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A healthcare provider wearing gloves and a mask shows a form to a patient.

Impact through Understanding

Health Literacy, Readability and Informed Patients 

What is health literacy?  

Health literacy and numeracy are measures of how well the general public understands their healthcare.

High health literacy rates usually translate to informed patients. Of course, not everyone has access to education about their healthcare. This could be due to general reading level, language barriers or other accessibility issues.   

Some systems for assessing health literacy include:  

  • The Newest Vital Sign (NVS)
  • Test of Functional Health Literacy in Adults (TOFHLA)   
  • Rapid Estimate of Adult Literacy in Medicine (REALM )
  • Food Label Literacy for Applied Nutrition Knowledge questionnaire (FLLANK)  

There are even assessments for specific diagnoses:  

  • Asthma Numeracy Questionnaire (ANQ)  
  • HBP-health literacy scale (HPB-HLS)  
  • Diabetes Numeracy Test (DNT-15)  

According to the International Encyclopedia of Public Health, health literacy is "the ability of citizens to make sound decisions concerning health in daily life."

Why does health literacy matter? 

Patients that understand their medical care are more likely to follow instructions for use correctly and thus more likely to achieve the desired effect. Improving patient outcomes is always the goal; understandable healthcare documents are key to achieving it.  

Public health efforts related to patient literacy are important for addressing other societal inequities. For example, health outcomes are often correlated with education level and race. A 2006 publication in the Journal of General Internal Medicine showed that at the time, health literacy rates had a small to moderate effect on general health status. Yet the ability of the healthcare industry to address health literacy is much greater than the industry’s current abilities to refresh educational programs or reform communities to reduce systemic racism. 

  

How does health literacy relate to vaccine uptake?  

The public’s ability to understand and trust medical professionals is of utmost importance during vaccine rollout. While some populations are eager to get immunized no matter the brand, others are skeptical. Resistance to taking the COVID-19 vaccine can be attributed to suspicion about the “new” mRNA technology, doubt that a vaccine with produced at speed is effective or safe, a history of mistreatment by healthcare systems and more. Better informed, more health-literate patients are more likely to get immunized.  

A patient examines a medical form.

Who monitors readability and health literacy? 

Both governmental entities and non-profit organizations recommend (and sometimes require) certain standards of readability.   

A 2015 estimate of European health literacy showed disparities in understanding across countries, with a rough range from 3 to 6 of 10 patients who showed insufficient comprehension of their healthcare decisions.   

The Agency for Healthcare Research and Quality (AHRQ) suggests that relying on readability formulas can result in an inaccurate assessment of content. It defines clarity in no uncertain terms: 

 “Information is clear if the audience for that information can understand it.”  

That’s a short way of saying that no matter how technically experienced a report writer, the understandability of a text is determined by the reader. That means “readability” is in some ways a person-to-person experience rather than a simple set grade.  

Some readability comparisons make sense: typically developing children will need simpler instructions than a typically developed middle-aged adult. But many are not as intuitive: in 2018, Chinese literacy rates ranged from 99.8 percent for 15 to 24 year olds to 85 percent for those 65 and older. (This dip in literacy in older generations repeats in many other countries as well.)  

  

Who can change health literacy and increase understanding?  

While lifelong education is one entry point for improved patient understanding, a quicker way to achieve the same goal is to modify current, past and future content to be accessible to all.  


How can Lionbridge help?  

The Lionbridge Life Sciences team is dedicated to building bridges between medical and scientific communities and the people who benefit from their innovations. Our solution architecting services and project management expertise offers boutique level customization with the power and experience of a multinational company.   

We can roll all your pharmaceutical, medical device or clinical trial needs into one fulfilling relationship. Our experts can translate your work not just into any language, but any register or reading level. And we are always up to date on the latest regulations, which means one less worry for your team.  

Our complete set of tech-enabled services that provide organizations with total insight into readability and understandability. Powerful machine learning tools provide quantitative scoring against various metrics, and expert insights into content creation processes drive faster, smoother market entry. 

Reach out to us today to find out how we can help your company do your best work by giving you ours.  

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April M. Crehan
AUTHOR
April M. Crehan