Digital Literacy, Health Literacy, and Tools Developed for Program Implementation

hello and welcome to digital literacy health literacy and tools developed for program implementation event one in our four part webinar series on tips and tools for closing the digital divide my name is brittany thomas associate director of the network of the national library of medicine all of us community engagement center and i will be your host for today’s event over the next four days the network of the national library of medicine is proud to be partnering with wisconsin health literacy the black greek letter consortium stem queens latino academy of workforce development milwaukee public library lgbtq plus detroit generations online and the american association of health and disabilities to offer this webinar series to learn about health literacy insights best practices and available tools designed for meaningful and effective engagement with diverse populations before i introduce today’s speakers i’d like to review a few housekeeping items this event is being offered through zoom webinar youtube live and facebook live captioning is available if you’re watching this in zoom webinar you may access captioning in english and in spanish via the links that are available to you in the chat in youtube you can turn on captions in english by clicking the cc button at the bottom of the video to turn on captioning in english on facebook select the down arrow in the upper right corner of the page select settings and privacy then select settings then scroll down to the bottom of the left column and select videos finally select the drop down box next to always show captions and choose on please message us through your platform’s chat box if you need assistance finding captioning or if you have any other technical issues we are also recording this presentation with closed captioning and are posting the recording on nnlm’s youtube channel we will send out a recording of the panel to all event registrants within one week although you are muted your participation is important for today’s learning outcomes throughout the event please use the chat box to post questions and comments our presenters will respond to as many questions as possible during our time together finally at the close of today’s program you will be redirected to our online survey please take a few moments to share your feedback for our nnlm members interested in medical library association continuing education or consumer health information specialization you must first complete the online survey before receiving instructions for how to obtain credit for your participation the world health organization defines digital health literacy as the ability to seek find understand and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem now more than ever the ability to navigate online resources is crucial according to the pew research center 35 of us adults have gone online to figure out a medical condition in that the internet is a de facto second opinion and even the first opinion for many people according to the world health organization 575 million results are returned by google when searching for cancer and 250 million when we’re searching for diabetes that is an overwhelming amount of information as people rely on technology for health information and health care systems shipped to telehealth it’s important that everyone has the ability to access understand and use these resources closing the digital divide can also increase diverse participation in biomedical research like the national institutes of health all of us research program nnlm and all of us have teamed up with wisconsin health literacy to provide resources to communities that address health disparities the digital divide creates during this four-part webinar series diverse community partners who work with or represent communities that are historically underrepresented in biomedical research will define health literacy and describe the relationship between literacy and social determinants of health they will identify the importance of digital health literacy in making informed health decisions they will share culturally humble best practices to effectively and meaningfully communicate with diverse populations to improve health literacy and they will discuss how to use the free and accessible interactive videos and guides developed by wisconsin health literacy to support the development of digital health information skills in your community now with great pleasure please allow me to introduce you to tay’s presenters caitlin moet is the project manager at wisconsin health literacy caitlin holds a bachelor’s degree in marketing from the university of wisconsin-la crosse and has nine years of experience in non-profit organizations including work in health literacy healthcare communications and community relations at wisconsin health literacy caitlin focuses on managing grant funded projects on safe medication use opioid pain medication health insurance and digital health literacy throughout the state of wisconsin stan hudson is the health literacy director for wisconsin literacy stan is a health literacy expert and health policy analyst with almost 25 years of experience in health services research and over 15 years of experience in health literacy and curriculum development stan earned an m.a in sociology from the university of missouri with a focus on race class and gender inequalities and earned bas history political science and sociology from columbia college over the last two decades stan has led the development and implementation of health literacy and health justice education programs and curricula for health professionals in training and in practice caitlin and stan thank you so much for joining us i will now pass it over to you [Music] thank you brittany so welcome to this presentation of health and digital literacy tools to assist in the all of us program implementation i am stan hudson from wisconsin health literacy and with my colleague caitlin moab today we are going to provide an overview of digital and health literacy resources that you can use as you recruit community members we will be uh covering several topics from health and digital literacy using plain language and enhancing people’s ability to find reliable health information online and other tools that you may find beneficial at the end of the program you will be able to identify the importance of health literacy as it relates to digital literacy and finding reliable health information online and apply new digital literacy techniques to your practice and community programming and so um we’re going to go into more about medical terminology and next slide please richard and so we’re going to talk a little bit about plain language and so as you think about medical terminology and how a health professional or a doctor might talk about bones in this case prevents osteoporosis or osteoporosis what uh what might be some plain language choices you know it could be you know prevents bones from decaying or as we have here um keeps bones strong and so you know prevents and decaying are not the simplest words so they’re probably not the best words a simple word for prevent would be stop and a simple word for decaying would be bad so you could plain language uh prevents bones from decaying to be like stops bones from going bad but you might have more words used to explain things in plain language but as long as you get the message clear and easy to understand that that is the most important a lot of times we use a lot of jargon in in medicine and health and so making that easier for folks to grasp and using everyday common language is a great strategy so next slide please so here are some words some more words and statements to think about many of these are are used in everyday conversation and emails and so you can see that we can always find i think easier words another thing especially in medical jargon to pay attention to is that we use words a little differently in medicine for it for example you know we admit people to the hospital