Health Literacy Month: what is health literacy?

 

October marks Health Literacy month, so throughout October the library and knowledge service will be sharing key information and resources to support understanding and skills around this important topic.

Definitions

But first, what is health literacy? The World Health Organisation describes health literacy as knowledge and competencies that enable people “to access, understand, appraise, and use information and services in ways that promote and maintain good health and well-being for themselves and those around them”.

The U.S. Centers for Disease Control and Prevention has also refined the definition of health literacy by dividing it into personal health literacy and organisational health literacy:

• Personal health literacy: “the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.”
• Organisational health literacy: “the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.”

These definitions emphasise that healthcare organisations have a role to play in supporting individuals to access and interpret health information.

Examples

In 2015, Rowlands et al. sampled nationally available health materials in England, such as education leaflets, medicine labels and reports related to public health. They used data from a survey assessing literacy and numeracy skills to evaluate whether these materials matched the competencies of the UK population. They estimated that the literacy skills of 43% of adults aged 16-65 fell below the threshold needed to understand and interpret the textual information of the health materials. For materials containing numbers, they calculated that 61% of adults would not have the combined literacy and numeracy skills needed to understand the materials.

What could low health literacy look like in the real world? Some examples of the impacts of low health literacy include:

• Someone not attending a cancer test because they couldn’t find the right department – not knowing that radiology and X-ray indicated the same thing.
• Someone spraying their inhaler on their neck because they had been told to spray it on their throat.
• Someone who stopped taking their diabetes medication because they couldn’t understand the instructions.

Why is health literacy important?

As you can imagine, when people struggle to understand health information it can have a range of negative impacts:

• It limits people’s ability to make well-informed decisions about their own health and can mean they suffer worse health outcomes.
• It may lead to missed appointments, inappropriate use of A&E, wasted medications or avoidable hospital stays, which also impacts the NHS financially.
• It widens existing socioeconomic inequalities, especially where people face barriers to education, internet access, digital devices or information in accessible formats.
• People may feel embarrassed, frustrated or helpless when they struggle to understand the information given to them.

What can be done?

There are many tools and techniques that can be used to improve health literacy. These topics are covered by guides from organisations such as the Patient Information Forum and the NHS Alliance. Look for further blog posts over the coming days where we will highlight tips for staff to support patients' health literacy.

To find out more, you can also register for our upcoming training session about health literacy awareness, on 7^th October on Teams, by finding the course on MTW Learning.

Finding papers for journal clubs

 

Are you interested in getting involved in a journal club? The library’s Knowledge and Evidence Specialists are happy to provide advice and support for journal club set-up or participation and growth. Here we’ve compiled some handy tips for finding and selecting papers to discuss in a journal club.

 

Aims of a journal club

There are many purposes to running a journal club, including:

• To learn how to critically appraise literature
• To improve participants’ understanding of research methodology and evidence-based practice
• To keep up to date with current literature
• To maintain constant involvement in research
• To enhance communication and debating skills through presentations and discussions
• To network with other staff

Initial thoughts for selecting a paper

• Look for original research (e.g. RCTs, cohort studies etc.) or systematic reviews and meta-analyses, avoiding opinion pieces or general literature reviews (without robust search methodology). It’s also good to vary study designs from session to session.
• Think about how recently the article has been published and how important it is for the article to be up-to-date for the topic/field.
• Select articles from reputable journals (use the Think.Check.Submit. website’s advice to avoid predatory/fake/deceptive journals).
• Think about what the current issues are for your group’s area(s) of practice or learning. What might be of interest and relevance to them?
• Be aware of the length of the article and how much time participants need for pre-reading before the session.

Browsing

If you don’t have a specific idea of a topic or question, you could browse certain journals or platforms to find an article of interest. Potential resources could be:

• BrowZine: a website and mobile app that allows you to browse e-journals from different publishers in one simple interface on any device. You can browse by specialty and find links to the full articles.
• BMJ Best Practice or DynaMed: to find further reading on topics of interest, you could search for a particular condition/treatment on these point-of-care tools. Look in the references section for hyperlinks to original research  – these may be potential papers for appraisal.
• The NHS Knowledge & Library Hub is suitable for quick keyword searches.

You will need an Open Athens account to access BMJ Best Practice, DynaMed and the full text of articles that we subscribe to. You can register for an account at https://openathens.nice.org.uk/

If you find an article which you would like to use but can’t access through Open Athens, please email the library.

Structured searching

If you are aware of a gap in your team’s knowledge or have a clinical question in mind, you can structure a search strategy to retrieve results in databases.

One way of framing a clinical question in order to search for a paper is PICO: Patient/Population, Intervention, Comparison and Outcome(s). Not all of these elements have to be present, for example, you might not want to specify a comparison.

Once you have identified the key concepts in your question, you can pull out the key terms, as well as the synonyms and variant forms of these words – think spelling (US and UK English), plural v. singular, abbreviations, etc.

E.g. for the term ‘training’ you could include education, learning, instruction, CPD, workshop etc.

The asterisk * can be used in many databases to search for the root of the word you have typed in and retrieve any alternate endings, e.g. train* for either train, training, trained, trainer, trainee etc.

(However, be aware that truncation can sometimes make your search too broad.)

Once you have your terms, combine them together with OR or AND. E.g. (anxiety OR generali#ed anxiety disorder OR GAD) AND (Cognitive Behavio?ral Therapy OR CBT) AND (older adult* OR older person* OR older people OR elderly)

Structured searches can be carried out in databases such as Medline, Embase, Emcare and PsycInfo on the Ovid platform. You will need an Open Athens account to access the Ovid databases.

If you would like training on how to search for articles, use databases or critically appraise the articles you find, please email the Knowledge and Evidence Specialists: mtw-tr.evidence.specialists @nhs.net.