What is health literacy?

I'm working on a couple different articles at the moment, and one article that has popped up (repeatedly) in our lit review and thinking about these projects is a great article from 2010 about what health literacy is.  The abstract is:

The concept of health literacy evolved from a history of defining, redefining, and quantifying the functional literacy needs of the adult population. Along with these changes has come the recognition that sophisticated literacy skills are increasingly needed to function in society and that low literacy may have an effect on health and health care. We present a brief history of literacy in the United States, followed by a discussion of the origins and conceptualization of health literacy. Increased attention to this important issue suggests the need to review existing definitions of the term "health literacy," because despite the growing interest in this field, one question that persists is, "What is health literacy?"

The article came from an issue of the Journal of Health Communication:  Berkman, N. D., Davis, T. C., & McCormack, L. (2010). Health Literacy: What Is It? Journal of Health Communication: International Perspectives, 15(S2), 9-19. 

The more I read this article, the more I value its perspective, utility, and the way it gets me thinking about my own health literacy research.  I have a couple projects going related to health literacy measurement, and the point this article makes about picking a definition of health literacy that matches the research project, is a really crucial one.

Anyway, it's a great article, and I just wanted to share it with anyone interested in this area who hasn't seen it to this point.

NPR - Hospital Costs Go Public: What Changes In Health Care?

Yesterday I listened to an interesting Talk of the Nation segment about hospital costs going public.  This was all over the news.  A chunk of the conversation really jumped out at me:

Well, and this is where it becomes really complicated because consumers are used to seeing costs or charges related to quality. So if we look at Yelp, for example, we'll say OK, a four-dollar-sign restaurant is probably higher quality than a two-dollar-sign restaurant, and they might make that same assumption about health care, too. 

And so just as Jordan said, there's not really great research out there showing that the difference in the quality is as vast as the difference in the charges. So what - while we do hope that price transparency is an initial first step, one concern is that people actually start flocking to higher-cost hospitals or higher-charge hospitals thinking that it offers better care, and that might not be the case at all.

This is a side of this going public that wouldn't have initially occurred to me, but the way consumers equate cost and quality seems dead on.  Given the research that shows hospital costs aren't necessarily associated with actual quality, this is obviously a problem.  I don't even know what this means, but there seems to be an interesting project to be had here...

It got my wheels turning.

Strategy, Then Tactics

I'm a Twitter user (@mackert), and I follow enough people that updates kind of fly by all day.  I see plenty of interesting posts, but that doesn't mean I probably miss a lot more than I catch.  Such is life.

A tweet from Susannah Fox caught my eye: "If you're targeting teens, you need to consider texting. Deep dive discussion of SMS and health."  This led to me posting a comment on her blog on this topic here.

The main point of the conversation was about the importance of getting to a strategy and then tactics, rather than starting with a tactic (SMS, Twitter, whatever) and then working backwards.  This is a problem I run into teaching advertising every semester, as well as a tendency to rely on obvious/easy solutions (Facebook is seemingly the answer to EVERY problem) rather than think about how consumers actually experience media and interact with advertising.

So at this point I'd like to recommend Truth, Lies, and Advertising (Amazon link).  It's a great look at account planning, the advertising role that (in its simplest conceptualization) is "the voice of the consumer."  It's the job of this person to know consumers inside and out, and the end result is (hopefully) better advertising.

While it's tough to think of an account planner outside the agency (it's an ad agency job, basically), the general approach of account planning certainly could play an important role in improving the practice of health promotion.  For those interested, Truth, Lies, and Advertising is a great place to start.

Measles and Vaccines in Wales

I was reading this article this morning while eating breakfast:

Measles epidemic: Outbreak in Wales tied to Andrew Wakefield’s discredited work

I think the oddest part of this, which I'd never heard before, was how Tony Blair declined to talk about giving the vaccine to his old children, even though he did.  That's so strange, behaviorally, and likely contributed to doubts around the vaccine...  Just wanted to point to this given that new (at least to me) bit of info.

Freakonomics and Obesity

Listening to this podcast right now and wanted to share.  Definitely some interesting thoughts on fighting obesity: http://www.freakonomics.com/2013/03/27/100-ways-to-fight-obesity-a-new-freakonomics-radio-podcast/

The Cloud for Research

So this isn't anything specifically about health communication, but over the last year or so I've come to really see the benefits of cloud storage for protecting my research and keeping me more productive.  A few years ago I had a hard drive crash that almost cost me some really valuable data, since I hadn't backed up for a while.