but that is not the most common way that the word admit is used in everyday language and so that’s another thing to consider is that people may be coming in with their common everyday understandings of these words and yet we use them a little differently so next slide please richard but it is just more than plain language and so i’m going to show a video and this video is from the american medical association and it gives a good overview of what it is like for patients experiencing times of low health literacy i i was sick a lot i was sick a lot because i probably missed dosage and didn’t realize it i was in the hospital a lot when they did give me medicine i didn’t take it right i admit to it i just didn’t understand them and i didn’t have the nerve to ask them the right way of doing it i just didn’t have the nerve to ask them and i didn’t want anyone to know i couldn’t read i can’t read this well i guess the doctor gave it to me so it’s okay for me to take it when your children have fever what do you usually give them motrin or tyler normally motrin because that’s what my doctor recommended how old is your daughter she is four she’s four okay i would um give her the um four to five a tablespoon and a half one caps one capsule that’s right one capsule one capsule i don’t know this is that twice twice twice daily okay so what so how would you take this when i see it’s not only telling you how to take it say take it twice daily but it don’t say what time to take it do you know what hypertension means if i asked you what that was because when i look at this i think well maybe you have hypertension and i’ve been taking care of that for a long time hypered hyper like you’re hyper what does being hyper mean to you that’s that’s um where you can’t be steel you always got to be doing something do you think i think you’re hyper and have hypertension yeah i don’t know that’s what i consider it okay being you know okay but you know you have high blood pressure okay but hypertension doesn’t mean the same to you so if i ask you if you have hypertension you’re going to just think i think you’re jumping around on the chair or something like that something different just being hyper you know okay all right well i haven’t done a very good job teaching you what hypertension is because i think you take that medicine for your hypertension and that’s one of the things that i try to work with you on is your blood pressure and high blood pressure and hypertension to us it’s the same thing the same thing yeah i have a small breakfast and then i take my pills i usually take 16 every morning sometimes it’s difficult to um for me to take these pills because if they say one tablet twice daily um i don’t know if they’re talking take one in the morning one in the evening or take one in the afternoon or one in the evening so usually what i do is take two of them in the morning then this way i know i have them if you have a reading problem you go to the doctor that can be very scary it’s like a nightmare you walk in that office and um mostly if you realize first thing you’re gonna have to do if that’s your first visit is fill out a form your heart beat real fast you’re scared you don’t know what to do you want to turn around and walk out i have at approximately 30 or 31 i went into the gynecologist and complained about part of this not working correctly and he said we can repair that great i didn’t ask all the right questions when i showed up two weeks later at the admissions office at the hospital they put enough papers in front of me i’ll bet there were five papers that i needed to sign well i wasn’t going to say excuse me but i don’t read really well and i certainly don’t read fast and i’m concerned with some of these words to me it was lines and circles over sheets and sheets and sheets and i wasn’t going to reveal my sense of stupidity so i signed everywhere they told me to sign never read it and then a couple weeks later in the follow-up office visit the nurse said how are you feeling since your hysterectomy now i acted as normal as i could inside my mouth fell open and i thought to myself how could i be so stupid as to allow somebody to take part in my body and i didn’t know it so that video shares experiences from people with very diverse backgrounds and professions and reading levels yet there were similarities in the way they talked about their health experiences as being confusing unsure and stupid and as far as whenever i watch that video and and i’m you know i have a master’s degree i’ve worked in the healthcare setting now for over 25 years i still can relate to a lot of those stories of struggling with some of those same health literacy challenges and trying to get my health needs met and so think about this what are some things that you’ve noticed that would suggest community members may have a difficult time understanding how to navigate digital literacy skills to even sign up for the all of us program next slide please richard so health literacy is really kind of a delicate balance between two sides it’s between the skills that people have and the demands and expectations we place on individuals to understand information and manage their health unfortunately we do not teach health literacy skills like we do reading writing and math in elementary and secondary education this means that most people are learning their personal health literacy skills on the fly when they’re sick in pain or worried about a loved one or family member and as you know that is not the best way to learn new things and new skills so we must think more carefully about that second definition of organizational health literacy and even though you may not be in that in the health industry so to speak you know thinking about how we can translate that so that people can actually access and be able to participate in the all of us program next slide and so health literacy really means you know that a person is able to understand various different things whether that’s just basically understanding your appointment slip so you make it to your appointment on time instructions on prescription label bottles as we saw in that video that can be quite challenging for folks especially when those are just take two pills twice a day which leaves it up to interpretation as to what specific times to take it um and really just understanding what the doctor may have said to them so why they may need to take that medication and how they need to take that medication and so these are all challenges that we face every day and and even in a certain context some of us who are highly educated and uh can navigate healthcare normally might not be able and also have these lower health literacy skills and so we talk about instead of trying to figure out what a person’s health literacy skills are because those can change depending on the circumstances of the context i’m really taking more of what we call a universal precautions approach to health literacy and understanding that at any time we communicate with someone there is a risk of misunderstanding and we need to do a few things to make it a lot easier and i i’ll cover those few things in in just a few minutes next slide please and so we’re going to talk a little bit more and and caitlin will for sure go into more about finding and understanding information online because that’s an overwhelming challenge these days as most of us with the pandemic have moved to trying to find some of this stuff online it can be a real challenge next slide and so as we think about what we do in those situations when you want to find either be as simple as a healthy recipe or you see your child has a new rash and want to find out what it could be or you need to find a new health insurance plan and shop through either a portal with your employer or one of the portals on the exchanges and things like that research shows that more questions like these are being searched online our world is shifting to more virtual and relying on the internet especially with the pandemic forcing us to stay in our homes and not being able to approach our