Tackling eHealth Literacy

As I waited in the exam room on a recent visit to my doctor’s office, I noticed there was a large wall display with an interactive screen. It resembled a smartphone and I could use the touchscreen to scroll and learn about various conditions, diabetes, heart disease, Alzheimer’s, and colon health. Each menu included signs and symptoms of illness, and information on diagnosis, treatment, and prognosis. The designs were bright, jargon was kept to a minimum and defined when used, and navigating was simple for routine smartphone users. The display also included short videos supporting the on-screen text.

“Great!” I thought, “But what about patients who don’t have strong English skills or those who don’t feel confident engaging with the display? How do they get the information if they don’t directly ask for it?”

As a health communication specialist in CDC’s health literacy program, my job requires me to think about answers to those questions. Findings from the 2003 National Assessment of Adult Literacy suggest limited health literacy is a problem for many people and an issue that public health and health care professionals can take action to improve.

Understanding eHealth

These days it seems like everyone has a smartphone. Health services are increasingly being delivered through web-based and mobile resources. Examples of electronic health (eHealth) services include electronic communication between patients and providers, electronic medical records, patient portals, and personal health records. Mobile health (mHealth), a subcategory of eHealth, includes using tablets and phones to access apps and wearable tracking devices.

As these technical advancements increase so do the demands on a person’s health literacy. As a result, people with limited health literacy may have more challenges accessing health information. It is important to understand how a person’s level of health literacy can influence use. Equally important is how health professionals and communication specialists can provide support for those who may have difficulty using eHealth systems.

Learning from research

We recently posted a research summary called eHealth literacy: Playing catch-up with eHealth on CDC’s Health Literacy website. There are a few important lessons from these studies, including

• A growing number of studies are exploring the use of eHealth resources and self-management of chronic conditions.
• Three common characteristics that may limit use of eHealth resources were older age, lower household income level, and limited health literacy.
• Even when research participants reported high confidence in knowing where to go to find health information, they did not report the same level of confidence in assessing the quality of materials or using them to make health-related decisions.

Taking action

As organizations continue to develop and promote use of eHealth resources we must consider how health literacy and eHealth literacy influence how they are being used.

Health professionals can:

• Ask your patient how confident they feel managing their own health
• Identify the knowledge or skill gaps and create a plan with your patient
• Give your patient a recommendation for top sources of health information on the web
• Ask your patient about their preferred and available communication options – in person, email, apps, patient portal
• Be familiar with your organization’s language translation services
• Evaluate your office’s web content

Communication professionals can:

• Use plain language strategies
• Assess readability of all materials
• Use Health Literacy Online recommendations
• Incorporate images and graphics that complement and reinforce text
• Design materials for people with limited English skills
• Consider demographic characteristics when determining the channel and source for different audience segments

People can:

• Ask questions and repeat information when talking to your doctor or nurse to make sure you understand what they are telling you
• Bring all of your medicines, including vitamins and herbal medicine, to your next doctor’s visit to review how to take them
• Let the doctor’s office know if you need an interpreter if you don’t speak or understand English

Lourdes M. Martinez, PhD is a health communication specialist in the Office of the Associate Director for Communication. In her role, Dr. Martinez leads staff training on plain language principles to facilitate understanding and application of clear health communication for web, social and digital media projects, and print materials. She also assists programs across the agency to develop and implement strategic communication plans to advance clear communication practices.

The Communication Research and Evaluation blog series highlights innovative research and evaluation methods used at CDC to improve behavior change campaigns.