Communication Methods for Low Health Literacy Patients

By: Madison Boissiere, Undergraduate Student in Food Science and Human Nutrition at the University of Illinois Urbana-Champaign.

Health Literacy

According to the CDC, health literacy is defined as “the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions”. It is essential for dietitians and other health professionals to be aware of their patients’ health literacy in order to maximize the amount of information communicated with the patient.

Low Health Literacy

Low Health Literacy is most common among:

• Older adults
• Minorities
• Low socioeconomic populations
• People with limited English proficiency

Patients with low health literacy may need help with:

• Filling out health forms
• Sharing their medical history
• Seeking preventative health care
• Communicating their health needs and preferences
• Knowing how certain risk factors affect health
• Understanding medication directions
• Managing chronic health issues

Assessing Patients with Low Health Literacy

Those with limited health literacy share common traits that RDs must look out for. These traits include using concrete and immediate language rather than abstract terminology, literal interpretations, and difficulties processing information, such as menus or medicine instructions.

Oftentimes, patients try to hide their literacy skills by saying statements such as “I left my glasses at home” or “I will read this when I get home”. Take note of these statements and adjust your communication with the patient and offer support when necessary.

Health literacy can take the form of aspects other than reading. Bridgette Collado, MA, RD, a health and nutrition communication consultant, says “Numeracy, computer literacy, and visual, hearing, and cognitive impairments also have a role in health literacy”. By understanding the different aspects related to health literacy, dietitians will be able to assess a patient’s skills during sessions and promote a means of understanding between the patient and dietitian.

Dietitians can communicate with patients with low health literacy by:

Limiting lessons taught in one session

Less is more when it comes to teaching lessons. Patients will be able to understand and remember more information when they learn it over a longer period of time.

Using simple language and defining technical terms

Always define medical terminology and limit the use of jargon. For example, instead of using the word “positive” when describing test work results, use terms like “not okay” or “above normal”.

Organizing information so that the most important points stand out

Make central ideas most prominent in conversation and circle any important information on pamphlets and documents. Include definitions with key terms to ensure the patient can look at the information at home and still understand it.

Asking patients to teach back what was taught to them

If a patient struggles to repeat the information back correctly, rephrase information rather than simply repeating it. Dietitians can also ask how the patient plans on using the information. For example, a dietitian may ask a patient what they will eat for breakfast tomorrow to limit their salt intake. 

Practicing active listening

Ask open-ended questions and encourage the patient to share any information or questions they have.

Using examples and activities

Practicing real-life skills with your patient will build confidence and improve their memory on the subject. Some great activities are practicing reading food labels or demonstrating portion sizes using real-life models.

Using materials and language written in a seventh-grade reading level or below

For example, instead of saying “Studies show that the Mediterranean diet is associated with a decreased risk of cardiovascular disease”, say “The Mediterranean diet can lower the risk of heart disease.”

In essence, dietitians are here to help translate the science of nutrition into real-life solutions to help promote healthy lifestyles to their patients. Being able to effectively communicate information with patients will set them up for success in their own lives and impact the decisions they make throughout their lifetime.

References

1. Centers for Disease Control and Prevention. “What Is Health Literacy?” Centers for Disease Control and Prevention, 23 Oct. 2019, cdc.gov/healthliteracy/learn/index.html

2. Ip, Melissa, MA, RD. “Keys to Clear Communication – How to Improve Comprehension Among Patients With Limited Health Literacy.” Today’s Dietitian, todaysdietitian.com/newarchives/050310p26.shtml

3. Network of the National Library of Medicine. “Health Literacy.” Network of the National Library of Medicine, nnlm.gov/initiatives/topics/health-literacy

4. S. Health Resources & Services Administration. “Health Literacy.” U.S. Health Resources & Services Administration, 13 Aug. 2019, www.hrsa.gov/about/organization/bureaus/ohe/health-literacy/index.html

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