Published Materials
Tips to Protect Yourself and Others From COVID-19
Duke University Health System Patient Education
Duke University Health System (DUHS) hospital discharge instructions, also called After Visit Summaries (AVS) previously included 5 to 7 pages of COVID-19 information. The documents did not incorporate best practices for patients and caregivers with low health literacy. Patients, along with clinical team members, stated the information was too long and hard to understand.
The DUHS Patient Education* team collaborated with key, multi-disciplinary stakeholders to create a concise and useful document. This guide contained accurate COVID-19 safety information and would replace outdated, lengthy materials. They sought to create a document that pediatric and adult patients could use across DUHS. The new document focused only on pertinent and essential information.
A one-page COVID-19 resource replaced the previous 7-page document and includes embedded links to direct patients and caregivers to more information. Throughout the document, they incorporated health literacy writing and design principles, including icons, intentional use of white space, consistent use of plain language, and action-oriented words.
*DUHS Patient Education:
- Margaret Sturdivant, MSN, RN, CPPS, Administrative Director for Patient Education and Clinical Affiliations
- Mary Susan Moss, BSN, RN, MA, OCN, Project Lead and Clinical Nurse Educator
- Jen Massengill, MSN, RN, CNML, Clinical Nurse Educator
Award Recipient Quote
“Our team is incredibly honored and grateful to have been chosen for an IHA Health Literacy Award for 2022. We would first like to thank IHA for the many health literacy resources as well as avenues for continuing education and collaboration across the world that enable us to better serve our patients and caregivers. We are encouraged by the work we are able to complete at Duke University Health System (DUHS) to educate our patients in the modalities most appropriate for them and the clinicians we support. We are excited to be recognized for our work to publish materials to reach patients with low literacy, ultimately improving their outcomes. Our work at DUHS is enhanced by close partnerships and collaboration with the teams in Infection Prevention, Marketing, Technology Solutions, and the Patient Education Governance Council. Without their help and expertise, our work would not be possible. We hope to have the opportunity to meet and network with many of you in the future. For now, please accept our extreme appreciation on behalf of Duke University Health System and the patients we serve.”
From left to right: Margaret Sturdivant, Chuck Rodgers, Mary Susan Moss, Jen Massengill
Research
Focused Ethnography: Storytelling for Hispanics with Low Health Literacy and Diabetes
Virginia H. Cadenhead, PhD, RN, CNM
Assistant Professor of NursingCalifornia Baptist University
Storytelling is an intervention that can take many forms and address various health issues. Short, fictional stories are recommended in teaching people from oral cultures, and those with very low literacy. Previous research had shown that storytelling was effective in improving health outcomes for chronic disease management. The use of short, fictional stories for diabetes self-management education had not been researched among Hispanics with limited health literacy and diabetes.
Virginia Cadenhead, PhD, RN, CNM, Assistant Professor of Nursing at California Baptist University, primary researcher, has experience using storytelling for diabetes education in Guatemala. Health literacy experts recommend the learner verification interview. Dr. Cadenhead led the formative research project using that method along with traditional, ethnographic research.
Dr. Cadenhead wrote short, fictional stories that were culturally appropriate and designed to impart diabetes knowledge. The stories were further reviewed by certified diabetes educators. Individuals who identified as Hispanic and diagnosed with diabetes listened to the stories and answered questions about their storytelling experience. After analyzing the data, the result is 5 stories in both English and Spanish. These stories are designed for diabetes self-management knowledge, and may possibly change health outcomes for an at-risk population with limited literacy.
Award Recipient Quote
“I am so grateful to the IHA for their years of helping to improve patient outcomes using health literacy. I hope to continue to my research into storytelling as a tool for patient education, and am grateful to the IHA for supporting me in that effort. I am grateful to Dr Marion Dunkerley who introduced me to IHA when I began my doctoral work. I am grateful to California Baptist University for supporting me in my research, and to the University of Texas at Tyler where I was guided by my advisor, Dr Beth Mastel-Smith in my investigation into fictional storytelling for diabetes education. Thank you for recognizing my research with this award.”– Dr. Virginia H. Cadenhead
From left to right: Dean Karen Bradley and Dr. Virginia H. Cadenhead
International
The SUCCESS project: Development of a best practice health literacy app for adults living with chronic kidney disease
Dr. Danielle Muscat
Sydney Health Literacy Lab, University of Sydney
Chronic Kidney Disease (CKD) affects approximately 10% of the Australian population, with 110 people per million starting treatment for kidney failure each year. There is a marked social gradient in prevalence and incidence of CKD globally, and inadequate health literacy is common in individuals living with this condition.
