HealthEd Blog

It’s All in the Numbers: Bringing Health Numeracy to Life to Drive Patient Understanding

 “People tend to comprehend more and make better-informed decisions when the presentation format makes the most important information easier to evaluate and when less cognitive effort is required.” Ellen Peters, PhD, research scientist; associate professor of psychology, Ohio State University 

After more than 20 years as a healthcare professional and health educator, I wonder if we have become desensitized to the weight and complexity of treatment decisions for patients and care partners. At the end of the day, patients and care partners universally ask 2 questions: “Will this treatment work?” and “What are the side effects?”  It has always fascinated me that patients and care partners often ask these 2 questions even after they’ve reviewed educational materials and received counseling from their healthcare providers. 

So, why are these questions so common when almost all branded websites and materials offer a “Benefits of Brand X” section? The most common approach to presenting benefits and risk information is through numerical trial data. During a recent market research interview, a patient said, “I have never heard of ‘placebo’ is this another treatment? The moderator of the interview went on to describe the placebo as a “sugar pill.” The patient responded, “does sugar help with this condition?”

Because we work with trial data every day, we forget that most patients don’t live in the world of clinical trials. To complicate matters, regulatory guidelines often require the inclusion of robust study design, which is important but only adds to the complexity and diverts attention from the information that patients and care partners are most interested in: benefits and risks. 

Defining health numeracy

Peters et al (2007) define health numeracy as “an element of health literacy that refers to the ability to understand numbers.” Findings from the National Adult Literacy Survey show “almost half of the general population has difficulty with relatively simple numeric tasks such as calculating the difference between a regular price and a sales price or estimating the cost per ounce of a grocery item.” They have difficulty while using a calculator. If you add the emotional weight of treatment decisions and health challenges to this situation, it is easy to see why patients and care partners are struggling. 

Here is a list of best practices for driving health numeracy when presenting benefit/risk information.

Less is more. Marketers, medical/legal/regulatory, and agencies need to work collaboratively to identify the most effective, responsible, and balanced approach to presenting what patients and caregivers most want and need to know. For example, onerous study design can be confusing and may be less important to patients. Is there an opportunity to minimize some study design or present study background in a way that does not compete with priority benefit/risk information.

Reduce required inferences and calculations. Studies have shown that percentages are difficult for patients to process and relate to. Patients struggle to see how such numerical concepts relate to their own situation, and they often misinterpret the information.  Steps for simplifying calculations include: 

• Use ratios, and keep the denominator constant to reduce effort and increase comprehension (20 of 1000; 1 of 1000)
• Choose using absolute risks (for example, 3 of 1000) will have a stroke) over using relative risks (50 percent higher chance of stroke)
• Avoid using decimals
• Use the same time span when expressing efficacy and risk
• Use meaningful visual cues and displays to highlight the meaning of information
• Summarize key information
• Avoid using confidence intervals because people tend to accept or reject information fully without adjusting for data quality

Test and revise formats carefully to reduce the effects of low numeracy. Approaches to presenting numeric information should be tested with target audiences whenever possible. Without usability testing, time and resources are invested with no real guide as to whether the content will impact the target.

The decisions of people with low numeracy are likely to be informed more by non-numeric sources of information. In reality, it is NOT “all in the numbers.” Treatment decisions are also a subjective, emotional experience. It is very difficult to validate or capture these emotions through numbers.  This may be one reason why patients and care partners are so active on social media portals seeking the stories and experiences from other patients and care partners. 

It is important to know and involve your audience and as you develop benefit and risk communications. This can help educators and marketers to develop the optimal approach to presenting clear numerical presentation of outcomes with relatable, balanced stories of patients, care partners, and healthcare providers. 

Christopher G. Kelly, MEd
VP, Health Education
HealthEd

 

How to Build Patients' Skills Using Adult Learning Principles

Going Beyond Informing

So much of patient education is about sharing information – about risks, symptoms, treatment options, lifestyle changes and so much more.  However, it is critical to go deeper than merely informing patients if we expect substantive changes in their thinking and behavior. We must acknowledge what patients bring to a learning situation: their hopes and fears, their motivations, and the questions that indicate their priorities and problems. By using adult learning principles to underpin our skill-building efforts, we can more successfully help patients identify and address their needs – and be successful in managing their health.

