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Healthcare and Community Approaches to Improving Health
Literacy With Vulnerable Senior Populations – The Southeast
Pennsylvania Regional Enhancements Addressing Disconnects in
Cardiovascular Health Communication (READS) Project
Rob Simmons, DrPH, MPH, CHES, CPH, Thomas Jefferson
University, School of Population Health; James Plumb, MD, MPH,
Thomas Jefferson University, Dept. of Family and Community
Medicine; Rickie Brawer, PhD, MPH, CHES, Thomas Jefferson
University and Hospital; Patricia Yurchick, RN, MBA, CPHQ, The
Health Care Improvement Foundation; Kate Flynn, FACHE, The
Health Care Improvement Foundation
The limited level of health literacy is a serious and escalating public
health issue. Consumers must be proficient in health literacy to lead
healthy lifestyles, to effectively navigate the healthcare system, and
to advocate for their health needs. The Health Care Improvement
Foundation (HCIF), in collaboration with Thomas Jefferson
University and Hospital in Philadelphia has organized a coalition
to address health literacy in Southeast Pennsylvania. Its goals are to
identify, implement and evaluate educational and systems changes
to enhance the cardiovascular (CVD) health literacy needs of adults
aged 50+, and improve their ability to communicate effectively with
healthcare providers/staff at multiple points of care to promote their
ability to effectively act on cardiovascular health information. This
regional project incorporates best practices and chronic disease prevention
competencies in health literacy training and patient empowerment
activities to enhance the quality and safety activities in health
systems and hospitals. Its work focuses on health literacy as a key
determinant underlying disparate outcomes in hypertension, coronary
artery disease, congestive heart failure and stroke with an emphasis on
low income and diverse populations including non-English speaking
patients and consumers. The model guiding this work is the Expanded
Chronic Care Model which combines Wagner’s Chronic Care Model
with the Institute of Healthcare Improvement’s Triple Aim Initiative
emphasizing system change, the patient and provider care experience,
and improved outcomes. The anticipated impact includes :1)
Institutionalization of effective communication materials and strategies
into the culture of patient quality and safety; 2) A centralized educational
materials repository; 3) Reduced CVD related readmissions;
4) Reduced CVD medical errors; 5) Improved CVD patient disease
management/ self-care behaviors; 6) Increased patient and provider
satisfaction with health communication; 7) Policy changes that support
patient-centered health care services; 8) Improved cardiovascular
health outcomes. The Coalition and its professional and community
advisory groups will create new materials, programs and polices/
systems that support and enhance programs and activities including
managing medications, coaching/handoffs, and personal health records
as examples to take to scale in hospital/health systems as well as integrating
literacy improvement techniques and strategies, such as Teach
Back, Plain Language, Creating a Shame Free Environment, and
Ask Me 3 via toolkits, staff development, training of trainers, patient
activation, and the use of peer educators. Mini-grants to healthcare
organizations and community agencies will be a key mechanism for
program development, implementation, and evaluation. An overview
of the initiative will be presented along with tools and resources.
Passing Policy-The Game Changer for Healthier Communities
Tracy Wiedt, MPH, YMCA of the USA
The YMCA of the USA (Y-USA) began the Healthier Communities
Initiative (HCI) to engage community leaders, convened by local
YMCAs, in policy change efforts that support and promote healthy
lifestyles. These initiatives empower local communities with proven
strategies and models to create and sustain positive, lasting change for
healthy living. Three distinct projects encompass HCI – Pioneering
Healthier Communities (PHC), Statewide Pioneering Healthier
Communities (Statewide PHC) and Action Communities for Health,
Innovation, and EnVironmental ChangE (ACHIEVE). Nearly 200
Ys have contributed to the initiative through multi-sectoral, organically
grown, local strategies addressing the needs of communities
nationwide. Local efforts have led to large scale impacts including:
increased access to and use of attractive and safe locations for physical
activity; supportive environments to complement and support individual
and family efforts to make health decisions; increased healthy
food choices in restaurants, grocery stores, worksites, schools and
other community settings; and reduced inequities in health and access
to opportunities. Y-USA’s HCI is joined and supported by national
organizations such as the Society for Public Health Education, Robert
Wood Johnson Foundation, American Planning Association and Trust
for America’s Health as well as federal agencies including the Centers
for Disease Control and Prevention. Recent evolutions of the initiative
comprise the Pioneering Healthier Communities Health Equity
program (PHC-HE) and the Southern States Strategy to further
engage and build capacity in those communities with the greatest burden
of chronic disease. Y-USA will present the overarching national
perspective of all three projects, the various iterations, the vision for
the initiative, as well as the current and projected outcomes on the
health of communities participating in HCI. Local HCI initiatives
will be highlighted to illustrate the impact of policies on health and
well-being while demonstrating the actions taken to accomplish changes
in the game.
SOPHE-NACDD 2011 Joint Academy and Midyear Scientific Meeting 35