A process for creating data report-back tools to improve equity in environmental health.

Background: Although there is increasing interest in reporting results of environmental research efforts back to participants, evidence-based tools have not yet been applied to developed materials to ensure their accessibility in terms of literacy, numeracy, and data visualization demand. Additionally, there is not yet guidance as to how to formally assess the created materials to assure a match with the intended audience.

Methods: Relying on formative qualitative research with participants of an indoor air quality study in Dorchester, Massachusetts, we identified means of enhancing accessibility of indoor air quality data report-back materials for participants.

Characterizing the Environmental Health Literacy and Sensemaking of Indoor Air Quality of Research Participants.

This study is based on in-depth semi-structured interviews with the participants of an indoor air quality monitoring study. The purpose of the interviews was to capture participants' perceptions of indoor air quality and engage them in a discussion of those factors that influenced their behavior. Interview study participants ( = 20) noted the importance of family health concerns and their own sensory awareness of possible contaminants.

A Call for More Rigor in Science and Health Communication.

Successful dissemination of scientific knowledge relies on the ability of the writer, speaker, and designer to provide information and data that is both available and accessible to the audience for whom it is intended. Scientific rigor, uniformly applied to the development of medicines, products, and devices must be applied, as well, to communications-spoken, written, posted, or displayed. Rigorous development and design protocols call for formative research data gathering, careful pilot testing with members of the intended audience, needed revisions, and rigorous assessments.

Collaborative updating of an organizational health literacy tool confirms medical librarians' leadership roles.

Background: A librarian led task force at the University of Tennessee Medical Center sought to evaluate their medical centre's health literacy attributes utilizing a widely used tool. This research ultimately led to the update of the tool.

Objectives: To discuss the evaluation of health literacy attributes of health care organizations and detail the process of updating the Health Literacy Environment of Hospitals and Health Centers (HLEHHC) tool.

Enhancing organizational health literacy in a rural Missouri clinic: a qualitative case study.

Purpose: The purpose of this paper is to evaluate a collaborative effort between a health care organization and academic institution to strengthen organizational health literacy.

Design/methodology/approach: The intervention took place at a rural, federally qualified health clinic in Missouri between May 2009 and April 2011. Qualitative interviews of key informants were conducted before (=35) and after (=23) the intervention to examine program implementation and success in effecting organizational change.

Communication between Health Professionals and Community Residents in Fukushima: A Focus on the Feedback Loop.

Interactive communication and the ability to consider feedback are critical for linking health professionals and the community. Goto and colleagues developed and conducted health literacy training workshops for public health nurses after the 2011 nuclear accident in Fukushima to improve their communication skills. The present study aimed to examine the association between past workshop attendance and nurses' attitudes toward feedback from community residents.

Lingering health-related anxiety about radiation among Fukushima residents as correlated with media information following the accident at Fukushima Daiichi Nuclear Power Plant.

Following the March 2011 accident at Fukushima Daiichi Nuclear Power Plant, many residents of Fukushima have faced anxieties about the health impacts of radiation exposure. Considering that source of information may influence resident anxiety, this study aimed to elucidate the correlation between the two. In addition, a health literacy query was included to examine a possible relationship between anxiety and health literacy skills.

Health Literacy Considerations for a New Cancer Prevention Initiative.

Cancer prevention efforts are newly focused on the older adult population. Adult literacy and health literacy findings and suggestions can help shape more efficacious health communication strategies and thereby increase the "accessibility" of important health information and the potential for healthful action. National and international surveys of adult literacy skills have consistently offered problematic findings that older adults have more limited proficiencies than do younger working adults and face difficulties using commonly available materials to accomplish everyday tasks.

Expanding Environmental Health Literacy-A Focus on Water Quality and Tribal Lands.

Environmental health literacy (EHL), an evolving concept, has potential for significant public health impact. However, complex skills are needed to access and use information, to study and document hazards, to link findings to health outcomes, and to understand the complexities of regulations and laws needed to take efficacious action. Because water issues are creating headlines world-wide, we draw from several water-related cases on American Indian tribal lands to examine some of the complexities associated with building needed skills, obtaining accessible information, and navigating the layers of laws and regulations that enable or inhibit efficacious action.

Literacy Analysis of Spanish Online Resources for Breast Reconstruction.

Background: Health literacy studies indicate that literacy skills are linked to access to information and health outcomes, potentially contributing to health disparities. In the United States, minority and immigrant populations are more likely to have lower literacy skills than are other population groups. The aim of this study is to evaluate web-based health information prepared in Spanish for Hispanic women considering breast reconstruction surgery.

Collaborative Processes of Developing A Health Literacy Toolkit: A Case from Fukushima after the Nuclear Accident.