Let’s imagine a typical scenario: Ellen has had diabetes for several years. She has been doing her best to manage her diet and exercise plan, and always takes her oral medications. However, at her most recent visit to her doctor, she learned that she now needs to add insulin to her routine.  How can we address this situation using an approach that combines adult learning with skill building?

What is Adult Learning?

Adult learning theory, sometimes called andragogy, includes a number of principles. Three of these are clearly related to helping patients build skills to manage their health.

• Readiness to learn: Adults become ready to learn when they need information to effectively cope with real challenges they are having.
• Motivation:  For adults, there is no “test” that will reflect a certain grade, but there are real life outcomes which may result from this learning. This means that adults are driven by internal motivation, such as the desire for maintaining or improving their health or quality of life, or avoiding worse health.
• Task-centered learning: For everyday learning, adults want to figure out how to acquire a skill or solve the problem at hand, rather than needing to learn everything about a topic.

Back to our scenario: At a quick glance, it would seem that the next step for Ellen is to have a healthcare professional demonstrate how Ellen can give herself insulin injections. We can imagine a caring educator seated with Ellen in the provider’s office. They probably have a somewhat limited time in which to meet and review the device use. How can the educator build Ellen’s confidence and skills in that initial demonstration? How will the educator know that Ellen will be able to do the injections on her own?

• Assess Ellen’s readiness to learn by talking about what she thinks and feels about starting insulin and, perhaps for the first time, must inject herself. While this might seem like a time-consuming discussion that could take away from “training” time, it is critical to Ellen’s success that she identify and share her concerns and hopes so that the educator can dispel misconceptions and support her emotionally. This can clear the way for Ellen to be open to learning about the device and her new phase of treatment. And, it’s not a conversation that can be had until this time in her treatment, so having it earlier will not benefit her learning.
• Understand Ellen’s health goals related to using the device. How does Ellen see the use of insulin and this particular device as supporting her diabetes management?  Will it help her control symptoms? Will it enable her to do more of what she wants to do? Tying the use of the device to this internal motivation is another layer of preparation for active learning.
• Now, demonstrate the tasks and involve her in each step. This is where the step-by-step instructions come in handy, and offer the educator tools to demonstrate each step of the process, such as how to safely and effectively choose her dose and deliver her medication.  As part of this process, the educator will ask Ellen to verbalize and demonstrate the key steps required to show that she has learned each skill. And, to continue with the support for task-based learning, a final step is to show the trouble-shooting guide or tips to empower Ellen in her continued use of the device at home.

This skill-building approach allows for the acknowledgement of the patient’s emotions and desires as part of the practical adoption of skills. This recognition and balanced approach not only enhances the physical skills, but builds confidence as well. This combination, called self-efficacy, is the true end goal of patient education.

Laura Wilson, MEd
SVP, Health Education
HealthEd

 

 

A Common Ground: Patient Education and PCORI

What do a quasigovernmental agency and a healthcare marketing agency have in common? Patient-centeredness. You may have read about the newly established Patient-Centered Outcomes Research Institute (PCORI),which is made possible by the Affordable Care Act. This organization is working to get at the root of a conversation of great importance to patients and the pharmaceutical industry alike. How do all stakeholders—including healthcare providers, payers, care partners, pharmaceutical companies, device manufacturers, and patients—support the way patients make informed decisions that are right for them?

What are key patient questions?

PCORI is now funding pilot research projects that will help us all understand how to answer these questions that patients may ask:

1. Given my personal characteristics, conditions, and preferences, what should I expect will happen to me?
2. What are my options, and what are the benefits and harms of those options?
3. What can I do to improve the outcomes that are most important to me?
4. How can the healthcare system improve my chances of achieving the outcomes I prefer?

How can we respond?

You may be thinking that it will take time and money to learn the answers. That it is too far removed from our work every day.

However, these questions and others like them should be central to all patient education and marketing efforts. To truly help people adhere to new regimens, we need to uncover challenges they have when faced with starting a new medicine or using a new device. Patients should also fully understand their personal risks. Risk and benefit information should be simplified so that all stakeholders can make informed decisions. Patients should be able to identify the outcomes that are important to them and should know ways to discuss these with their healthcare teams.

