Page 97 - Health Literacy, eHealth, and Communication: Putting the Consumer First: Workshop Summary

Health Literacy, eHealth, and Communication: Putting the Consumer First: Workshop Summary

HeALtH LiteRACY, eHeALtH, AnD CoMMUniCAtion

health literacy, one audience member suggested that the behavior side of
the equation is less prominent than it could be. A major goal is to motivate
behavior change that will lead to improved health. However the people
who are experts in behavior modification and behavior change don’t seem
to have played a major role.
Harris responded that, at is core, Healthy People is a stakeholder-
driven effort. The groups organizing it are made up of federal government
people. But there is an important forum for the public and for profession-
als to put forth their ideas about what Healthy People 2020 should look
like. Friedman stated that it is often said in health informatics that the
field is 80 percent about psychology and sociology and 20 percent about
technology. It may be that individuals are attracted to the field because it
is more about people and changing the way they work in a positive way
than it is about software and hardware.
One audience member said that one of the specific objectives in
the health communication goal of Healthy People 2010 was to increase
individuals’ health literacy. The National Assessment of Adult Literacy
(NAAL) instrument was developed as a way of measuring this objective.
Because there was measurement at only one point, however, it is not
possible to determine whether individual health literacy has improved.
Furthermore, the measure is about reading comprehension in a health
context, which is not the same as health literacy. Dave Baker says that
4
health literacy is the interaction or the combination of what the individual
brings to the situation and the demands placed on the individual, both the
print and verbal demands. Much of the discussion and effort surrounding
health literacy has focused on trying to reduce the demands.
Some of the other measures in Healthy People 2010 concern people’s
use of the Internet for health information. There is a graphic of the NAAL
results that displays the amount of information that people get from the
Internet by health literacy level. People with below basic levels of health
literacy had very low rates of using the Internet and people in the profi-
cient category had very high rates. This might be a good measure to use.
IT could be measured again in 5 years to determine if there is an increase
in people with limited literacy using the Internet for health information.
Another audience member asked whether we are accommodating
or skill building. Accommodating is a legitimate strategy, but it needs to
be recognized as such. One must also recognize that the determinants of
health are very broad.
One participant asked how much of the IT conversation addresses

4 David W. Baker wrote The meaning and the measure of health literacy. 2006. Journal of
General internal Medicine: official Journal of the Society for Research and education in Primary
Care internal Medicine 21(8):878-883.

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