This led me to Google Drive as a solution that let me keep a real-time backup of 5GB of data for free.  It became my model to keep active projects in Google Drive, since it constantly synced to the cloud.  This also meant that I was able to access my research files from my other devices (phone and tablet), which came in quite handy more often than I might have thought.

UT recently signed on with another provider that gives 25GB of cloud storage, so I've moved off Google Drive.  But for those out there who haven't looked into something like Google Drive, I'd highly recommend it.

Call for Abstracts: SFT-13 Conference

I went to the Successes and Failures in Telehealth conference a few years ago, and I loved the event.  The presentations were really interesting, and Brisbane was a great city to visit.  For anyone interested in telehealth, this is a conference you should definitely head to at least once!

Deadline for abstracts is July 8.  More info here.

Number of Early Childhood Vaccines Not Linked to Autism

"The sad part is, by focusing on the question of whether vaccines cause autism spectrum disorders, they're missing the opportunity to look at what the real causes are," she says. "It's not vaccines."

I thought the pull quote in this NPR story was really impactful.  The story covered recent research indicating the number of early childhood vaccines isn't linked to autism.  The story was quite realistic in how some skeptics are just never going to be swayed by research like this, which seems to be a newer feature of stories like this.  (At least I don't remember them usually being there.)

The other bit of the story that was interesting, from a health communication point of view, was this:

Autism Speaks, a major advocacy and research group, seems ready to move beyond the vaccine issue. Geraldine Dawson, the group's top scientist, praised the new study and says the result should clear the way for research on other potential causes of autism.

Sooner or later I'm going to do a study on vaccines and autism, because the topic is endlessly fascinating to me.  In this case, I wonder how a group like Autism Speaks coming out with a statement like this shifts the views of some of those hardcore skeptics.  Is it a more trusted source for information?  Or is there a view that they've been co-opted in some way by the "powers that be" to say something like this?

Interesting story, and great news that researchers are working hard to disprove these kinds of myths.

Texas and Healthcare Delivery

Working at UT, and living in Austin, much of my research out in the "real world" tends to be focused on the greater Austin and Central Texas area.  Opportunities to think about Texas more broadly are a great chance to think about the bigger picture in this state, and the keynote at a conference I was at Wednesday really drove home one of the amazing things about healthcare delivery in Texas.

St. David's CHPR had their annual conference, which was focused on Meeting the Mental Health Needs of Texans, hit on a range of issues related to mental health in Texas.  I was only able to stay for the first few presentations and the poster session, since I had to teach, but the keynote presenter (Sam Shore: The State of Mental Health Challenges and Innovations in Texas) put up a slide that really drove home the size of Texas in terms of both geographic area and population.  Basically it showed a map of Texas with different counties/areas highlighted that corresponded to other states in the U.S.  I remember Maryland being one of them, but there were five or six listed.  (I wish the PowerPoint was online, or a version of that map, but I can't find it.)

Anyway, it was an extremely interesting presentation.  It was impressive hearing about some of the innovative strategies for improving mental health interventions around the state.  Sometimes stories about healthcare in Texas are more oriented toward doom and gloom, and there are certainly problems to solve...  But given the challenges involved in shifting and improving healthcare delivery in a state as enormous as Texas, it was heartening hearing these kinds of success stories and research into better ways to do it.

“Think the sink:” Preliminary evaluation of a handwashing promotion campaign

Another article just came out in print, a pilot/preliminary evaluation of a social norms-based hand washing campaign.  It's out at the American Journal of Infection Control:

Owing to its utility in guiding the planning and evaluation of health promotion campaigns, the Theory of Planned Behavior was used to implement a 1-month campaign aimed at increasing handwashing among college students. Based on observations of bathroom users' handwashing behavior (n = 1,005) and an online survey (n = 188), overall handwashing did not increase as a result of the campaign; however, more students did use soap (58% vs 70%). Future campaigns designed to increase handwashing behavior in students may be advised to target messages according to gender difference–based responsiveness to handwashing norms.

This project was a ton of fun to work on, starting with a class project around promoting hand washing on campus all the way through developing the materials we used on this project and actually observing the changes in hand washing behavior.

You can get it at the AJIC website here. The reference is:

Mackert, M., Liang, M., & Champlin, S. (2013) “Think the Sink:” Development and Preliminary Evaluation of a Campus Hand Washing Campaign. American Journal of Infection Control. (41) 3, 275-277. doi: 10.1016/j.ajic.2012.03.023