health communities as much as we would like but according to the pew research center there are over 1 billion health related searches done on google every day so a lot of people are really turning online to try to find those answers even those working in healthcare use online resources to help answer questions you may notice this next time you’re at a doctor’s appointment it’s like so the new norm is looking online for advice information and even having conversations our hearsay is becoming what we hear and do online the latest findings from that 2013 pew study conducted showed that 81 of us adults use the internet in addition 59 percent of adults look up health remain information online with 39 of those uh searches were for someone else so we’re looking online for other folks as well pew research recently reported that just over half of u.s adults about 53 said the internet has been essential for them personally during the pandemics so we can see that even more folks are really relying on that right now next slide and so according that’s and that’s that one sorry so this is an opportunity in a challenge for us to make sure we can get more folks using the internet to support their health decisions because it’s only 53 that means 47 percent of folks we still need to get connected and and using these resources next slide and one of the challenges is the amount of print materials is decreasing and the amount of information found online is increasing whether that’s through patient portals or other mechanisms especially with the pandemic many health systems have really started to try to push out information more electronically than in the paper copies and so this is important because those fifty percent of health searches have an impact on someone’s health today people are given a more active role in their health there is an emphasis on patient-centered care where the patient is involved more in the decision-making process doctors used to be the ones who had control of the information they had access to the journals and the textbooks and this information was not easily available to patients now patients have access to health information because the information is available on the internet and patients can quickly look up their personal health information hopefully through health portals and accounts that are reliable but then also there’s a lot of misinformation too as we have seen with the pandemic out flying around on social media and other sources next slide however there is a digital divide we know that about 4 out of every 10 us adults and 6 out of every 10 older adults have low health literacy and those with low literacy are less likely to use online resources a study from the national association of adult literacy reported adults with the most limited health literacy rarely use digital resources for health information when you compare low literacy to those who were labeled or who tested at proficient health literacy levels only 15 of adults with below basic health literacy use the internet some or a lot of the time for information on health topics compared to 62 percent of those with proficient health literacy so low literacy learners report having difficulty finding reliable health information online navigating and even reading web pages and accessing the internet next slide so we’re going to review a tool that was used to track a person’s eyes as they navigate a website this is called usability testing the images show two different eye tracking situations comparing someone with limited digital literacy to someone with proficient digital literacy can you guess which one is which just by looking the computer user on the left has proficient digital literacy the lines and numbers show the user can easily navigate the website and has a consistent flow from left to right top to bottom the computer user on the right has limited digital literacy the lines and numbers show the user re-read many of the words and sentences and had a difficult time following the flow of the web page next slide and so we’re going to talk a little bit about plain language and communication techniques next slide and so what can you do to help folks use online resources these are four of our digital and health literacy strategies you can apply to your practice and these are what i would call the universal precautions that you can use so don’t assume the unknown and apply these universal cautions this refers to taking specific actions that minimize that risk of miscommunication for everyone when it is unclear who might be affected for example health care workers take universal precautions when they minimize the risk of infection by using gloves washing hands and proper disposal techniques health literacy universal precautions are needed because providers don’t always know which patients have limited health literacy nor do we always have the time to really try to check that so this concept can be applied to someone that is coming into your library or into your program to use online resources for health information people might not know how to log into a computer how to navigate a browser how to sign up for an email account or even know what a browser or email account is so apply these plain language concepts discussed early in this section and use simple words and focus on three key messages for people to understand speak clearly and at a moderate pace slow down when speaking and showing people how to navigate the internet a person is likely to only remember a few new points of information at one time and repetition helps with remembering so chunk that information down and you may have to cover it several times before that person understands and you can also use what we call teach back in your practice teach back is a way to verify understanding so instead of asking what questions do you have or do you understand which gives you a yes or no answer which really doesn’t tell you much you can have people repeat in their own words what you just discussed in a non-shaming way so you know i know we just talked about several things i want to make sure i did a good job of explaining things can you just tell me back a little bit of what you understood that we talked about and so it’s not a test of the person but of how well i explain the concept and so it can be a really great tool because then you understand not only what the person understood but how they understood it and it gives you a chance to correct any of those potential miscommunications and misunderstandings next slide and so to compare most newspapers are generally written at a sixth grade level progress is being made to rewrite health information brochures pamphlets consent forms etc at more readable levels but it’s still a challenge and and many health systems are not quite there yet and and there are tools to assess readability however they’re still imperfect and much work needs to be done so we can get to those levels because we we have to remember that the average american reads at about a of six to seventh grade level but they comprehend generally one to two reading levels below so we’re talking the average american comprehends at a fourth to sixth grade level next slide and so one thing is especially today with uh being here with the nnlm is libraries and librarians contribute a lot of strengths to help us advance the culture of health and digital literacy and in enhance accessibility and trustworthiness and so you know one is we don’t we can’t assume access is available for everyone and we can’t assume that everyone knows how to use a computer and libraries are one of the best resources for community members who don’t have access to the internet to come and use the wi-fi that is available there as well as use the instruction from the librarians on how to access these systems that they need to to find that information for themselves or even to sign up for the all of us program and so i’m going to turn it over to caitlin now so she can talk more about digital health clitoris great thank you stan and thank you for giving us that background on digital health literacy