Dr. Danielle Muscat, BPsych(Hons), PhD, Post-Doctoral Research Fellow, and a multi-disciplinary team at the University of Sydney developed the SUCCESS app to support Australian patients. Specifically, the app supports adults with kidney failure requiring dialysis, allowing them to actively participate in self-management and decision-making. Dr. Muscat also led the feasibility testing (2020) and randomized evaluation (ongoing) of the app.
The SUCCESS app content was informed by health literacy theory, which recognises the importance of reducing the complexity of health information, as well as equipping consumers with the skills necessary to access, understand, and act on this information. This is the first Australian app informed by a theoretical model of health literacy and developed to promote active patient participation in CKD management and decision-making.
Award Recipient Quote
“I would like to thank the Institute for Healthcare Advancement for taking the time to recognise those who have made outstanding achievements in health literacy. It is an honour to be recognised for the International award and I am proud to be able to showcase the work our team has put into developing the SUCCESS app. This would not have been possible without the funding and support we have received from Kidney Health Australia, Sydney Health Partners, and the New South Wales Ministry of Health via the Translational Research Grant Scheme.I hope that this award reflects the passion I have for improving health literacy; I look forward to continuing to create innovative solutions to bring about positive changes in the field and for the lives of those most in need.”
Innovative Programs
The Utility of Community-Academic Partnerships in Increasing Vaccine Uptake Across Minoritized Groups
Loma Linda University Health, Inland Empire of Concerned African American Churches, El Sol Educational Center
In early 2021, Loma Linda University Health (LLUH) housed the largest COVID-19 vaccination site in San Bernardino County, CA. Although 1000 to. 1900 people were vaccinated daily, only 3% of those vaccinated were Black. To address this discrepancy, LLUH developed a tiered approach to increasing vaccine uptake within the Black community.
Jacinda Abdul-Mutakabbir, PharmD, MPH, lead pharmacist, and her team* addressed the importance of faith and community leaders engaging minoritized communities in health literacy initiatives. They collaborated with minority faith leaders of Congregations Organized for Prophetic Engagement. Their aim was to deliver information sessions describing the available COVID-19 vaccinations.
Following these information sessions, Jacinda and her Loma Linda University team started vaccination clinics at the churches of Black pastors within the targeted communities. Jacinda and her team have successfully vaccinated over 2,000 Black and LatinX individuals with a single dose of a COVID-19 vaccine. Through bi-monthly sessions, they continue to provide education through the Zoom platform.
*Loma Linda University Health Team
- Dr. Juan Carlos Belliard
- Dr. Bridgette Peteet
- Pastor Samuel Casey
- Bishop Kelvin Simmons
- Mr. Alex Fajardo
Award Recipient Quote
“We would first like to thank IHA for honoring innovative programs advancing health literacy for the last 15+ years. The organization has been transformative to healthcare and health equity. The members of our community-academic partnership model: Loma Linda University Health, Congregation Organized for Prophetic Engagement, the Inland Empire of Concerned of African American Churches, and the El Sol Neighborhood Education Center, are incredibly grateful to be featured amongst this year’s honorees. Our success would not have been possible without the earning trust and respect of the Inland Empire Black and Hispanic/Latino communities. It has been out honor to work to promote vaccine equity across these minoritized groups. It is our to continue to provide education and innovative health models that assists in mitigating health inquires recognized within racially and ethnically minoritized communities.”
From left to right: Dr. Juan Carlos Belliard PhD, MPH, Pastor Samuel Casey, Dr. Bridgette Peteet PhD, Dr. Jacinda Abdul-Mutakabbir PharmD, MPH, Valentina Sanbria (representative for El Sol), not pictured: Alex Fajardo (El Sol)