the Johnson & Johnson Health Care Institute and senior lecturer on decisions, operations, and technology management at the University of California, Los Angeles,
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From page 39... ...
"We grew our evaluation method with the feedback from the agencies," she said. Herman added that every Head Start grantee received the survey data Anderson School of Management, and the statements are not endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.
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From page 40... ...
New said that her coalition had just started building its capacity in its communities, which involves building the capacity of individuals who would be willing to volunteer their time to projects that improve health in their community. Within her organization, she had to find champions who would help take information about addressing health equity and administer a survey with the coalition members, and then provide trainings to those organizations.
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From page 41... ...
Her team has presented at literacy conferences and at Oklahoma Health Equity Campaign meetings that are broadcast to most of the state's county health departments. She also provides opportunities for the grantees to receive continuing education in health literacy, including through an annual summit she organizes, and by providing funds for grantees to attend the Wisconsin Health Literacy summit.
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From page 42... ...
She said that although her program's resources were varied enough to satisfy the needs of those programs, the demand today is greater than what they can meet. She said that after about 6 years, Head Start agencies realized that her program exists to help them with their core missions and that the data her program shares with them can make a big difference to their activities.
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From page 43... ...
"I am hoping this will be another big success," said Gelders. New said that the Oklahoma Health Equity Campaign is changing what it is doing as it transitions to being a nonprofit organization.
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From page 44... ...
Her team has also developed a training menu for all of the program's community partners, and all of these trainings have been vetted and approved based on evidence and are available to the community. Her program has measures of satisfaction for some interventions, such as sending the program's public relations partner into communities to teach people how to do an interview with the media about health insurance, but the evidence is "looser." As far as what she does when a community asks for something for which her program does not have an evidence-based solution, O'Leary said that she has 25 smart people who have the skills to find information, put it together in an accessible way using health literacy strategies for the appropriate audience, deliver it to the requesting community, and then solicit the community's feedback.
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From page 45... ...
Willis, who happens to be the chair of a Head Start board, said that many Head Start programs do have partnerships with school districts, and that with new performance standards, she believes there will be more tracking into the secondary school setting. Lindsey Robinson from the American Dental Association thanked O'Leary and Herman for emphasizing oral health in their programs.
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From page 46... ...
Herman commented that her program just completed a survey of Head Start programs and found that the thousand or so responding agencies all reported that they had become the center of information in their neighborhoods and are now going out into the community to give talks and discuss the resources they have. "That is, I believe, the first step toward expanding," said Herman.
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From page 47... ...
EXAMPLES OF COMMUNITY-BASED HEALTH LITERACY PROGRAMS 47 creates with the Head Start grantees. "They know that we are giving them the tools to be able to succeed, but as part of the contract, they know that they need to provide the data that we then analyze and share with them.
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