About the role of librarians in health literacy.

People of all ages, backgrounds, and education levels need health information, but often find it difficult to find and understand. Low literacy levels, in terms of reading, and being able to find, understand, and apply information, are a barrier to successful patient participation, and this is problematic, given the increasing recognition about the importance of engaging patients in the treatment decision-making process.

Health literacy and health information literacy are phrases that are becoming more widely used, sometimes interchangeably. However, there is a difference, and this post hopes to clarify the meaning of each.

Health literacy

Health literacy is the ability to understand instructions provided by health professionals.

Quote

In England, 42% of working-age adults are unable to understand and make use of everyday health information, rising to 61% when numeracy skills are also required for comprehension.
Treadgold P and Grant C (2013) 'Making the case for information'

Quote

Around 1 in 5 adults cannot read or understand simple instructions or labels such as those found on medicine bottles.
Bostock S and Steptoe A (2012)

The inability to read can result in patients taking medicines at the wrong times, not following dosages correctly, or not understanding instructions properly (Koh HK and others, 2012). For example, if the label on the prescription says “Take 3 tablets daily”, does this mean take 3 tablets at the same time or take 1 tablet 3 times a day? The quote below, comes from a Facebook post written by a surgeon, and perfectly illustrates the consequences of misunderstanding medical instructions.

Health information literacy

Health information literacy, although often referred to as health literacy, has a more in-depth scope. It is not only about access to the Internet and online health information, but also about having the skills required by people to effectively recognise.

  • What they need to know about their condition and treatment options.
  • How to find that information, to fill those knowledge gaps.
  • How to appraise the information to ensure it is good quality, and relevant to their personal context.
  • How to use the information with their health professionals so that they can make an informed decision that suits their needs (Schillinger D, and others, 2022; Remshardt MA, 2011).

Poor health information literacy can result in poorer health outcomes, unhealthy lifestyles, increased incidence of chronic conditions and mortality, greater use of emergency services, and increased hospital stays (Treadgold and Grant, 2013; Berkman ND, 2011; Baker, 2007; Raynor DT, 2012; Oliveira D, Bosco A, di Lorito C, 2019; Dufour I and others, 2019; Fabbri and others, 2018; Balakrishnan and others, 2017)

Role of librarians

Quote

Give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime.
Maimonides

This quote reflects the importance of health information literacy, because if you find the information for the patient, their query will be satisfied, but if you teach them to search and appraise, they will be able to make informed decisions throughout their care pathways.

Health information literacy is an area where librarians, from all sectors, whether medical, public or academic, are in a strong position to support. They already have the resources, skills, and processes in place (Bragard and others, 2017). Librarians can signpost people to the best sources, and teach them to search, retrieve, and appraise what they find (Peterson, Aslani, and Williams, 2003). Medical librarians have the skills associated with evidence-based practice, as it is embedded in their roles, their primary function being teaching health professionals how to find and appraise the evidence. They also have access to the relevant information sources, while public and school librarians are a trusted source within their communities, and understand the local context. Working in partnership would improve access to good quality health information at a location accessible to local people, who most likely would not have access to medical libraries.

People benefit from having access to good quality health information because it enables them to make informed decisions and follow their treatment regimens more effectively and safely (Vida Estacio, Whittle and Protheroe, 2019; Miller, 2016; Pollock and Grime, 2003). Informed patients are more likely to comply with the treatment regime, resulting in improved health, and reduced length of stay, and hospital admissions. Since the average doctor’s visit in England lasts 8-10 minutes (The Royal Australasian College of Physicians, 2009), patients need to be ready to ask the right questions. Helping patients to self-manage by improving their health information literacy skills will benefit both the patient and the health system (Treadgold and Grant, 2013; Panagioti and others, 2018; World Health Organization, 2009). By improving access to clear, current, accurate, and understandable consumer health information, health inequalities can be reduced and patients will feel more empowered (Treadgold and Grant, 2013; Belcastro and Ramsaroop-Hansen, 2017) .

Creating health information literacy support programmes and resources is a new area for medical, public, and school libraries to work and lead on together. Library communities would benefit, in terms of professional development, more efficient working practices, and demonstrating value to the community. Patients could see improved health outcomes and better quality of life, health, and wellbeing, while health services might see a reduction in health service utilisation.