it’s going to be important to keep those principles in mind as we cover the rest of today’s discussion and learn about the programming that has been developed and implemented by your team at wisconsin health literacy the national network of libraries and medicine and the all of us research program next slide please stan mentioned earlier the amount of health information found online is increasing with our work revolving around breaking down barriers of miscommunication and misinformation we realize the need for addressing digital health literacy and create curriculum for diverse communities the first program i want to introduce you to is health online finding information you can trust this has been the backbone of most of the digital literacy resources we’re going to share today next slide to help in the development of materials the program was piloted and created based on participation in the communities we partner with through literacy member participation including low literacy learners aging and disability resource centers refugee and immigrant communities indigenous communities and communities of color we ask learners why they go online to look up health information what they want to find and what barriers they have with accessing health information online from surveys sent to adult literacy programs we found that learners want to find health information and symptoms resources to stay healthy and information in other languages we also learned that the learners want help scanning the website’s relevancy so it goes back to the eye tracking slide that stan had talked about and help with reading a web page next slide please a focus group was conducted by wisconsin health literacy and medical students volunteering from the university of wisconsin school of medicine and public health 20 patients participated in a focus group talking about finding reliable health information online majority of the participants age range was 50 to 70 years old with a total age range from 24 to 82 years old 55 percent were female and racial populations included caucasian african-american american and hispanic based on participant feedback it was concluded that the younger population preferred using a health portal such as mychart and searching symptoms online while the older populations preferred going to see a medical professional such as urgent care or seeing their primary care provider when asked what the top three websites were they grew the group said mail clinic webmd and using google to find health information next slide wisconsin health literacy developed a digital health literacy program health online finding information you can trust to focus on improving the digital divide thanks to the support of the national network of libraries of medicine the greater midwest region wisconsin health literacy has been facilitating community-based workshop for patrons and a trained the trainer session for librarians all over wisconsin since 2018.One of my favorite quotes um from one of the participants at a library in wisconsin she stated you’re never too old at 91 years old i’m still learning and try my best and and that was a participant at the community-based workshop in in iowa county in wisconsin and from the first phase of the program it reached really many diverse populations as 180 participants identified being 55 years or older 53 identified having low literacy and 78 identified being an english language learner the project reached 17 different ethnicities in 22 wisconsin counties you can find the full results of phase one of the program by going to the website listed in the chat box next slide please the goal for the project was to help consumers especially from vulnerable populations and those at risk for low health literacy identify and effectively use trustworthy sources of online health information next slide the objectives were to facilitate workshops in wisconsin for seniors in other low health literacy and vulnerable populations i have a 20 increase in participants stated confidence to access trustworthy health information online and to also see a 20 increase in naming criteria for evaluating a website next slide workshop handouts are given to all participants to follow along during the presentation materials are available in english spanish swahili somali arabic burmese chinese and hmong handout one shown here has list recommended websites and has a website evaluation checklist on the back next slide this is the checklist and it is adapted from the national libraries of medicine web eval checklist next slide handout 2 shown here highlights sections discussed during the workshop with space to take notes we developed the handout this way as we worked with a pilot group at mauston public library in wisconsin and the patrons there really wanted that space during the workshops if you do these online programs to take their own notes and follow along even though it is a digital literacy program they wanted to have the option to take those notes home and and create their own language so they could remember and on the back side of the handout at the bottom is a program url which we’ll put in the chat box in its um our wix site that we developed for the online curriculum in case participants would like to reference the workshop materials with a clickable link after the presentation additional resources are available to help facilitate a workshop for community members the resources include a pre-survey and pulse survey for participants to take during the workshop an instructor script to help you facilitate the workshop using health literacy principles a powerpoint presentation to use as a visual while facilitating the workshop along with the handouts that we just looked at the free digital health resources can be accessed on the nlmnlm website and we’ll put that in the chat box for you as well and then the workshop can also be accessed using our online curriculum that i discussed before using the wix site from the url that was previously given next slide please health online program conducted pre and post surveys to gather knowledge based feedback from the information presented to community members in 2019 the first phase of the program was completed based on a survey population of 282 participants of the community-based workshops there was a significant increase in participants learned knowledge of the topic and overall confidence in finding reliable health information online after the workshop we saw a 40.2 percent increase in identifying reliable websites a 32.2 percent increase in using evaluation techniques to find credible websites and a 37.3 increase in feeling confident and finding good health information online so we um succeeded in reaching our our objectives and beyond and it really was a great program and now we are in phase two of the program that is wrapping up this april so you may be wondering well how can i get involved and and use this whether it be hosting an online program like we just talked about it doesn’t have to be that involved in that in depth you can just become familiar with the online program get comfortable go to that link that i mentioned before partner with community organizations this is a big one many libraries host programmings at your site but we’re finding that actually going to the senior sites going to the meal sites going to the community centers reaching out with those other organizations that might be hosting other events and taking your work there and meeting them there can go a long ways to develop relationships and then in the future bring them to your library or organization to host a workshop you can also bookmark medlineplus which is a tool developed by the national libraries on medicine a website and they are they have so much good information on there about health information easy to use um and i’ll be explaining that that’s in one of the um online learning model online learning modules excuse me um a little bit later i’ll talk about trained staff and especially what stan had been talking about previously on health literacy digital literacy and the digital