Organizational Health Literacy as a Tool for Health Equity: Application in a High-Risk Infant Follow-Up Program
Abstract
:1. Introduction
2. Materials and Methods
2.1. Information Items
2.2. Environment Locations
2.3. Data Collection
2.3.1. Information Assessments
2.3.2. Environmental Assessments
2.4. Data Analysis
2.4.1. Information Assessments
Assessment Tool | |||||||
---|---|---|---|---|---|---|---|
SMOG * | PMOSE/ IKIRSCH | SAM | CDC CCI | PEMAT Understandability | PEMAT Actionability | Numeracy ^ | |
Print Material | |||||||
Family Feedback Form | 12 | Low Level 2 Grade 8 | - | - | 11/17 (64.7%) | 4/6 (66.7%) | - |
Clinic Welcome Packet | 14 (13) 1 | Very Low Level 1 Grade 5 | 22/44 (50%) | 10/17 (58.8%) | 10/15 (66.7%) | 2/5 (40%) | ✓ |
MCHAT-R | 8 (6) 2 | - | - | - | 7/11 (63.6%) | 3/5 (60%) | - |
ASQ-42 Month | 7 | Moderate Level 3 Grade 9 | - | - | 15/16 (93.8%) | 4/5 (80%) | - |
Turning Three | 11 | - | 19/44 (43.2%) | 6/18 (33.3%) | 7/16 (43.8%) | 3/6 (50%) | ✓ |
Average Score: | 10.4 −9.5 | Low Level 2 Grade 8 | 46.6% | 46.1% | 66.5% | 59.3% | - |
Website Material (clinic) | |||||||
Retinopathy of Prematurity Overview | 14 (13) 3 | - | 16/36 (44.4%) | 3/11 (27.3%) | 10/13 (76.9%) | 0/0 (0%) | ✓ |
Hearing Loss Overview | 12 | - | 16/36 (44.4%) | 4/11 (36.4%) | 7/12 (58.3%) | 1/5 (20%) | ✓ |
Cerebral Palsy Overview | 13 (12) 4 | - | 16/36 (44.4%) | 2/11 (18.2%) | 8/12 (66.7%) | 0/0 (0%) | - |
Your Visit | 11 (11) 5 | - | 21/36 (58.3%) | 6/17 (35.3%) | 9/13 (69.2%) | 2/5 (40%) | - |
Average Score: Website | 12.5 −12 | - | 47.9% | 29.3% | 67.8% | 15% | - |
Average Score: Total (Print & Website) | 11.3 −11 | Low Level 2 Grade 8 (print) | 47.5% | 34.9% | 67.1% | 39.6% | - |
2.4.2. Environmental Assessments
3. Results
3.1. Information Assessment
3.2. Environmental Assessment
Pre-Visit Environment
3.3. Visit Environment
4. Discussion
4.1. Moving Forward
4.2. Lessons Reinforced
4.3. Five Recommended Next Steps (Figure 2): These Results Suggest a Need for Evidence-Based Practice as Follows
4.3.1. Prioritize Plain Language in Written Text, Conversations, and Signage
4.3.2. Place the Onus on the System, Program, and/or Staff, Not on Patient “Understanding” or Individual Skills
4.3.3. Map Out the Steps Required to Understand, Access, and Use Information or Services
4.3.4. Emphasize Practices That Ensure Understanding, Accessibility, and Actionability
4.3.5. Check In with Others—Engage Staff and Families/Patients
4.4. Implications
4.5. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Material | Description |
---|---|
Family Feedback Form (2021) | A two-page handout given to parents/guardians of children seen in the clinic. The document outlines the major findings and recommendations from the visit and common referrals and resources. |
Clinic Welcome Packet (2021) | A comprehensive letter distributed to parents/guardians of the clinic. It summarizes the program goals and objectives, answers common questions, and provides a referral form. |
MCHAT-R (2021) | The Modified Checklist for Autism in Toddlers–Revised. A parent-reported screening checklist to assess the risk of an autism spectrum disorder diagnosis among young children. |
ASQ-42 Month (2021) | The Ages & Stages Questionnaires, 42 Month. A parent-reported assessment to screen for developmental delays or other crucial milestones when a child is 42 months old. The questionnaires are completed by parents and scored by professionals. |
Clinic Website|Retinopathy of Prematurity Overview (2021) | A web page connected to the clinic on the hospital website. It aims to educate parents/guardians on retinopathy of prematurity in children. |
Clinic Website|Hearing Loss Overview (2021) | A web page connected to the clinic on the hospital website. It aims to educate parents/guardians on hearing loss in children. |
Clinic Website|Cerebral Palsy Overview (2021) | A web page connected to the clinic on the hospital website. It aims to educate parents/guardians on cerebral palsy in children. |
Clinic Website|Your Visit (2021) | A web page connected to the clinic on the hospital website. It aims to educate parents/guardians on the details of each visit to the clinic. |
Turning Three (2021) | A presentation offered to parents/guardians of the clinic, developed by the Federation for Children with Special Needs Parent Training and Information Center, to help educate parents/guardians on the intricacies of Early Intervention and Special Education starting at age 3. |
Material | Numeric Demand | ||
---|---|---|---|
Describe | Interpret | Decision | |
Clinic Welcome Packet | 0% | 33.30% | 66.70% |
Clinic Website—Retinopathy of Prematurity Overview | 60% | 40% | 0% |
Clinic Website—Hearing Loss Overview | 40% | 80% | 0% |
Turning Three | 0% | 33.30% | 66.70% |
Domain ** | Sub-Domain, Part | Score % + |
---|---|---|
Institutional Practices | -- | 66% |
Part 1: Resources | 100% | |
Part 2: Orientation, Development, | 55% | |
and Expectations | ||
Orientation | 69% | |
Development | 30% | |
Expectations | 67% | |
Navigation | -- | 68% |
Part 1: Arrival | 22% | |
Arrival and Departure | 0% | |
Entry and Lobby Access | 40% | |
Part 2: Wayfinding | 89% | |
Staff Assistance | 94% | |
Hallways and Navigation Ease | 83% | |
Services and Specialty Areas | 100% | |
Culture and Language | -- | 66% |
Communication | -- | 52% |
Print Materials | 46% | |
Forms | 42% | |
Websites | 51% | |
Patient Portals | 71% |
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© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Rosenfeld, L.E.; McCullagh, K.; King, C.J.; Torres, M.; Litt, J.S. Organizational Health Literacy as a Tool for Health Equity: Application in a High-Risk Infant Follow-Up Program. Children 2023, 10, 1658. https://doi.org/10.3390/children10101658
Rosenfeld LE, McCullagh K, King CJ, Torres M, Litt JS. Organizational Health Literacy as a Tool for Health Equity: Application in a High-Risk Infant Follow-Up Program. Children. 2023; 10(10):1658. https://doi.org/10.3390/children10101658
Chicago/Turabian StyleRosenfeld, Lindsay E., Kelly McCullagh, Carolyn J. King, Micaela Torres, and Jonathan S. Litt. 2023. "Organizational Health Literacy as a Tool for Health Equity: Application in a High-Risk Infant Follow-Up Program" Children 10, no. 10: 1658. https://doi.org/10.3390/children10101658
APA StyleRosenfeld, L. E., McCullagh, K., King, C. J., Torres, M., & Litt, J. S. (2023). Organizational Health Literacy as a Tool for Health Equity: Application in a High-Risk Infant Follow-Up Program. Children, 10(10), 1658. https://doi.org/10.3390/children10101658