Following the Fukushima nuclear accident in 2011, the central government provided health and radiation-related information that was incomplete, difficult to understand and contradictory, leading to widespread distrust in the community. Thus, from 2013 to 2014, we developed and implemented a series of health literacy training workshops for local public health nurses, often the first health care professionals with whom members of the community interact. The results from our program evaluation revealed that the task of paraphrasing professional terms and skills related to relaying numeric information to the community were difficult for the nurses to acquire.

Literacy analysis of National Comprehensive Cancer Network patient guidelines for the most common malignancies in the United States.

Background: Cancer information is of critical interest to the public. The National Comprehensive Cancer Network (NCCN) offers a series of comprehensive patient guidelines on the management of the most common cancer diagnoses. This study was aimed at assessing the health literacy demands of NCCN patient guidelines for the most common malignancies in the United States.

Health Literacy: Insights and Issues.

Definitions, by their very nature, establish a shared understanding of words and concepts but also set parameters for inquiry and measures. Health literacy, a term that emerged in the 1990s, has been defined in numerous ways over time and is still considered an evolving concept. This chapter provides a discussion of the difficulties inherent in restricted definitions that have led to research gaps.

Readability, complexity, and suitability analysis of online lymphedema resources.

Background: Over 72% of Americans use online health information to assist in health care decision-making. Previous studies of lymphedema literature have focused only on reading level of patient-oriented materials online. Findings indicate they are too advanced for most patients to comprehend.

Readability, complexity, and suitability of online resources for mastectomy and lumpectomy.

Background: Nearly half of American adults have low or marginal health literacy. This negatively affects patients' participation, decision-making, satisfaction, and overall outcomes especially when there is a mismatch between information provided and the skills of the intended audience. Recommendations that patient information be written below the sixth grade level have been made for over three decades.

The health literacy dyad: the contribution of future GPs in England.

Background: Health literacy studies have primarily focused on the cognitive and social skills of individuals needed to gain access to, understand, and use health information. This area of study is undergoing a paradigm shift with increased attention being paid to the skills of practitioners and an examination of their contribution to the link between literacy and health outcomes. The aim of this study was to describe the health literacy related competencies of General Practice (GP) trainees who will soon be responsible for the clinical encounter.

Consumer knowledge about over-the-counter NSAIDs: they don't know what they don't know.

Objective: To investigate consumers' knowledge about commonly purchased over-the-counter (OTC) products containing ibuprofen.

Methods: Customers buying two popular OTC ibuprofen-containing products (Nurofen or Nurofen Plus ) were asked to complete a short survey assessing their knowledge about the products.

Results: The survey was completed by 262 respondents, most of whom were older than 50 years of age; female; well-educated; with adequate functional health literacy.

Improving low health literacy and patient engagement: A social ecological approach.

Objective: This article posits four principal objectives related to the overarching goal of broadening the conceptualization of health literacy. We propose a social ecological approach to health literacy and patient engagement by illustrating how this multilevel approach offers an array of strategic options for interventions.

Discussion: A social ecological approach supports a broader understanding of health literacy that aligns with increased patient engagement.

A Mismatch Between Patient Education Materials About Sickle Cell Disease and the Literacy Level of Their Intended Audience.

Introduction: Despite the first goal of the 2010 National Action Plan to Improve Health Literacy, the literacy demands of much health information exceeds the reading skills of most US adults. The objective of this study was to assess the health literacy level of publicly available patient education materials for people with sickle cell disease (SCD).

Methods: We used 5 validated tools to evaluate 9 print and 4 online patient education materials: the simple measure of gobbledygook (SMOG) to assess reading grade level, the Peter Mosenthal and Irwin Kirsch readability formula (PMOSE/IKIRSCH) to assess structure and density, the Patient Education Materials Assessment Tool (PEMAT) to assess actionability (how well readers will know what to do after reading the material) and understandability, the Centers for Disease Control and Prevention's (CDC's) Clear Communication Index (Index) to obtain a comprehensive literacy demand score, and the Printed Cancer Education Materials for African Americans Cultural Sensitivity Assessment Tool.

Health Literacy Training for Public Health Nurses in Fukushima: A Multi-site Program Evaluation.

Public health nurses (PHNs) are community residents' access points to health information and services in Japan. After the Fukushima nuclear accident, they were challenged to communicate radiation-related health information to best meet community needs. We previously developed and evaluated the outcome of a single-site health literacy training program to augment PHNs' ability to improve community residents' access to written health information.

Role of Health Literacy in Self-Reported Musculoskeletal Disorders.

Self-report of musculoskeletal conditions is often used to estimate population prevalence and to determine disease burden and influence policy. However, self-report of certain musculoskeletal conditions is frequently inaccurate, suggesting inadequate communication to the patient of their diagnosis. The aim of this study is to determine the association between functional health literacy (FHL) and self-reported musculoskeletal conditions in a representative population survey.