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Introduction1
The increasingly diverse ethnic composition of the United States population has created a profound and ongoing demographic shift, and public health and health care organizations face many challenges as they move to address and adapt to this change. In addition, said Bernard Rosof, chief executive officer of the Quality in Healthcare Advisory Group, in his introductory remarks to this workshop, the current political climate has created tremendous uncertainty about what the future holds for a strong, vibrant, multicultural United States, making it more difficult and vital to provide needed public health services to everyone living in this country.
To better understand how the public health and health care communities can meet the challenges of serving an increasingly diverse population, the Roundtable on Health Literacy created an ad hoc committee2 to plan and conduct a public workshop on facilitating health communication with immigrant, refugee, and migrant populations through the use of health
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1 This section is based on the presentation by Bernard Rosof, chief executive officer of the Quality in Healthcare Advisory Group, and the statements are not endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.
2 The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop was prepared by the workshop rapporteur as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine, and they should not be construed as reflecting any group consensus.
literate approaches3 (see Box 1-1). The goal of the workshop, explained Rosof, was to identify approaches that will enable organizations that serve these ethnically and culturally diverse populations in a manner that allows all members of these communities to obtain, process, and understand basic health information and the services needed to make appropriate health and personal decisions.
“The wide variety of language and cultures and the lack of understanding of how to effectively use public health and health care services make it imperative that health literacy approaches be used to align health system demands with individual skills, individual abilities, and individual knowledge,” said Rosof. Health literate approaches, he added, will provide linguistically and culturally appropriate materials and services, which in turn will contribute to better care coordination, adherence to care plans, contribute to person and family-centered care, and to achieving the quadruple aim of providing better care, improving the health of the community and the population, making care affordable, and creating joy in practice.
ORGANIZATION OF THE PROCEEDINGS
An independent planning committee organized this workshop in accordance with the procedures of the National Academies of Sciences, Engineering, and Medicine. (See Appendix A for the workshop agenda.) The
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3 Health literate approaches provide culturally and linguistically appropriate information in a manner that facilitates understanding and using that information to make informed health decisions.
planning committee’s members were Gem Daus, Jennifer Dillaha, Alicia Fernandez, Megan Rooney, Bernard Rosof, Umair Shah, Alina Shaw, and Winston Wong. This publication summarizes the workshop’s presentations and discussions, and it highlights important lessons, practical strategies, and opportunities for using the principles of health literacy4 to facilitate health communication with immigrant, refugee, and migrant populations. Chapter 2 recounts a moderated discussion on the challenges immigrant, refugee, and migrant populations in the United States face regarding health and accessing health care, and Chapter 3 continues that discussion with examples of how various organizations are providing care to members of those populations. Chapter 4 considers the interplay between health literacy and outreach efforts in immigrant, refugee, and migrant communities, and Chapter 5 provides some examples of health literacy principles being applied to communication with immigrants, refugees, and migrants. Chapter 6 discusses where future efforts might focus.
In accordance with the policies of the National Academies, the workshop did not attempt to establish any conclusions or recommendations about needs and future directions, focusing instead on issues identified by the speakers and workshop participants. In addition, the organizing committee’s role was limited to planning the workshop. The Proceedings of a Workshop was prepared by the workshop rapporteur as a factual summary of what occurred at the workshop.
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4 The following principles of health literacy, articulated by the Centers for Disease Control and Prevention for use in public health, are also applicable to health care. They include (1) “Ensure public health information and services are appropriate and easy to understand and use; (2) Involve representatives from your target audience in planning, implementing, disseminating, and evaluating health information and services; (3) Develop key partnerships to help facilitate change, influence behavior, and generate interest in health literacy; and (4) Support changes to improve public health professional health literacy skills.” See https://www.cdc.gov/healthliteracy/training/page1619.html (accessed June 5, 2017). Additional discussion can be found in a paper by Parker and Jacobson (2014) at https://nam.edu/perspectives-2014-health-literacy-principles-guidance-for-making-information-understandable-useful-and-navigable (accessed June 5, 2017).
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