While the PCORI research results will help us all refine our patient education and support efforts, there is no need to wait. It’s already possible to develop patient-centered materials that support these objectives.

 

Laura Wilson, MEd
SVP, Health Education
HealthEd

 

 

Adherence Begins Before Treatment: 5 Strategies You Must Consider to Drive Effective Patient Interactions

At a recent presentation of the ExL Patient Adherence Summit, I had the privilege of presenting HealthEd’s unique strategic approach to promoting adherence. Focusing on the top 5 strategies to drive effective patient interactions, we covered recommendations and rationale for including deeply patient-centric strategy to drive adherence through:

1.      Mapping the patient journey

The patient journey helps form and secure brand strategy by providing a predictive snapshot in time of the aggregate patient experience. Through it, we distill insights and translate emotional and environmental barriers to wellness into visual, actionable frameworks. It is informed by a multitude of inputs, including qualitative and quantitative research, ethnographies, brand research, social media, literature reviews, and focus groups and in-depth interviews. Because we view adherence as a cumulative experience, patient journeys take into account every stage of the patient experience—including initial awareness of the disease or product, taking the first dose, and continuing with treatments through maintenance.

2.      Identifying a behavior change model

Utilizing a behavior change model helps us to explain people’s behaviors, as well as how people can be influenced to change. As with the patient journey, a behavior change model is predictive in nature and can help identify issues that a patient may have with the disease or therapy. Behavior change models evolve beyond the typical pharmaceutical model of awareness, conversion, initiation, and adherence to look at the individual motivating or inhibitory factors that influence behavior change. These factors can then be leveraged or manipulated to drive desired behaviors, such as successful adherence.

3.      Understanding the clinical encounter

The clinical encounter is an important key strategy to drive patient interactions because it embodies the complex dynamic not only between doctor and patient but also between other important (and sometimes not top-of-mind) stakeholders. These can include nurses, allied health professionals, caregivers, support groups, pharmacists, and the brand sales force. It can also illustrate the dynamics between those individuals and groups. Identifying these complex relationships and interactions can help brands to leverage each tactic appropriately and at the correct key moment.

4.      Measuring patient behavior

Measuring patient behavior goes beyond typical pharma measurement variables such as script refills. Rather, measuring patient behavior focuses on measuring change in patients’ skills, knowledge, attitudes, behavioral intention, and unique behavior change model metrics. In doing so, we can determine baseline levels and demonstrate the power of tactical interventions to influence behavior change—which can ultimately lead to successful adherence.

5.      Using health literacy principles

Last, incorporating health literacy principles into patient communications can help to aid adherence by assisting the roughly 90% of the population that has less-than-proficient health literacy. Using health literacy guidelines can lead to greater comprehension, which ultimately relates to greater adherence. It also leads to a greater financial impact for brands. The importance of meeting health literacy guidelines is being recognized by government entities such as the FDA’s Office of Prescription Drug Promotion.

These 5 strategic areas aim to place the patient at the center of the brand experience to drive effective patient interactions. The dynamic relationship of all 5 considerations helps create a strong, targeted, and effective brand experience that fosters adherence.

Adherence Begins Before Treatment: EXL Adherence Summit Presentation

View more PowerPoint from HealthEd

 

Liz Carden, MPH, CHES
Manager, Health Education
HealthEd 

 

 

The Rise of the Nanoeducators: Why Behavior-Change Programs Will Never Be the Same

Have you seen the science fiction movie in which the mad scientist invents a chip to implant in patients’ bodies and then controls it with a wireless device?

Wait a minute. That’s not a movie. It’s real.

Massachusetts Institute of Technology professors Robert Langer and Michael Cima just published the results of their chip-implantation trial conducted with 7 Danish women who have osteoporosis. Patients did not receive the medication—teriparatide, a growth hormone—by injection; rather, each dose was sealed inside a chip. Doctors implanted the chips in each woman’s abdomen. When a remote control was triggered, a tiny foil seal on the chip would melt, releasing a dose of hormone into the patient's bloodstream.

And we all thought FDA social media guidance was a big deal.