divide that we’re facing and then again host a workshop either on site or with a partner organization a lot of the tools that i described earlier are made for you to host this virtually and just go to the nnlm website for the all of us research program and they have those tools for use you to use freely next slide so now that we’ve had an overview of digital health literacy program that has been successfully implemented over the years we’re going to talk about additional tools that focus on both digital health literacy and general digital literacy information as britt explained earlier the net the network of national libraries of medicine is partnering with the all of us research program to support all of us partners public libraries nnlm members and community partners interested in supporting the participants digital literacy needs wisconsin health literacy worked with nnlm to develop several materials and activities relevant to all of us in digital literacy supporting health online videos and guides are being developed for professionals to engage with their communities both in person and online these were these resources will be available on the nnlm all of us website again featured in the chat box next slide educational videos were created to support health online curriculum these videos are based from the health online program we just reviewed the health online finding information you can trust seven videos have been created they’re approximately six to eight minute versions and this version is used for a classroom setting preferred and then we have also developed a two minute version with the purpose of posting on social media and giving a brief overview of the video the six to eight minute video and encouraging the viewers to learn more um and using your online platform or where these videos will be streamed through on youtube of checking out more of those videos all of the videos are in english and spanish and again the videos will be streamed through youtube to share on your website’s social media pages and add to your digital learning curriculums and that will be shared after this virtual programming series the youtube links so now we are going to share with you the video the two minute video that we have developed just so you can get a general idea of something that you could post online and this is a shortened video of something that we would encourage you to share on your website if you could or encourage them to incorporate an online or in class studying curriculum many people have questions when they leave the doctor’s office you might have questions and try to find answers online let’s talk about how to find safe and true information online begin by using a search engine like google or bing every search engine has a search bar in the bar type the words you want to look for if you do not want companies to track your searches you can use the search engine duckduckgo but if you open a new tab outside of your duckduckgo search companies can start tracking your information again if you want privacy on all tabs you can open a private browser like google chrome incognito now let’s talk about tips to help you search for information online think of key words to help you find specific information here are more tips tip one type all the symptoms you have if you have a toothache pain by your nose and a headache type all three symptoms in the search bar tip 2 type full names not acronyms in your search if you want to find information about an upper respiratory infection type those three words not the acronym uri tip 3 type gender specific terms in your search tip 4 type age specific words in your search now let’s try a search using the search engine google and look for information on healthy eating if you search only the words healthy food you get a lot of search results you may not need let’s pretend you are a teenager searching for healthy foods you can search for healthy foods for a teenager you can see that you get better search results because you added the age when you see your search results do not just choose the top options the top two results are not always the best scroll down and compare the results this is the end of this video remember information you find online does not replace advice from a medical professional health literacy worked with the network of the national library of medicine to create this video okay great so you can see that was a very short video that would be easy to share on facebook on your website and many other twitter some other options so we made sure it was within the time limit that you could post those on social media and then encourage them so the the longer six to eight minute version this is going to be important to incorporate these videos in a classroom setting and have the option to use an open discussion and pausing videos between new topics i’m giving participants an opportunity to work on an electronic device while they’re learning from the content the curriculum being spoken about just because it is digital literacy learning so having them do what they’re learning gives them an opportunity to have a hands-on learning approach and a better chance for remembering the information that was just presented so that’s highly encouraged um not just to play that six to eight minute video all at once next slide please so the guides break down how to use the videos and best practices for reaching diverse audiences entailing to meet the needs of participants which this is going to bring us to into our next discussion the resource guides the guides will be available in english and in spanish for professionals to use and really get you comfortable with sharing these digital literacy resources for those community members patrons that you support the guides include a program summary a program plan materials and resources for training and community education along with descriptions of intended audiences of who to reach in recommendations along with links to relevant online resources and then finally important as evaluation plans so you can if you’re wanting to do assessments of the program and need that evaluation tool in your organization there will be recommendations on how to use an evaluation plan to do knowledge gain assessments next slide please so two okay the two kits um the guys that are created to support the all of us free online learning modules displayed here on the slide um for the all of us training and these are provided on the all of us training education center so we will put that link in the chat box for you where you can go out and look at these online learning modules the online learning modules review how to avoid scams and phishing create a strong and easy to remember password find reliable health information online so being a website detective and that has a lot to do we’ve just been reviewing i was talking about the health online finding information you can trust that is a good duplicate of that information and then use medlineplus to find reliable health information online so medlineplus is that website i was telling you about that the national libraries of medicine supports um through the national institute of health they have if you’re not familiar with this website i encourage you to check it out and it’s medlineplus.gov where we give the guide and the resource on how to use that website and then the last online learning module is how to get a free email address um email addresses are needed a lot not only within just getting communication from your doctor or wanting to sign up for newsletters and all that information but if you need to sign up for a health portal now you also need to get a free email address so that’s something important that community members need to know how to do and then how to create the strong passwords to keep their email safe from spams and other harmful viruses so those are information that the guides will go over and again i encourage you to check out the all of us training at education center and learning modules yourself so you know what the information being presented is next slide please so a diverse