A Health Literacy Progression . . .

By Linda Rohret
Raleigh, NC

My awareness of the importance of health literacy was a gradual progression that began early in my life. However, I can see landmarks during different stages of my life that brought me to where I am now—a health educator whose career revolves around the critical need for health literacy. Each of these landmarks carried lessons with them that became an essential part of how I view health literacy.

As a child

My father had an eighth grade education. After his father died, he had to quit school to help take care of his family. However, he was an intelligent man who actively sought out knowledge. While I was growing up, I don’t think there was ever an evening I did not see my father sit down and read the paper from beginning to end, often with a dictionary in hand. And our dinnertime was often punctuated by lively, informed discussions between him and my mother about the issues of the day. But I was always acutely aware that my father’s lack of education was a source of shame for him, and it was a topic that was never discussed in our family. His shame left an indelible mark on me and has influenced how I perceive "uneducated people."

Lesson learned: Even "uneducated" people such as my father can be intelligent, and we should be careful not to prejudge or label them.

As a professional medical illustrator

One of my first jobs was at a VA Medical Center, where I prepared the artwork for projects in multiple disciplines. To fully understand the type of art work required, I would read all related content that authors submitted. For many projects, I would question the content if it didn’t make sense to me and offer suggestions for making the text more understandable to the intended audience. Most often, the authors would respond with something like "Oh, I didn’t think of that," and would accept my change.

I was intrigued by the realization that effective health communication projects required not only appropriate graphics and layout but also reading content that would be easily understood by the people who used it. This realization eventually led to my getting a master’s degree in health education instructional design.

Lesson learned: To be of behavior change value, an educational piece must be comprehensively understandable and must take into account the background and reading skills of the intended audience.

As a parent

My 7^th grade daughter had oral surgery to remove her wisdom teeth. This experience increased my awareness of the importance of timing and emotions when giving health information to a patient or caregiver.

I waited in the waiting room while my daughter’s wisdom teeth were pulled. Just after I was called to the front desk to be told how to provide care and what I might expect, a dental assistant brought my daughter through a door. My daughter was staggering, had a contorted face, and was muttering odd things. I couldn’t believe my eyes – what had happened to my daughter?

The desk staff continued to go over the care information page, but all the while I was distracted by my daughter’s condition. I heard and understood very little that was explained to me. I called back with my questions once I got my daughter home and made her comfortable.

Lesson learned: Whenever possible, we should carefully choose the time for delivering health information to a patient or caregiver. We should try to avoid competing with the environment, with emotions, or any other distractions that might interfere with our client’s hearing, seeing, and other ways of understanding and assimilating information, no matter what the educational level or experience of the client!

In summary

Learning is multidimensional and each person is unique. Thus, we must carefully consider the situation and needs of our audience when designing, creating, and using health education materials and when giving medical diagnoses.

Linda L. Rohret, MA, RHEd is a health education instructional designer/writing consultant who has worked on wide variety of projects including geriatric education, public health, cancer education, cancer survivorship, computer-aided instruction, and social marketing. She also is a volunteer on this year's Health Literacy Month team.

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