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Health literacy training addressed by Cindy Abole Public Relations The ability to read warning labels on a medicine bottle or follow care instructions relating to a patient’s recovery is part of a silent problem among 46 percent of American adults.   Nearly half of all American adults (90 million people) have trouble understanding and using basic health information, according to a recent report from the Institute of Medicine. The results place adult patients at risk for receiving proper health care and affecting their overall patient safety. In 1995 the Journal of the American Medical Association reported that 42 percent of respondents were unable to understand and follow directions about taking medicines on an empty stomach. Another 60 percent could not read and understand a standard patient consent form. The statistics are worse among the elderly or persons with chronic, physical or mental health conditions.   October is National Health Literacy Month. At MUSC, patient/family and clinical educators will provide an educational program for health care professionals on health literacy Oct. 17. The class will address this hidden health care problem and provide new insight and tools to improve communications between medical personnel, patients, and families.   The class is one of several educational initiatives coordinated by Karen Rankine, R.N., coordinator of MUSC Patient/Family Education and Interpreter Service, and the MUSC Health Literacy Task Force.   In February 2003, Rankine and the group administered the Rapid Estimate of Adult Literacy in Medicine (REALM) survey to adult patients and caregivers of pediatric patients, ages 18 and older. The five-minute assessment tool focuses on word recognition and is used to evaluate a participant’s reading skills through recognition and pronunciation of medical-related words from three multi-level word lists. Following the test, participants receive a raw score based upon the number of correctly-pronounced words, which is converted to a reading grade range.   The REALM survey was successfully conducted in multiple care areas on campus including the Main Hospital, Children’s Hospital, Transitional Care Unit, Institute of Psychiatry and Ambulatory Care. The team then worked to interpret survey results with health literacy consultant Terry C. Davis, Ph.D., professor in the Department of Medicine and Pediatrics at Louisiana State University Health Sciences Center in Shreveport, La. The survey revealed that 66 percent of participants were reading at a high school level or above and 34 percent read below the high school level. These statistics are on par with national findings. Health care professionals are therefore challenged to modify patient education materials which are usually between the 10th-through-12th-grade reading levels. Other strategies used to help patients understand health information include using plain language, citing examples through demonstrations, drawing pictures or pictograms and using patient-teacher review.      “It’s important that we pool our resources of people, training and tools to conduct effective health literacy education,” said Rankine. “Addressing these issues can develop healthy communicative relationships between medical personnel and patients, decrease hospitalization costs and prevent medical errors. It’s what all of us need to provide as effective caregivers.”      The group shared the results of the survey in a 2004 article that appeared in the professional journal, “Advance for Nurses.” Rankine and the task force are also collaborating with the Trident Literacy Association to develop a future health literacy program at MUSC clinics and related locations.   In another related effort, Rankine and other staff were interested in addressing reading and literacy issues among specific patient groups. They created a patient admissions/discharge video series for Spanish-speaking obstetrics patients. Amy Williams, R.N., and Josie Silvagnoli, full-time Spanish interpreter, worked with Educational Technology Services to create and produce a short, orientation video to the Children's Hospital which is currently in use throughout the facility and will be on the Medical Center's Get Well Network.   For more information contact Rankine at rankinkh@musc.edu or call 792-5078.    Clinical Services Orientation/Patient-Family Education Training “Help Your Patient Understand: A Health Literacy Update,” Oct. 17: 10:30 to 11:15 a.m. and 2 to 2:45 p.m., 2W Classroom MUSC Health Literacy Task Force Mary Johnson, educator, Children’s Hospital; Lisa Kozlowski, diabetes educator; Val Evans Kreil, speech/language pathologist; Karen Rankine, Patient and Family Education and Interpreter Service coordinator; Bryan Counts, Patient and Family Education coordinator, IOP; Susan Hamner, clinical educator, Ambulatory Care Services; and Jo Anne Sandefur, clinical education coordinator, Respiratory Care.   Friday, Oct. 14, 2005 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.