In truth, remote-control medicine and the use of so-called smart objects raise questions that may not have answers for a long time. Some are technical: Could the wireless chip controls be hacked? Some are privacy related: What if the government tries to mandate implants for certain diseases or populations?

Meantime, healthcare innovators have been making much progress with a different kind of chip implantation: not in people but in things. All of these smart objects share a goal: helping patients change behaviors in support of better health outcomes.

The smart objects are like health educators. Only smaller.

Some background: Behavior models have long informed health educators about the power of feedback to drive behavior change. The Health Belief Model, for example, suggests that for change to last, patients must know the consequences of their actions (that is, have feedback). The importance of feedback is why HealthEd recommends that clients provide medication tracking tools to patients. You can’t control what you don’t know.

So, why do people keep missing doses of medicine? For one thing, it takes work to track your behavior. Often, the patients and care partners we talk with ask for tools to help manage their conditions, but they don’t always use the tools. For another, it turns out there is value in having someone else—or something else—there for motivation. 

Enter smart objects. Thomas Goetz, author of The Decision Tree, wrote a great summary in “The Feedback Loop,” an article in Wired. Goetz explained that as the price of simple sensors drops—a motion-sensing accelerometer costs under $1, he wrote—the door opens to embed these tiny feedback generators into everyday objects.  

One example you may already know about: GlowCaps, those plastic tops for medicine bottles that light up when it’s time for a dose. A tiny chip in the plastic “knows” when you haven’t taken your medicine and, like a personal nurse, gently reminds you to follow your doctor’s orders. This virtual nurse can get progressively more assertive: GlowCaps play a reminder tune until a dose is taken. Then, if you’re still not compliant, GlowCaps can call you and send e-mail progress reports to your physician.

(Kind of makes an abdominal implant sound less invasive, doesn’t it?)

The manufacturer, Vitality Inc., raised eyebrows when a GlowCaps study resulted in a 98 percent adherence rate. But, as Goetz pointed out, here the technology plays second fiddle to the patient experience. A GlowCap is a humble piece of plastic fitted with the heart of a health educator. Get the user experience right, says Vitality CEO David Rose, and smart objects begin to feel “enchanted.”

There are many other examples of smart objects in healthcare, particularly in prevention and monitoring:

• The Humana Horsepower Challenge lets kids advance in a video game by using sensors attached to their sneakers. The game is meant to encourage physical play and exercise
• French-based Withings has won design awards for its connected products, including a blood pressure cuff that plugs into an iPhone, as well as a scale that can tweet your weight for motivation
• A stateside competitor, Fitbit, closed on a $12 million round of private equity funding in January. Its Fitbit Ultra, a clip-on health-tracking device, contains chips and sensors that analyze its wearer’s sleep patterns and exercise habits, which it reports back over the Web

All to say, while social media innovation gets most of the press, I think pharma and healthcare organizations should spend more time exploring behavior innovation. Learn about behavior models and how they can predict personal health decisions. Ensure that flesh-and-blood health educators are integrated with marketing teams. And explore the many ways that “nanoeducators”—tiny chips programmed with the brain of a behaviorist—can help you improve patient outcomes.

 

Jeff Greene
Director, Digital Strategy
HealthEd

 

 

Review Panels: A Key Driver for Innovation and Positive Outcomes

The Centers for Disease Control and Prevention (CDC) recently highlighted the foundational benefit of knowing and involving your audience when developing clear, innovative health communications. Here are 2 excerpts from recent CDC publications that capture these benefits:

Know your target audience: “The more you know about your primary segment, the better you can reach them with messages. Your up-front research should include understanding the needs and wants of the target audience on a more personal level, and their motivations and lifestyles so you can truly engage with them.”

Involve your target audience: “When members of the target audience participate in designing and testing communications, outcomes are more successful, including those for people with limited health literacy.”

This is not news to us. We have used review panels in all aspects of educational design and program development for the past 20 years.

Our panels include representatives of all people who influence health and business outcomes—such as patients, caregivers, healthcare providers, and knowledge leaders who have firsthand experience with a particular condition or treatment. 

