Health Literacy Heroes Answer The Call

In honor of August’s Health Literacy Month, you were asked to celebrate those around you who champion health literacy for patients, parents and our communities.

Based upon the nominations received, it’s as evident as the Bat-signal on a Gotham City night that there are many heroes here who enrich the knowledge of those we serve.

Take a moment to read more about why these individuals deserve to carry the mantle of Health Literacy Hero!

1. Breanna works closely with me on many projects. There are moments when she will take something that I have written or a presentation I have developed and point out all the ways that my language exceeds our target reading level. She does this with the copy that physicians write for us, too. She will carefully comb through the copy text and suggest revisions. Breanna keeps a copy of the Children’s Writer’s Word Book on her desk and uses Health Literacy Advisor routinely. Breanna is great at using plain language to sensitively and clearly communicate.
2. Breanna understands that health literacy is more than “just” the reading level we use. She knows that when it comes to health literacy, representing multiple cultures is equally important. Breanna consistently makes sure our content is easy to understand for vast array of people. She is quick to help us ask questions about the materials we develop: Will this be helpful for those who struggle with literacy?/Is there an audio/visual option? Will communities of color find this helpful and is it sensitive to their cultures? Are we using examples and stories from our communities along with evidence-based research available?

I would like to nominate Kathy Roden, RN, in the ED, as a Health Literacy Hero.

She always makes sure to simplify information for our families in the ED at discharge. She uses “teach back” to make sure she taught clearly and the family can follow-up correctly. She encourages family members to ask all questions. She uses an interpreter for every single encounter with families who speak another language to make sure there is not missing or misinterpreted information.

The Leadership Team of the Center for Children’s Health would like to nominate our entire 41-person team as Health Literacy Heroes. Our work centers on the communities in our six-county service area, the families with children and a multitude of partnerships that provide support to them.

We are so proud of the work that each employee in our department does to relay children’s health information in plain language. All of our employees are front-line advocates for preventative health, a medical and dental home, and asking questions for understanding. Here are some examples of how we promote health literacy on a regular basis:

Employees who work directly with families: (Healthy Homes, Save a Smile, Safe Kids North Texas, Build-a-Bridge):

• Provide individualized communication to each family they serve.
• Break down the information into clear, concise bits using terms familiar to the family.
• Use the “teach-back” method, to identify comprehension.

These employees have become such a trusted resource to families. The families relied heavily upon our team to navigate through the COVID environment. Our staff have been able to help address food insecurity, financial hardships, technology support for remote learning, school supplies, emergency appointments, as well as access to other vital resources.

Create health literate collaterals and review them annually:

• Aim for a 4^th-6^th grade reading level.
• Short, simple words.
• Use of the Children’s Writer’s Word Book and Health Literacy Advisor.
• Short sentences of 15 words or less.
• Use of bullets.
• Active voice.
• Repetition of key messages.
• Reference reputable websites/outside organizations for more information.
• Review new collaterals with members from other teams, who are not as familiar with the program and are able to point out gaps in communication.

Create culturally literate materials, approachable to a broad audience posing these questions:

• Will this be helpful for those who struggle with literacy?
• Is there an audio/visual option?
• Will communities of color find this helpful because of the representation they see?
• Are we using examples and stories from the communities we serve in conjunction with the evidence-based research available?

Create / Update Curriculum

• Age-appropriate.
• Easy instructions for teachers – good flow.
• Hands-on activities that reinforce the learning, role play or personal share outs.
• Discussion questions.
• Low or no-cost options.

Review consents and continue to make those as health literate as possible with the help of our fantastic Cook Children’s Legal Team.

Actively increase the health literacy of our community partners in our six-county service area.

• Have provided a webinar for Cook-led coalition members on Health Literacy basics
• Highlight the health literacy best practices used for the collateral and educational components developed
• Integrate health literacy best practices when communicating with members (email, phone, meetings)

With COVID, we have had to rely on many more digital surveys as part of taking our programming into the virtual world. We look at that process through a health literate lens not only for the language we are using, but also the usability factor.

• Is the survey absolutely needed (knowledge of survey fatigue)
• Keep the number of questions to a minimum
• Little to no fill in the blank questions
• Easy to read and fill out on a mobile phone

Examples of some specific projects:

• The Community-wide Children’s Health Assessment and Planning Survey, a major element of Cook Children’s Community Health Needs Assessment.
  • Reduced the questions from a little more than 100 questions to 56.
  • Developed a more visually appealing survey that easily moves from section to section.
• Created the video series “What’s Driving Your Decision” to provide community facing COVID-19 vaccine information. Scripted it specifically with health literacy in mind, asking our clinical presenters to use plain language as a guide.
• A gun safety “ages and stages” brochure was developed to help parents understand the value of safe storage throughout all the developmental stages of a child and into their teenage years.
• The development of oral health education kit, provided to elementary school teachers since we were unable to go into the schools ourselves. A video/book was provided, along with demonstration tools to reinforce the learning. Oral Health Kits containing a toothbrush, toothpaste, brushing calendar, stickers and more were provided for every child in the class.

Thank you for considering this department-wide nomination. We just couldn’t settle on one or two of our colleagues because everyone has been working hard to provide children’s health information to address all the needs we have across the region.

Terri Ford

Manager, Child Health Evaluation

Center for Children’s Health

On behalf of Marilyn Nappier, Courtney Barnard, Tonya Fuqua, D.D.S, Lenee Bassham and Becki Hale.