team of people from different communities have been sharing thoughts on how building these guides and how the five online learning modules just reviewed would be best introduced to support community engagement the team thought about questions who would these resources and materials benefit what resources would support the learning module topics and what local partnerships would strengthen dissemination along with another important tool is the evaluation piece so what evaluation techniques could be used to gauge participation knowledge so taking into consideration all these questions has been building our guides from that diverse team of people that our group has been working with and luckily we’ll get to hear more from these professionals in the upcoming days next slide please so for example some of the highlights in these guides we’ll look at one is we look at who these guys will benefit and katie burke from generations online shared and who will get to hear from on thursday of this virtual programming series included these guys should be used to help older adults as educating them as in older adults with these tools will enable them to strive to stay safe online the internet connects many older adults to the world outside and for many just one hacker or scammer getting through will undermine their confidence and may lead to them stop using the internet and why lisa jenkins from stem queens llc who’s also part of our team developing the guides and we’ll get to hear from her tomorrow during the series guest discussion shares on the importance of local partnerships in the guide she states if there are historically black colleges or universities in your area you can often find social justice organizations fraternities and sororities on campus that already do community outreach work and could connect you with stakeholders these groups often have annual community events you can join or be part of social justice organizations like the spirit house in her hometown of durham north carolina or gideon’s army in nashville are well connected with the needs of their community aligning with them would not only provide you with the guidance on how to reach your target community but also make you appear trustworthy which will increase participation so those are just a couple of examples of the information that is going to be provided in these guides and the in-depth recommendations from the diverse professionals that we had a chance of working with to build these guides next slide please so guest speakers will be joining the series discussion over the next three days the presenters will bring a wealth of information and experience for the communities they support we are honored to have speakers from the african american and latin next communities on tuesday april 20th refugee and immigrants in the lgbtq plus communities on wednesday april 21st along with older adults and persons with disabilities on wednesday april 22nd so we hope that you can continue joining us in these presentations the presenters will share their community experiences around digital literacy and health literacy and how to incorporate resources into professional space and strategies for cultural engagement if you are not registered for these events there is still time and register through the event page on the link in the chat box okay and at this time we are going to hear from britt in her closing and then open it up for questions caitlyn and stan thank you so much for presenting today on digital literacy health literacy and tools developed for program implementation to all of our audience members we want to thank you for attending this presentation the first in our four-part webinar series on tips and tools for closing the digital divide we hope you will join us tomorrow to hear from alicia jenkins co-ceo of stem queens and professor of computer science and health disparity informatician and bioesthetician at fisk university and julio garcia director of education at the latino academy of workforce development who will present on addressing health literacy with african american and latinx communities this program was made possible in partnership with wisconsin health literacy the national network of the libraries of medicine and the national institutes of health all of us research program before we go we invite you to provide feedback on this presentation by filling out a short survey the survey link is available to you in the chat and your responses will help us continually improve our programming thank you and see you tomorrow okay great so now we are going to i see a few um questions coming in to our discussion log and we’re going to start with the first one here i’m just going to open up my screen health literacy and patient consumer populations that are new as we gain life-saving expertise and technology can be skewed how can we find the right balance to achieve most empowering outcome do you want to answer that caitlyn you want me to if it’s saying if you want to do that and then if you want to ask the next one i think that’d be easiest to sure switch back and forth so so as i mentioned in my my talk that it is health literacy is this delicate balance between really meeting patients where they’re at and and providing that information as best we can using plain language and analogies that relate to those individuals so they can understand some of these more complex uh health concepts and things like that as well as just really uh walking people through i mean i i know one of the one of the challenges a lot of folks have and is just accessing their portal and being able to read the information in their portal whether it’s the doctor’s notes and those things and trying to really understand that right so i think you know health systems are starting to come around and understand that and provide more support to patients but at the same time there are a lot of folks that just aren’t getting the support that they need to really be actively engaged in their health especially in an online environment so anything that you all can do to really support patients understand the challenges that they’re experiencing and and give them the support they need to to overcome those challenges and be able to understand that information and make those decisions for themselves or navigate through systems to access resources and services and things can be a great thing yeah i agree stan and meeting them of where they’re at and that is how we’ve really designed a lot of the programming too a question was brought up in um the health online workshops we’ve been doing throughout the years of why do you keep talking about using google when there’s so many resources out there um you have to meet everyone where they’re at and not really try to go against them and using coming up with new ways and redirect their habits um when you open up your mobile device or on the computer what’s one of the first things that pops up is google so just working with your audience and your patrons and community members to meet them where they’re at is going to get you so much further than trying to keep introducing new ways of doing things and thinking that someone else has a better idea especially when you’re working with technology and again this is a lot of a lot of information so if you have the opportunity to also get better outcomes when people are trying to find health information online um also introduce them to like technology 101 classes okay this is can be a big struggle of just like how do you how do you get a smartphone and have that accessibility how do you get internet what is the internet how do you open up a browser how do you turn on a computer so those are some things that you have to think about before you start introducing this health online information and recommending certain websites and watching these videos is really taking consideration your audience and if they know about this information or do they need more education before they begin thanks caitlyn and i think that leads you know meeting people where we’re at uh someone had asked how do we use the