Around 10 years ago I attended my very first annual AADE meeting, and was introduced to the importance of assessing the health literacy of patients with diabetes. Prior to learning more about this concern, I felt that I was a good judge of what a patient did or did not understand, and I thought that having patients repeat back and/or demonstrate what I had taught was a valid means of determining a successful education encounter and thus, their ability to make competent health decisions. And for some patients, this is true. But much of health literacy has to do with a person’s ability to take what is learned and apply it in differing circumstances and environments, to convert numbers to meaningful information, to have basic knowledge of anatomy and bodily functions, and the ability to relate concepts. The importance of assessing for health literacy rings true when we consider the frequent and over use of emergency departments, re-admissions, and the underuse of preventive services (U.S. Department of Health and Human Services, 2010).
So what’s a diabetes educator to do? Considering the limited time in which we have to fill our patients’ heads with all the information they need to survive in the world of diabetes, how can we know where and how to direct education that is best suited to our patient’s ability to understand? One of the easiest ways to determine health literacy is the use of The Newest Vital Sign, a 3- minute tool which utilizes an ice cream nutrition label to screen and measure health literacy. Since I will be using a food label at some point during an initial visit, it is not outside my routine to make use of one to assess health literacy. To make the tool more acceptable to patients, I explain that nutrition labels contain a great deal of information that it is often difficult to understand, and that to some degree, there is too much information. If they are willing to answer 6 questions to the best of their ability, I explain how their answers will help me better gauge what and how I need to teach. I have been using The Newest Vital Sign for over a year and have yet to have a patient refuse. If you haven’t any experience in assessing health literacy and want to know more about it, check out the website at Newest Vital Sign. I’ll be very interested in knowing your ideas and opinions on this health topic.
References
Pfizer, Inc. (n.d.). The Newest Vital Sign: A health literacy assessment tool for patient care and research. Retrieved from http://www.pfizer.com/files/health/nvs_flipbook_english_final.pdf
U.S. Department of Health and Human Services. (2010). Quick guide to health literacy. Retrieved from http://www.health.gov/communication/literacy/quickguide/factsbasic.htm