Earlier this week Health and Human Services (HHS) released the enhanced National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. This is meant to be a blueprint to guide individuals and organizations in implementing culturally and linguistically appropriate services in order to help advance better health and health care in the United States. You can read the press release here.
According to the www.ThinkCulturalHealth.hhs.gov website:
Health inequities in our nation are well documented, and the provision of culturally and linguistically appropriate services (CLAS) is one strategy to help eliminate health inequities. By tailoring services to an individual’s culture and language preference, health professionals can help bring about positive health outcomes for diverse populations.
We couldn’t agree more. At VIA we believe that bridging the language gap is key to ensuring culturally diverse communities enjoy equal access to healthcare. That said, we realize that reaching out to an ever-expanding range of cultures in your community and finding solutions to best meet the growing needs for your limited English proficiency (LEP) populations is challenging and complex. But, we’re here to help. From websites to patient education, VIA tailors each communication to the targeted culture.
As dedicated healthcare specialists, we serve over 400 healthcare clients globally. We’ve built translation capabilities in over 125 languages and a hand-selected network of over 1,000 professional healthcare-specific linguists.
In addition, to help you with this particular aspect of health equity, we have also created a guide with tips about how to keep current with language access mandates while still providing culturally and linguistically meaningful healthcare communications to your members and community.
I just read an article that a bill for Cultural Competency (House Bill 2611) is heading to the House floor in Oregon which would allow the state’s medical licensing boards to require that health professionals must take cultural competency continuing education courses to remain licensed. Cultural competency training for health professionals is already the law of the land in six states including Washington and California, according to the U.S. Department of Health and Human Services. Five other states, as diverse as New York, Ohio, Georgia and Arizona are also currently considering adopting the practice.
Cultural competency, along with providing patient materials which can be fully understood in their native language at the appropriate literacy level, can greatly improve not only health literacy and patient engagement, but overall cost to individuals and our healthcare system at large. In “The HealthCare Blog” Judith Hibbard and Jessica Green share ample evidence that the behaviors people engage in and the health care choices they make have a very clear effect on both health and costs, both positively and negatively. Their study reported in the February issue of Health Affairs, highlights this role that patients play in determining health-related outcomes:
We found that patients who were more knowledgeable, skilled and confident about managing their day-to-day health and health care (also known as ‘patient activation,’ measured by the Patient Activation Measure) had health care costs that were 8 percent lower in the base year and 21 percent lower in the next year compared to patients who lacked this type of confidence and skill. These savings held true even after adjusting for patient differences, such as demographic factors and the severity of illnesses.
For more information check out our webinar: Culturally Competent Healthcare: Strategies and Tools for Making a Difference.
Continuing in the spirit of National Minority Health Month and expanding on Natalie’s blog last week, let us talk about ways to address health literacy when developing content in any language. Most of the tips are from Marketing 101, but others I have learned from working in the translation business. I hope they will help you develop easy-to-read materials for skilled readers as well as for those with reading and comprehension challenges.
Writing the Content – Goal: Make it easy to understand
- Use familiar and simple vocabulary.
- If you must use a difficult word, explain it to readers immediately after using it or provide a simpler alternative in parentheses.
- Avoid acronyms, abbreviations and jargon.
- Avoid bureaucratic language and legalese which is generally written at a high reading level and in an authoritarian tone.
- Write clearly in an active voice.
- Write one-topic paragraphs.
- Write in short sentences and use bullet points and numbers when possible.
- Test content for literacy/readability level with “Flesch-Kincaid Reading Level” aiming for 8th grade literacy level or lower.
Formatting the Content – Goal: Make it easy to read
- Use clear headings.
- Q&A formats work well.
- Use simple or familiar fonts and keep the number of different fonts down. (I recommend no more than two different fonts in same document.)
- Keep font size at 11 points or higher.
- A generous amount of “white space” offers the reader visual relief and improves the readability of a document.
- Take advantage of the power of pictures and graphics.
Want to know more? Check out our webinar titled “The Benefits of Health Literacy: Supporting Limited English Proficient Communities.”
April is National Minority Health Month and the theme for 2013 is “Advance Health Equity Now: Uniting our Communities to Bring Health Care Coverage to All.” One of the biggest barriers we see to health equity is health literacy. Not only does it make navigating eligibility under the Affordable Care Act (ACA) challenging for someone who hasn’t been in the system for a number of years and/or someone with Limited English Proficiency (LEP), it is also affecting member acquisition, satisfaction and retention, as well as critical access to information on wellness, prevention and disease management.
The need for awareness and adherence to health literacy principles has become a public health concern estimated to cost the U.S. economy between $100 and $238 billion annually. Health literacy is a broad issue for 90 million people in the US that affects their ability to stay healthy. Only 12 percent of adults in the US today have proficient health literacy skills according to the National Assessments of Adult Literacy (NAAL). This means that nine out of 10 adults may lack the skills they need to manage their care and improve their health. Furthermore, 14 percent of adults have below basic health literacy and are more likely to report their health as poor, as well as lack health insurance.
Education, language, culture, access to resources, and age are all factors that impact a person’s health literacy. Ensuring that health education messages are understood, comprehended and adhered to starts with creating content at an eighth grade or lower literacy level, speaking in first person and using short sentences. It’s also important to incorporate pictures, bullet points and simple easy to understand graphics. Lastly, incorporating cultural nuances for LEP populations will increase readers’ understanding of the material.
Find out more about how you can ensure literacy with your healthcare communications in our brief titled “Growing Challenges of Health Literacy.”