tablets and mobile devices yeah that’s a great question because many of the websites now are becoming mobile friendly for example that help online finding information you can trust that online curriculum is mobile friendly because sometimes you ask participants to bring their own device and that’s what they bring is a smart phone um or a tablet instead of a laptop um so how can you work with them on that and that goes into learning the app language right because there’s a lot of great information and apps so just again i would say having that comfort level yourself if you’re helping these participants patron community members whoever you may be helping use mobile devices is just have that comfort level yourself and then encouraging them to download reliable apps so there is you know a medicare app out there that could be used to download if they have medicare or for health and other health insurance they could check out their health insurance app because money cigna has one aetna has one so ask those questions and help those help them download those apps so they maybe don’t have to keep exploring on the websites and just have that direct access to that information did i answer that person’s question about using phones and mobile devices or was there something more specific i think you did great and we talked about two in the videos that’s what’s great about these um seven videos you know it’s breaking up these topics and how to search online for information but then we also talk about how to find reliable internet connection and and getting hot spots and wi-fi and using those mobile devices so that’s its own separate video that would be a a great tool to use in explaining how to use phones and mobile devices okay great the next question that came in is how do u.s literacy rates compare to other countries we’re a little bit above average on the international index the the average for literacy rate is uh 267 and and this is an international standard so you’d have to look up uh the way that that is measured but we we come in at 272 so just a little bit above average um compared to other countries um there are many other countries that do a lot better than us for example japan is closer to 300 and finland’s up near 290 and so they they score a significantly higher than us and even a statistical significance so so we do have some some work to do and and especially as we’re reaching out to other communities and um especially immigrant and refugee communities which we’ll spotlight in one of the upcoming sessions that’s something to definitely consider as we’re thinking about translating materials and things like that um you know a lot of people have a low literacy in their own even native language and especially when it comes to languages that are more based on a spoken and oral tradition rather than written tradition like the hmong language for older human they they probably cannot read their own language because that was never intended it was always a spoken oral tradition and and so those are other things to consider as we’re reaching out and trying to get more diverse populations engaged all right the next question that’s coming in are there any studies that compare broadband access to literacy rate i i’m sure there are but i don’t know i’m off hand uh caitlyn do you know any yeah that’s a great question um i don’t know of any offhand either and it’s something i could definitely look into um and supply more information but when you talk about broadband access that just brings up a whole another issue itself um and just hindering the ability to that information so i don’t know if you would say that to answer the question it wouldn’t directly relate to the literacy rate for my answer but more just the accessibility to get the information um and reliability so if someone has a really slow wi-fi um low broadband that’s going to hinder their experience of using online resources and not want to go online if it takes them forever to upload a page and look on information or if they have to continuously go to other locations and get that wi-fi so i know many libraries especially this past year with covet were wonderful and checking out free hot spots or using offering their parking lot to offer that free wi-fi access for those that might have limited broadband access which can make a huge difference for users and wanting to look online for that information or again in many providers are now going to telehealth or e-visits um so being able to just give them that opportunity to do that whether it be at a library other in a parking lot somewhere that has free wi-fi but it then again it’s letting those users know that that option is available and i think that’s where we run into the barrier is they just didn’t know they they had that accessibility so how do you continue to spread that message for the those most in need that need that information and that that’s a great question all right another question and thank you for the questions they keep coming in is health literacy measured and is there a correlation with general literacy yes uh i i health literacy is measured by many different means the the issue is that we’re still trying to find a really good population level measure it’s measured on the individual level and they have spent quite a bit of money researching trying to develop tests the the problem is that health literacy is so context specific that a lot of the tests don’t really generalize to other areas so like for example one of the ways to measure health literacy is a thing called the newest vital sign where it shows someone a food label and ask them three to four questions about that label to figure out how much they can work with that label and be able to answer the questions the the problem is that does that does do a really good job of showing how if someone can read a food label but that doesn’t translate as well into you know trying to access health information online or or going to the doctor and communicating with your doctor and things like that and and so it is it is a little problematic to try to measure at this time and and the other issue with measurement of health literacy even though it is correlated for sure with those folks who are more likely to have limited to low literacy levels and and difficulties reading are going to be more likely to have low health literacy but um even so it’s so context specific and and i you know just from my own experience you know i have had times where my i would like to think i’m pretty health literate because i’ve been studying this field now for almost 20 years and know all the tips and techniques but there have been many times in my life even recently where because of what i was told or how i was told at the doctor’s office or things or the information i came across it created confusion or i just couldn’t react to it i mean the the most recent one i can share is i i like to uh another thing you can do as a health literacy strategy is be a surrogate for someone so if someone has some health literacy challenges you can go with them to the doctor’s office and help them ask questions remember what the doctor said understand what the doctor said those sorts of things and so i i’d like to do that for my mother whenever i can when i’m in town and a couple years ago we went to the doctor and she was diagnosed with a uh a tumor behind her eye and as soon as we got that information and the doctor said it was cancer to be honest neither one of us could process any more information in that business and so even though i was very health literate at that time my health literacy was on the floor and so that’s why we really you know try to stress that anyone at any time can have these health literacy challenges or or even when i go out and i search through information it can be so overwhelming and daunting of trying to figure out what is reliable what you know because there’s contradictory information and and things like that and so so just providing whatever support we can to people and really kind of meeting them where they’re at at this point in time is really