By Ricardo V. López, MPH, CHES, Senior Educator, Population Health Program, Astrana Health
In this edition of Health Literacy Voices, Ricardo V. López reflects on the everyday leaders who move the field forward, the tool that transcends disciplines and why focusing on the end user is the most transformative change of all.
What Is Your Vision for the Field of Health Literacy?
A fully inclusive, multifacetedly integrated and recognized field across disciplines and sectors. Where it is always seen as the ROI evidence-informed solution that it is.
What Are Your Greatest Concerns for the Field?
That it’s systemically sacrificed and/or classified as an out-of-stream solution instead of being championed. At times it is the messenger—let’s continue to refine how we articulate the benefits of prioritizing health literacy and augment the way we champion it to those not familiar with its virtues. I often find myself operationalizing the very same tools of health literacy to advocate for health literacy. As you know, it’s humbling and at times frustrating, but our end users are worth it.
Which Historical or Contemporary Figure Best Represents the Principles of Health Literacy?
The historical trailblazing figures of our field have earned our praise and respect. However, I believe the figures that best represent the principles of health literacy are the day-to-day servant leaders on the front lines: the school parent who’s decided to learn to become a community health worker, the new graduate who’s bringing new energy to an established program, the nurse manager who sticks out their neck to champion the health literacy universal precautions approach, the director who’s decided to make the case for budgeting the organizational health literacy task force, the health literacy practitioner or advocate who’s realized they need to learn something new to help make the case for health literacy in their organization.
What Is the Most Misunderstood Aspect of Health Literacy?
In my professional opinion, the most common perception that stalls and impedes health literacy efforts is the perception that we wouldn’t need it if people were motivated to help themselves. As we know, the evidence doesn’t support that.
I’m not blaming the learner, and no one has explicitly “blamed the victim” in my trainings or professional interactions, but through experiential learning I can tell it’s a core aspect that needs to be addressed. We need to continue to find innovative ways to make the case that all of us benefit from health literacy efforts, especially those historically marginalized.
What Is Your Favorite Tool or Resource to Improve Health Literacy?
Teach-back transcends disciplines faster due to its practicality.
Teach-back. All health literacy tools, if not “cookie-cuttered,” are powerful, but in my experience teach-back transcends disciplines faster due to its practicality. With tools like plain language, the strengths-based approach, motivational interviewing and stages of change (just to name a few), new learners must grasp the foundational essence of absolute worth and health equity. I find that my training participants grasp the essence of teach-back at a faster rate, especially once they realize it saves time in the long run: fewer follow-up calls to re-explain things to patients.
Where Would You Most Like to See Health Literacy Make an Impact?
In for-profit health care. It’s changing, and many organizations in this field are pioneering great efforts, but health literacy in this field needs to take its rightful place as a pillar, like the Triple Aim. Yes, we can benefit from health literacy being integrated into undergraduate, graduate and professional school curriculums, and public policy might ultimately dictate it, but health care organizations are what will ultimately drive the conversation in patient care and health literacy. I ’m fortunate to be part of an organization that values health literacy.
How Do You Handle Setbacks or Resistance in Health Literacy Initiatives?
Remember the needs of the end user.
Remind myself that the evidence behind health literacy is bigger than all of us—it’s a matter of helping others to connect the dots.
Change is the only constant—always be willing to learn.
Be humble and ask for help—others are also fighting the good fight.
I don’t have the power to change the end user. I must find a way to help them find their own internal motivation for change.
How Do You Define Success in Health Literacy?
Overall, when it’s evident the end user is positively impacted. In health care, it’s when our patients’ outcomes are trending in the right direction, and we have documentation to prove it’s because of health literacy efforts.
What Innovation Holds the Most Promise for Improving Health Literacy?
I’m a strong believer in supporting and leveraging innovation. It’s part of the solution. But I’m also cautious not to certify a new innovation as the solution we’ve all been waiting for. Innovation must be an everyday ideal. And sometimes the smallest innovation is the most elegant—like when we develop a new approach based on the needs of a unique community after learning an existing evidence-based model doesn’t work.
If You Could Shape the Future of Health Literacy, What One Transformative Change Would You Make?
Always focus on the needs of the end user. Genuinely do what you can to accept the absolute worth of the end user through accurate empathy, and let go of the burden that plagues all of us—that we have the power to change them. It’s transformative in the sense that it’s the essence of our work, and sometimes we (I’m guilty of it as well) forget the simplicity of that focus.
About the Author
Ricardo V. López, MPH, CHES, is senior education lead for the Population Health Program at Astrana Health. He develops patient education and staff training programs and played a key role in helping the organization earn National Committee for Quality Assurance (NCQA) Population Health Program accreditation for heart failure and chronic kidney disease. With expertise across community, hospital and health care settings, he champions an evidence-based, interdisciplinary approach to improving patient outcomes.
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