Health literacy is increasingly important in today’s complex information ecosystem, both nationally and globally. Across the world, whether people live in “information rich” or “information poor” societies, the role of our profession is a vital one. In the developed world, the ubiquitous nature of health information creates a wealth of accessible content and simultaneously has created confusion as to what information is reliable, how health information can be utilized, and whether or not information is produced in a meaningful manner. In the developing world, content may be non-existent, culturally inappropriate or inaccessible in terms of language and other barriers. In order to mitigate the health information crisis we are now facing, we need to collaborate and respond to the challenges raised by the complexity of health information. Librarians and other information professionals can and must play an important role in improving health literacy in their communities. This paper considers international efforts towards improving health in both information poor and information rich settings, including work showcased in recent years at IFLA’s Health & Biosciences Libraries Section Open Sessions at the World Library & Information Congress (WLIC). It discusses health literacy in the US and other developed economies, and looks in detail at innovative work by the University of North Carolina at Chapel Hill (UNC)where the Health Sciences Library (HSL), a part of the University Libraries, has strengthened efforts surrounding health literacy in local communities and throughout the state. This paper provides examples of how to partner with multiple constituencies on health literacy and discusses future opportunities for growth and engagement.
Objective: The COVID-19 pandemic highlights the public’s need for quality health information that is understandable. This study aimed to identify (1) the extent to which COVID-19 messaging by state public health departments is understandable, actionable, and clear; (2) whether materials produced by public health departments are easily readable; (3) relationships between material type and understandability, actionability, clarity, and reading grade level; and (4) potential strategies to improve public health messaging around COVID-19. Methods: Based on US Centers for Disease Control and Prevention statistics from June 30, 2020, we identified the ten states with the most COVID-19 cases and selected forty-two materials (i.e., webpages, infographics, and videos) related to COVID-19 prevention according to predefined eligibility criteria. We applied three validated health literacy tools (i.e., Patient Education Materials Assessment Tool, CDC Clear Communication Index, and Flesch-Kincaid Grade Level) to assess material understandability, actionability, clarity, and readability. We also analyzed correlations between scores on the three health literacy tools and material types.Results: Overall, COVID-19 materials had high understandability and actionability but could be improved in terms of clarity and readability. Material type was significantly correlated with understandability, actionability, and clarity. Infographics and videos received higher scores on all tools.Conclusions: Based on our findings, we recommend public health entities apply a combination of these tools when developing health information materials to improve their understandability, actionability, and clarity. We also recommend using infographics and videos when possible, taking a human-centered approach to information design, and providing multiple modes and platforms for information delivery.
COLUMN EDITOR'S NOTE The "Global Perspectives" column gathers views on current topics of global interest from authors worldwide. Contributions from across the globe are valued and encouraged as they add a richness that is the voice of today's global information infrastructure.
BACKGROUND In response to the current COVID-19 crisis, public health departments across the U.S. have created, distributed, and shared COVID-19 health information. The extent to which information is understandable and actionable can be examined by use of validated health literacy and readability tools. Health information must be actionable, simple, and straightforward, particularly for health messages in times of urgency or during a health crisis. OBJECTIVE This study aimed (1) to use three validated health literacy tools to assess the understandability, actionability, clarity, and readability of COVID-19 health information created for the public by U.S. state public health departments; (2) to examine the correlations between understandability, actionability, clarity, readability, and material types; (3) to propose potential strategies to improve public health messaging. METHODS Based on CDC statistics on June 30, 2020, we identified the top 10 U.S. states with the highest number of COVID-19 cases. We visited the 10 state public health department websites and selected materials related to COVID-19 prevention according to a pre-defined eligibility criteria. Two raters independently assessed the materials by Patient Education and Materials Assessment Tool (PEMAT) and Clear Communication Index (Index). One rater generated the Flesch-Kincaid Grade Level (FKGL) score. Statistical analyses included (1) interrater reliability (IRR) by Cohen’s kappa; (2) the mean, median, standard deviation, range, minimum, maximum, and frequency scores associated with PEMAT, Index, and FKGL; (3) statistical significance of the correlation between PEMAT, Index, FKGL, and Material Type. RESULTS Of 42 materials in this study, (1) inter-rater reliability was 0.94. (2) The mean PEMAT (n=42) understandability was 88.67% (SD±17.69%), with a media of 94% and a range between 21% and 100%; the mean of PEMAT actionability was 88.48% (SD±14.3%), with a media of 100% and a range between 40% and 100%; the mean Index scores was 78.32 (SD±13.03), with a media of 78.35 and a range between 50 and 100. The mean of FKGL of the materials (n=34) was 7.11 (SD±2.60), with a media of 7.3 and a range between 1.7 and 12.5. (3) Correlations were significant (P<0.01) and positive between PEMAT understandability and actionability, PEMAT understandability and Index scores, PEMAT actionability and Index scores, PEMAT understandability and Material Type, PEMAT actionability and Material type. Correlations were significant (P<0.01) and negative between PEMAT understandability and FKGL scores, PEMAT actionability and FKGL scores, Index and FKGL scores, and FKGL and Material Types. No correlation was detected between Index scores and Material types (P>0.05). CONCLUSIONS COVID-19 health information provided by states for the public were easy to understand and act upon but could be improved in terms of readability and clear communication. The positive correlation identified between material types and PEMAT understandability/PEMAT actionability/Index scores respectively led to our recommendation on using more infographics and video format for public health messaging. CLINICALTRIAL N/A
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