Health information literacy: a library case study

Library Trends, Wntr, 2005 by Erica Burnham, Eileen Beany Peterson

ABSTRACT

CONCERN ABOUT HEALTH LITERACY IS ONE FACTOR driving an international movement to develop and disseminate health information that is easy to understand and appropriate for people who have difficulty reading or whose first language is not English. Libraries can work with organizations in their communities to improve the accessibility of materials. Strategies for effective collaboration will be outlined in the context of health literacy promotion efforts. Finally, the role that librarians can play to help deliver appropriate health information, using the example of one patient resource center, will be discussed.

INTRODUCTION

This article will discuss how libraries can participate in the dissemination of plain language and easy-to-read health information to the general public. People should have access to information that is appropriate for their needs and play an active role in their health and well-being. Understanding the information available with respect to health issues increasingly is the responsibility of the patient. Recent surveys evaluating the basic literacy skills of Americans, Canadians, and Europeans have turned up alarming results. Libraries and librarians can contribute to the health of their communities through their involvement with health literacy initiatives and by keeping literacy issues at the forefront.

This article will present a general framework of how illness, stress, fear, and cultural differences can impact the way in which people understand their health problems--not to mention the health care system itself. The example of one patient resource center will illustrate how libraries can collaborate with the communities they serve to increase understanding of health.

Using criteria familiar to many librarians for evaluating the appropriateness of printed materials, librarians can make management decisions that will benefit users and libraries alike. The concepts of purpose, scope, authority, currency, and audience help us understand who libraries are serving, which organizations are key targets for collaboration, and the purpose of library programs. Hopefully, this practical structure will help others get involved with issues of health literacy.

WHAT IS HEALTH LITERACY?

Literacy is used in many different contexts today. Libraries have long played a role in basic literacy education and are beginning to carve out their place in the new arena of information literacy. Finding definitions for the terminology of literacy is controversial. It is useful to understand the scope of the issue in order to develop programs and communicate with the community. A few definitions inform our work as librarians.

Literacy is "using printed and written information to function in society, to achieve one's goals, and to develop one's knowledge and potential" (National Center for Education Studies, n.d.). Health literacy is "the ability to read, understand, and act on health information" (Pfizer Clear Health Communication, n. d.), and "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions" (U.S. Department of Health and Human Services, 2000, p. 20). Information literacy is a set of abilities enabling individuals to "recognize when information is needed and have the ability to locate, evaluate, and use effectively the needed information" (American Library Association, 1989).

A working definition of health information literary is "the set of abilities needed to: recognize a health information need; identify likely information sources and use them to retrieve relevant information; assess the quality of the information and its applicability to a specific situation; and analyze, understand, and use the information to make good health decisions" (MLA Net, 2003).

WHAT IS KNOWN ABOUT BASIC ADULT LITERACY?

The National Adult Literacy Survey, conducted in 1992 and again in 2003, and the International Adult Literacy Survey, completed in 1994, gave North Americans and Europeans some startling news about the reading and writing abilities of those sixteen and over. Both surveys evaluated three types of literacy:

Prose literacy--the most common form of prose literacy used is the newspaper or magazine article

Document literacy--the questionnaire required participants to read information in table form or in lists, such as a bus schedule or a table of contents

Quantitative literacy--using a graph, chart, or performing an arithmetic operation, such as calculating a tip

Within each type of literacy, five levels were defined, with level one being the lowest and five the highest. In both surveys, so few respondents scored at level five (about 3 percent for both Canada and the United States) (Clark, 1996) that the results were deemed statistically insignificant and the scores were combined with those at level four.

Those adults at the lowest levels of literacy (levels one and two) are of greatest concern for literacy advocates. Between 20 and 23 percent of Americans scored at the lowest level of prose, document, and quantitative literacy, while closer to 15 percent of Canadians fell into this category (Clark, 1996). The numbers increased for level two, with over 25 percent of both Americans and Canadians scoring at this level (Reading the Future, 1996). These two levels combined represent close to half the adult population.