Librarians Helping to Combat Organizational Health Literacy Through an Updated Health Literacy Assessment Tool

Objective: Health literacy continues to be a challenge libraries and organizations face. To help address organizational health literacy, the University of Tennessee Medical Center (UTMC) created a Task Force and utilized the Health Literacy Environment of Hospitals and Health Centers (HLEHHC) tool to assess UTMC’s health literacy attributes. When using this tool, it was discovered that some of the questions needed to be updated. This will discuss the process in which the UTMC Task Force and original author Rima Rudd revised and updated the HLEHHC to create the Health Literacy Environment, version 2 (HLE2). Methods: This update was a two year collaborative process. An extensive literature review on health literacy was performed. Each section of the HLEHHC was reviewed, as well as each question, leading to question updates and removals. Changes were made to the rating scale to better reflect the questions. The new tool undertook a peer review process, followed by more updates. After those changes were made, the tool was pilot tested. Additional updates were then made based on pilot testing. Results: The HLE2 is composed of five new sections: Organizational Policies, Institutional Practices, Navigation, Culture and Language, and Communication. The rating scale is yes/no as well as a frequency Likert scale. Directions are located at the beginning of each section along with how to score. Conclusion: Through this collaborative process, Rima Rudd and the UTMC Task Force updated the HLEHHC to include timely questions and specific directions for use. Librarians are at the forefront helping to address the challenge of organizational health literacy. The HLE2 is available for use to analyze literacy-related barriers for organizations

Surveying hospital nurses to discover educational needs and preferences

Objective: The author investigated the educational needs of nurses in an American Nurses Credentialing Center Magnet hospital to determine topics of interest, instruction time and delivery preferences, and interest in a research information skills certificate provided by the library. Methods: A 9-question survey was distributed to 1,500 nursing staff of the hospital through email. Results: Surveys were completed by 865 respondents, which represented a response rate of 58%. The majority of respondents were registered nurses, licensed practical nurses, and paramedics (81%), and day-shift workers (65%). For education topics, nursing staff placed the highest priority on finding health-related mobile apps for professionals and developing evidence-based research skills. For mode of delivery, respondents expressed a preference for unit-based in-service, computer-based tutorials, and hands-on computer training. Most (70%) respondents expressed an interest in participating in a research information skills certificate program. Conclusions: Our survey results reveal an avenue for reinvigorating and updating the library’s educational program to match the needs of nursing staff and may offer valuable insight for other libraries seeking to do the same.  This article has been approved for the Medical Library Association’s Independent Reading Program

Computerized versus hand-scored health literacy tools: a comparison of Simple Measure of Gobbledygook (SMOG) and Flesch-Kincaid in printed patient education materials

Objective: The research compared and contrasted hand-scoring and computerized methods of evaluating the grade level of patient education materials that are distributed at an academic medical center in east Tennessee and sought to determine if these materials adhered to the American Medical Association’s (AMA’s) recommended reading level of sixth grade. Methods: Librarians at an academic medical center located in the heart of Appalachian Tennessee initiated the assessment of 150 of the most used printed patient education materials. Based on the Flesch-Kincaid (F-K) scoring rubric, 2 of the 150 documents were excluded from statistical comparisons due to the absence of text (images only). Researchers assessed the remaining 148 documents using the hand-scored Simple Measure of Gobbledygook (SMOG) method and the computerized F-K grade level method. For SMOG, 3 independent reviewers hand-scored each of the 150 documents. For F-K, documents were analyzed using Microsoft Word. Reading grade levels scores were entered into a database for statistical analysis. Inter-rater reliability was calculated using intra-class correlation coefficients (ICC). Paired t-tests were used to compare readability means. Results: Acceptable inter-rater reliability was found for SMOG (ICC=0.95). For the 148 documents assessed, SMOG produced a significantly higher mean reading grade level (M=9.6, SD=1.3) than F-K (M=6.5, SD=1.3; p<0.001). Additionally, when using the SMOG method of assessment, 147 of the 148 documents (99.3%) scored above the AMA’s recommended reading level of sixth grade. Conclusions: Computerized health literacy assessment tools, used by many national patient education material providers, might not be representative of the actual reading grade levels of patient education materials. This is problematic in regions like Appalachia because materials may not be comprehensible to the area’s low-literacy patients. Medical librarians have the potential to advance their role in patient education to better serve their patient populations