References

  1. Treadgold P and Grant C (2013) Making the case for information: Executive summary. London; 2013
  2. Bostock S and Steptoe A (2012) Association between low functional health literacy and mortality in older adults: longitudinal cohort study in British Medical Journal 344 e1602 to e11
  3. Glassman P and Almader-Douglas D (2013) Health literacy Worcester, MA: National Network of Libraries of Medicine
  4. Koh HK, Berwick DM, Clancy CM, Baur C, Brach C, Harris LM, and others (2012) New federal policy initiatives to boost health literacy can help the nation move beyond the cycle of costly ‘crisis care’ in Health Affairs (Project Hope) Volume 31 Issue 2 pages 434 to 443
  5. Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, and others (2022) Association of health literacy with diabetes outcomes in Journal of the American Medical Association Volume 288 Issue 4 pages 475 to 482
  6. Remshardt MA (2011) The impact of patient literacy on healthcare practices in Nursing Management Volume 42 Issue 11 pages 24 to 9
  7. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ and Crotty K (2011) Low health literacy and health outcomes: an updated systematic review in Annals of Internal Medicine Volume 155 Issue 2 pages 97 to 107
  8. Baker DW, Wolf MS, Feinglass J, Thompson Ja, Gazmararian Ja and Huang J (2007) Health literacy and mortality among elderly persons in Archives of Internal Medicine Volume 167 Issue 14 pages 1503 to 1509
  9. Raynor DT (2012) Health literacy: Is it time to shift our focus from patient to provider in British Medical Journal Volume 344 e2188
  10. Oliveira D, Bosco A, di Lorito C (2019) Is poor health literacy a risk factor for dementia in older adults? Systematic literature review of prospective cohort studies in Maturitas Volume 124 pages 8 to 14
  11. Dufour I, Lacasse A, Chouinard M, Chiu Y, Lafontaine S (2019) Health literacy and use of healthcare services among community-dwelling older adults living with chronic conditions in Clinical Nursing Studies Volume 7 Issue 2 pages 79 to 86
  12. Fabbri M, Yost K, Finney Rutten LJ, Manemann SM, Boyd CM, Jensen D, and others (2018) Health Literacy and Outcomes in Patients With Heart Failure: A Prospective Community Study in Mayo Clinic Proceedings Volume 93 Issue 1 pages 9 to 15
  13. Balakrishnan MP, Herndon JB, Zhang J, Payton T, Shuster J, Carden DL (2017) The Association of Health Literacy With Preventable Emergency Department Visits: A Cross-sectional Study Volume 24 Issue 9 pages 1042 to 1050
  14. Bragard I, Coucke P, Pétré B, Etienne A, Guillaume M (2017) Health literacy, a way to reduce social health inequalities in Revue Medicale de Liege Volume 72 Issue 1 pages 32 to 36
  15. Peterson G, Aslani P, Williams KA (2003) How do consumers search for and appraise information on medicines on the Internet? A qualitative study using focus groups in Journal of Medical Internet Research Volume 5 Issue 4
  16. Vida Estacio E, Whittle R, Protheroe J (2019) The digital divide: Examining socio-demographic factors associated with health literacy, access and use of internet to seek health information in Journal of Health Psychology Volume 24 Issue 12 pages 1668 to 16675.
  17. Miller TA (2016) Health literacy and adherence to medical treatment in chronic and acute illness: A meta-analysis in Patient Education and Counseling Volume 99 Issue 7 pages 1079 to 1086
  18. Pollock K, Grime J (2003) GPs’ perspectives on managing time in consultations with patients suffering from depression: a qualitative study in Family Practice Volume 20 Issue 3 pages 262-269
  19. The Royal Australasian College of Physicians (2009) Towards a national primary care strategy: A discussion paper from the Australian government, Sydney
  20. Panagioti M, Skevington SM, Hann M, Howells K, Blakemore A, Reeves D, and others (2018) Effect of health literacy on the quality of life of older patients with long-term conditions: a large cohort study in UK general practice Volume 27 Issue 5 pages 1257 to 1268
  21. World Health Organization (2009) editor Health promotion: Track 2: Health literacy and health behaviour 7th Global Conference on Health Promotion; Nairobi: World Health Organization
  22. Belcastro PA, Ramsaroop-Hansen H (2017) Addressing the Antinomy Between Health Education and Health Literacy in Advancing Personal Health and Public Health Outcomes Volume 87 Issue 12 pages 968 to 974
  23. Neal MRO, Geiger BF, Cellitti MA, Smith KH (2012) Web sense: Assisting individuals with disabilities and caregivers to find online health information in Journal of Consumer Health On the Internet Volume 16 Issue 3 pages 295 to 306
  24. SCONUL Advisory Committee on Information Literacy (1999) Information skills in higher education. London; 1999
  25. Akobeng AK (2005)  Principles of evidence based medicine in Archives of Disease in Childhood Volume 90 Issue 8 pages 837 to 840
  26. Sackett DL (1997) Evidence-based medicine in Seminars in Perinatology Volume 21 Issue 1 pages 3 to 5
  27. Silberg WM, Lundberg GD, Musacchio RA (1997) Assessing, controlling, and assuring the of medical information on the Internet quality in Journal of the American Medical Association Volume 277 Issue 15 pages 1244 to 1245

Ms Caroline De Brún