Image: Neeta Lind
I had some routine blood work done yesterday to test, amongst other things, my cholesterol levels and whether or not I had diabetes. My results pleased me as much as if I had scored perfectly on the SATs (which, physiologically speaking, I had.) It took me a while to figure out that I was as healthy as can be though, because the numbers didn't mean anything and the information my healthcare provider had on their website explaining what the tests were looking for was confusing and sparse. I ended up having to do some searching around on the web to decode it.
Literacy levels in this country are going down and they are inextricably tied to two key demographics: the health and wealth of our population. The 2003 National Adult Literacy Survey found that adults with the lowest literacy levels (a number that has increased since the last time the survey was conducted in 1992) are more likely than those at the higher levels to be poor and to have a physical, mental, or other health condition. Older adults (who typically have more health concerns–such as diabetes and high cholesterol–to deal with) are more likely than middle-aged or younger adults to demonstrate limited literacy skills: 40% of seniors aged 65 or older read at or below the 5th grade level. Yet most health-related materials are written at the 10th grade level.
If I, as a college educated and web savvy individual, have a hard time understanding what my test results mean, I worry about what some people with less education must make of theirs.
I give major points to my healthcare provider (Kaiser Permanente) for the speed in which I received my results and how easy it was to access them. I had blood drawn at 10:30am and by 3:35pm I'd received email notification that the results were available on my password-protected user page. Within 24 hours I also got an email from my doctor telling me how great the results were, asking me if I had any questions, and to keep up the good work. Talk about fantastic customer service. But what about the people who can't get theirs if they can't read, don't have a computer or are not technologically comfortable?
In addition to being aware of the literacy constraints that many people face it’s important for healthcare communicators to understand other aspects of their audience demographic. How do healthcare providers give out test results for folks in poor rural areas, for example?
Whether the delivery mechanism is in person, an online message, or a printout received by mail, it's commonly accepted that more than 60 percent of individuals are visual learners yet my test results were all text and numbers. Couple a lack of graphic design with words that are hard to understand for most people and it's no wonder some healthcare communications (in this case test results) don't make sense. A 2000 Harvard literature review of medical and public health research addressing literacy issues offers little in the way of recommendations to improve communications beyond the written word, yet these communications are often critical to helping patients understand and manage their ongoing health. Good visual cues and clever use of iconography can help all healthcare customers, regardless of their reading level.
In my test results I would have liked to see symbols that represent what each test is for and some sort of chart that shows the scores on it. People are by nature, typically competitive, even with themselves, and this would be a great way to show a person visually how they rank, normatively. Since these tests are done regularly, it could also be customized to track a person’s improvement (or not) over time, which could be a useful teaching tool for docs to use, regardless of how they communicate it.
It's great that I got an email from my doc, with an open invitation to ask questions. It turns out that I was able to find what I needed and didn't need help, but here's yet another instance where doing the research to understand your audience is important. A lot of people who have problems with literacy hide this fact from family members, co-workers and, most likely, their doctors. Plus, people can be busy or lazy, or both. How many people are going to take the time to follow up on these test scores to make sure they really understand them, and wouldn't it be more efficient for everyone if that information could be gotten easily from the initial communication?
Natalie Zensius is a marketing communications strategist with experience in both the for-profit and non-profit sectors. Learn more about Natalie at http:www.linkedin.com/in/nzensius.