By Cynthia Baur, PhD, Director, University of Maryland Horowitz Center for Health Literacy, and Clare Kelley, MS, HLS, CCLS, Plain Health with Clare
In this edition of Health Literacy Voices, health literacy experts Dr. Cynthia Baur and Clare Kelley weigh in at the intersection of health literacy research, policy and practice.
Cynthia Baur, PhD: Where the Cycle Starts Matters
The Practice-Research-Policy cycle can start at any of the three phases, and the starting point influences what happens next. Practice may seem like the most intuitive starting point because everyone wants to know if the intervention will work in the “real world.” But interventions are limited by time, money, scope and other factors.
Policy might be an obvious starting point too because it can create the framework for practice and research, but we don’t always know what makes good policies.
Research with an eye toward practice and policy makes the best use of all our resources.
Therefore, research with an eye toward practice and policy makes the best use of all our resources, and the health literacy field hasn’t yet created this virtuous cycle. Interprofessional teams that combine expertise in practice, research and policy are one way to add scientific rigor, practicality and broader impact to what we do in health literacy.
About Cynthia: Cynthia Baur, PhD, is a health literacy and health communication expert focused on improving health literacy at the individual, family, community and organizational levels. She directs the University of Maryland Horowitz Center for Health Literacy, the nation’s first academic health literacy center, and is a professor in the Department of Behavioral and Community Health. In 2022, Dr. Baur and other advocates worked with Maryland Delegate Joseline Peña-Melnyk, who sponsored Maryland HB1082, to designate the Horowitz Center as the state’s consumer health information hub. Dr. Baur is the principal investigator on multiple federal and state funded projects on health literacy, clear communication, digital health, diabetes prevention and organizational health literacy improvement. During the COVID-19 pandemic, the center provided communications support to Maryland local health departments and coalitions, and before and after the pandemic, the center has supported the Maryland Department of Health and local health departments on the state’s diabetes action plan. Dr. Baur provides training and expert advice to local, state and national committees and initiatives. Before coming to UMD, she served for almost 20 years in the federal Office of Disease Prevention and Health Promotion and the Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services. She was CDC’s Plain Language and Health Literacy Lead from 2011 to 2016.
Clare Kelley, MS, HLS, CCLS: Lessons From Child Life
We know that research, policy and practice are all important spokes of the health literacy wheel. The question is: What can we do to get the wheel rolling? It can help to look at other health disciplines that have faced the same question.
Certified child life specialists work with patients and families in pediatric hospitals. Their role is to provide services like diagnosis education, psychological preparation for procedures and coping support. It’s still a relatively new field, so specialists often face pushback from providers. These vital services are sometimes viewed as a “nice to have” for patient experience instead of what they are: imperative for patient psychological safety.
This is where research and policy come in. Studies show that when a pediatric patient has child life support, they comply with care more quickly, cope better and experience less medical trauma. With these studies to back up their practice, child life specialists have been able to advocate for patient- and family-centered policies at their institutions. At some hospitals, it’s now policy to try every other possible solution before holding a child down for a procedure. Some hospitals require that a child life specialist be consulted when a child receives a chronic or serious diagnosis. These policies reflect the research findings and officially embed child life services into practice.
What can we learn from this?
Research is the foundation: We have to know what works before we can implement and scale it.
Policy holds us accountable: It’s what will move health literacy from one-off interventions to becoming the standard of care.
Practice is the goal: With the research and policy to back up our work, we can reach the most people with the best possible resources.
About Clare: Clare Kelley is a certified child life specialist and health literacy specialist with a background in patient education, plain language writing and accessible content design. She runs a health literacy practice, Plain Health with Clare, where she creates engaging, audience-centered resources that help make complex health information easier to understand. She also serves as the chair of USHLA’s marketing and communications task force.
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