Enhance patients’ health literacy with audio-visual and face-to-face education

Health literacy tools include:

Read on to see how different doctors use these tools.

If you only treat your patients’ illnesses at your clinic, and then send them home, your duties are incomplete. Helping patients better understand their illness or procedure is[s2If !is_user_logged_in()]…

[/s2If][s2If is_user_logged_in()] a crucial aspect of being a high-quality physician.


“It is very vital to promote health literacy as well as health-seeking behavior in our patients and families to achieve health for all.”
Sharad Gogate, MD, ob/gyn and perinatologist in Mumbai, India, and a member of mdCurrent-India’s Ob/Gyn Editorial Advisory Board

Key Point: Improving health literacy among your patients is not a one-size-fits-all approach and should address the unique cultural and educational characteristics of your patients. Regardless of the format, use simple language in the regional dialect patients are most comfortable with and experiment with different education techniques until you find what works best. Evaluate and reassess regularly to ensure the materials you use are still effective.

Promoting health literacy also means expanding patients’ knowledge beyond the illness they are experiencing or procedure they are undergoing. The handouts and audio-visual materials you choose, as well as the conversations you and your support staff have with patients, can help patients understand how to prevent diseases, recognize conditions before they worsen, and detect health problems in friends and family members.

Expanding health literacy among patients—especially those patients who cannot read—is challenging. But improving patients’ medical knowledge is possible regardless of their education level. Physicians who are skilled patient educators advise fellow clinicians not to limit themselves to one teaching technique, and to follow patients’ cues to determine the most effective education method for each patient.

Address multiple populations with signage

Aniruddha Malpani, MD, medical director of Malpani Infertility Clinic in Mumbai, India, and author of a physician- and patient-education blog, cites the familiar adage, “A picture is worth a thousand words.” A simple way to help patients with limited language and literacy skills, Malpani explains, is to provide signage consisting of symbols understood by multiple populations. Use multilingual signs only if your practice is not too linguistically diverse, he notes. But if you encounter people with a wide range of language backgrounds, symbols are a better way to communicate.

Malpani refers physicians to “We all speak together,” a Robert Wood Johnson Foundation project that has developed 28 easy-to-understand symbols for use in healthcare settings. Click here to download the symbols and for ideas on how to use them in your practice.

Teaching methods should be flexible

Sharad Gogate, MD, a gynecologist, obstetrician, and perinatologist practicing in Mumbai, enhances health literacy in his practice with flip charts, diagrams, and Microsoft PowerPoint presentations. “It is very vital to promote health literacy as well as health-seeking behavior in patients and families,” he says. “We put a lot of emphasis on this in our practice to achieve health for all.”

The stress on simple language, use of regional dialects, and everyday examples and metaphors help patients understand their treatment or procedure, Gogate points out. Many of his patients are semi-literate, he adds, so they may require some extra time. Referring computer-savvy patients to health information on the Internet can be very helpful, but Gogate cautions clinicians to first evaluate the information to ensure accuracy and relevancy.

Dhiraj Gada, MD, a reproductive endocrinology and infertility specialist, and the director of Gada Life ART Center in Indore, incorporates a wide range of health literacy materials into his practice, but has found audio-visual materials, such as videos and websites, to be most effective. He holds weekly staff training sessions on promoting patient education and health literacy.

Face-to-face teaching is best

Health literacy is a concern for Sanjay Kalra, MD, DM, an endocrinologist in Karnal, Haryana. Although he uses handouts and wall posters to educate his diabetic patients about their illness, he relies primarily on one-to-one discussions. “Health literacy is important for patient empowerment,” he says. “This, in turn, helps improve the quality of shared decision-making, and optimizes therapeutic outcomes.”

When Kalra arranges for individual counseling via his clinic’s diabetes educators and dieticians, he makes sure that the counselor is from the same social background as the patient. For informed consent forms he recommends face-to-face explanations. “We start by explaining in local dialect,” he says. “A few minutes spent on proper information early on saves countless hours of misunderstanding later. Listen to the patient first, then talk.”

Whichever techniques you choose, make improving health literacy at your clinic a priority and include it in all planning and evaluation activities, Malpani says. Conduct regular evaluations of your clinic’s physical environment and internal support systems for health literacy. And ask your illiterate patients to help assess the impact of your programs and policies. This may seem to be a lot of work, but any clinic that does not reach out to all patients is going to find it increasingly difficult to stay viable.
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