the best solution instead of trying to measure or guess that someone may be having low health literacy it seems like when we provide information using these techniques using teach back chunking down information using plain language that even highly intelligent highly skilled health lyric folks still appreciate that and so the the risk of offending someone because there is this fear of talking down to folks but the research has shown that that risk is so minimal compared to the risk of misunderstanding and then somebody making a mistake or making a decision that wasn’t what they intended and so the the next question and i don’t know if you want to take this caitlyn or if you want me to but is health literacy a required course in med schools i would love to take this um it is not a required course in in all places i can say that i don’t know if you know maybe there’s some specifics out there um but just for example we have the opportunity to work with our local university the university of wisconsin-madison and they have a community health engagement program and it’s a fascinating program we work with third year med students and when they come on to help volunteer in our team one of the first questions is you know why did you choose to work for help volunteer for health literacy have you heard of health literacy and it’s always the comment of well it’s been reviewed in our curriculum you know but it’s not like a whole section itself tested out and passed this course on health literacy so it’s really interesting to hear that it’s not part of the required curriculum on their end but that they still talk about and then they have the option though to reach out to our organization and work on these health literacy community engagement projects and they they come in eager to learn want to learn and i think really even beyond and before med students is reaching students at even a younger age about health literacy principles and if we can incorporate that curriculum with with all people whether they go into the health profession that not um it’s just a very important tool and resource to have going forward in an adult life of especially when you talk about you know insurance and way finding the hospital there’s so many things that once they turn 18 they’re responsible for this information and i can say from my personal experience as well i didn’t know about health insurance when i got out of high school i always thought that the doctor and everything was for free because it was just something you went to and i never saw the bills and so when i went to college i was visiting the doctor frequently and i started seeing these bills coming in and i’m like oh well what is this i had no idea so just preparing even before those medical students um preparing high schoolers for what is going to come in the real world and setting them up for good health literacy abilities i think is important as well stan do you have i worked with several med schools i i would say that this is something that for um health professionals that have long graduated they did not have any sort of communications training in school so this is something that’s new i i do believe many schools have started to integrate health literacy across the curriculum but those those students have just only graduated in the last few years and so most health professionals might not have an idea of what health literacy is we we do a lot of training for professionals and and you’d be surprised about doctors just never hearing that term before and things but i think a lot of them are are really trying to integrate that in because it is it is vital to the process and and two as we slowly change you know in healthcare our reimbursement mechanisms because right now it’s kind of uh still a little fee for service where we pay for everything that’s done and as we move to more what we’re calling value-based healthcare where you get paid for the outcome communications is going to play a much more important role and and hopefully health professionals will get a lot more time to really communicate effectively with with folks because i i know it can be challenging to communicate everything you have to in a you know a six to 12 minute video or visit with someone and things just just from that perspective but but in the meantime we can we can do our best and understand and as caitlyn said and until we really start teaching kids these health literacy skills we we can expect just everyday people to have these skills and so that’s why we really need to consider this as we’re reaching out and and trying to engage people in in their health in various ways yeah it’s really great um to see the schools shifting to importing including the health literacy curriculums as part of their their learning modules so that’s great the next question that came in is will the federal government subsidize federally qualified health clinics to offer health literacy classes i would think so it may not be a direct program but i could very easily see how fuhcs could uh divert dollars to those programs and and that should fall well within you know them meeting their community needs and and things like that and so i would i would highly encourage that you know and especially as fqhcs and other health systems are are working to improve health literacy one of the things that we always recommend and and you can do it too as you’re as you’re building your all of us programs if you can get those community members in to give you feedback as you’re developing those programs you will create a lot more meaningful programs that will really address those true local needs and challenges that people face and so we always encourage people to uh involve your you know those you serve whether it’s patrons whether it’s patients um whatever but involve them up front and early in the process because they can provide you with so much meaningful information to really help make these programs the best that they can be [Music] great we’ll give it just a little more time here if there’s any last minute questions that want to come in and again if you have any questions on the all of us program we encourage you to refer to the join all of us website that will be in the chat box join all of us.org okay i had a few comments i was going to read them um so this is a great reminder to be aware that although one may appear able to read that is not always the case many would surprise you i i love that comment because uh one of the things that i think it highlights is that um there’s a common bias that we all have called similarity bias where we tend to think that when we see someone and they speak like us and they dress like us that they have the same level of education as us and a lot of times acting on that assumption can lead to those misunderstandings and things so so that’s why teach back is a great method and it’s probably the most evidence-based health literacy practice to really you know understand what that person understood with the conversation that you just had and with what especially if they’re going to do something whether that’s signing off the all of us program um searching for information about some condition or symptoms they’re having those sorts of things it’s a it’s a great reminder to just double check and make sure that they’ve got a clear understanding on how to do that absolutely okay well thank you all for joining us today um with no more questions we will wrap it up in our discussion and we hope that you can join us for our upcoming presentations over the next three days and it will be aired at 12 o’clock p.m eastern time so join us for the african-americans and latinx communities tomorrow tuesday april 20th the refugee and immigrants in the lgbtq plus communities on wednesday april 21st and older adults and persons with disabilities on wednesday april 22nd and again there’s the registration link in the chat box if you still need to register for the event or otherwise we will close today’s session and we look forward to seeing you tomorrow do do you

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