Health Literacy 2.0: Integrating Patient Health Literacy Screening with Universal Precautions

Health Literacy in Pediatric Consultations on Allergy Prevention

BACKGROUND

The first 3 years of life offer an opportunity to prevent allergic diseases. Pediatricians are an important source of health information for parents. However, a certain degree of health literacy is necessary to understand, appraise, and apply preventive behavior, which can be supported by health literacy (HL) sensitive consultations and a HL friendly environment.

OBJECTIVE

In this study, we want to shed light on how pediatricians in outpatient care in Germany advise on early childhood allergy prevention (ECAP) and how they consider parental HL.

METHODS

We conducted 19 semi-standardized telephone interviews with pediatricians from North-Rhine-Westphalia and Bavaria. The interviews were audio-recorded, transcribed, pseudonymized, and subjected to content analysis.

KEY RESULTS

Current ECAP recommendations were well known among our sample. Despite the shift of evidence from avoidance of allergens toward early exposure, providing advice on ECAP was considered non-controversial and it was widely assumed that recommendations were easy to understand and apply for parents. However, ECAP was treated as an implicit topic resonating among others like infant nutrition and hygiene. Regarding HL, our interview partners were not aware of HL as a concept. However, they deemed it necessary to somehow assess parental information level and ability to understand provided information. Formal HL screening was not applied, but implicit strategies based on intuition and experience. Concerning effective HL-sensitive communication techniques, interviewees named the adaptation of language and visual support of explanations. More advanced techniques like Teach Back were considered too time-consuming. Medical assistants were considered important in providing an HL-sensitive environment. Time constraints and the high amount of information were considered major barriers regarding HL-sensitive ECAP counseling.

CONCLUSION

It seems warranted to enhance professional education and training for pediatricians in HL and HL-sensitive communication, to reach all parents with HL-sensitive ECAP counseling. [HLRP: Health Literacy Research and Practice. 2024;8(2):e47-e61.].

Roles of Health Literacy in Relation to Social Determinants of Health and Recommendations for Informatics-Based Interventions: Systematic Review

BACKGROUND

Health literacy (HL) is the ability to make informed decisions using health information. As health data and information availability increase due to online clinic notes and patient portals, it is important to understand how HL relates to social determinants of health (SDoH) and the place of informatics in mitigating disparities.

OBJECTIVE

This systematic literature review aims to examine the role of HL in interactions with SDoH and to identify feasible HL-based interventions that address low patient understanding of health information to improve clinic note-sharing efficacy.

METHODS

The review examined 2 databases, Scopus and PubMed, for English-language articles relating to HL and SDoH. We conducted a quantitative analysis of study characteristics and qualitative synthesis to determine the roles of HL and interventions.

RESULTS

The results (n=43) were analyzed quantitatively and qualitatively for study characteristics, the role of HL, and interventions. Most articles (n=23) noted that HL was a result of SDoH, but other articles noted that it could also be a mediator for SdoH (n=6) or a modifiable SdoH (n=14) itself.

CONCLUSIONS

The multivariable nature of HL indicates that it could form the basis for many interventions to combat low patient understandability, including 4 interventions using informatics-based solutions. HL is a crucial, multidimensional skill in supporting patient understanding of health materials. Designing interventions aimed at improving HL or addressing poor HL in patients can help increase comprehension of health information, including the information contained in clinic notes shared with patients.