As a health educator, I can honestly say that I learn something new from every review panelist interaction. Patients and caregivers who are living with health conditions offer a unique perspective. This can also be said for professionals who provide care and education on a daily basis.

A recent story will bring this to life. I was interviewing a patient and nurse separately to better understand why patients were struggling with appropriate use of a medicine when starting a new treatment. The exchange below captures the magic that happens when you involve your audience.

My question to a patient: “So, when did you first hear about your diagnosis?”

Patient: “They told me about the diagnosis, and I didn’t hear anything after that.  The doctor and nurse walked me through a pamphlet, but when I got home, I didn’t remember anything they said. To complicate matters, I didn’t actually receive the treatment in the mail for 2 to 3 weeks, so by the time I needed to start treatment, I was anxious and had so many questions.”

My follow-up questions to a nurse: “In talking with patients, we have learned that they feel overwhelmed after hearing their diagnosis and have difficulty in processing the education they receive about their treatment.  We also heard that there is a time delay in receiving their treatment, so by the time they start treatment, they are anxious and don’t recall what to expect and what to do. Is that common, and how do you combat this challenge?

Nurse: “Wow—what a great insight! This is so true, but until now I didn’t really give it a thought. I have heard of some offices scheduling a follow-up education session about new treatments when counseling occurs on the same day as hearing difficult news. In terms of the time delay, I wonder if there is a way to call or send e-mails during the delay period to reinforce key things patients need to know and do before starting treatment. It might also help to acknowledge this barrier before educating about a new treatment. I would be happy to review anything you guys develop.”

These vignettes capture the amazing interactions we have with review panelists as we develop our materials and campaigns. They also show the huge void that exists when we do not take the time to know and involve our audience.

Christopher G. Kelly, MEd
Director, Health Education
HealthEd

 

The Search for Quality Health Information

We’ve all been there. Concerned about a rash. Starting a new medication. Or, possibly, just diagnosed with an unfamiliar disease.

What is one of the first things you do when you go home? Chances are your response is that you open your Internet browser and use Google to find out as much health information as possible. But how do you know if the information you discover is accurate, credible, relevant, and trustworthy? In many cases you (and many others like you) cannot tell for sure, so you continue to search. Before you know it, hours have gone by, and you still haven’t found good answers. Worse, you may have found information that’s inaccurate, outdated, or otherwise causes you unnecessary alarm.

In the quest for quality health information, healthcare professionals often face this same struggle. According to new research conducted in late 2011 by HealthEd On Demand, a part of the HealthEd Group, healthcare professionals -- specifically 99% of dietitians -- consider educational materials to be important or essential.

The survey highlighted that the Internet is a common source for educational materials and health information. Handouts, websites, books, pamphlets, and videos are now all available at the click of the mouse. However, evaluating quality as well as relevance (for instance, culturally appropriate, health literacy) for their patients can be tricky. To overcome this challenge, healthcare professionals often look to specific sources they can trust -- but even that involves combing through a lot of different resources, as illustrated in the survey results infographic snapshot below:

 

Further, the amount of time it takes healthcare professionals to find and organize materials is a clear frustration. This frustration is illustrated in the infographic snapshot below:

After all the time and effort searching for and evaluating quality education materials, it must be common to wonder, “Isn’t there a tool that can do all this work for us?” Healthcare professionals may even wish they had a tool that would help them know whether their patients are actually using those resources -- a tool that provides them a feedback loop so they know whether their time and effort educating patients is working.

Here at HealthEd, we also asked ourselves this question and immediately started brainstorming a solution. That’s why we’ve been developing a free tool to make it easy for healthcare providers to find, save and share quality health information with their patients and track their progress. 

It’s called HealthEd On Demand: http://www.healthedondemand.com.

To learn more about the challenges we’re trying to address, you can check out the full infographic of the survey results at:

https://healthedondemand.com/HeodPages/Pages/Dietitians_Survey.htm.

We hope our new tool will save us all the time and frustration in searching for quality health information -- because we’ve all “been there.”

 

Laura Catalusci
Specialist, Health Education

Mobile Healtherati Convene in New Jersey; Pharma Forgets to RSVP

At last week’s mHealthcon, the soon-to-be-annual event that brings together mobile health entrepreneurs, marketers, patients, and investors to talk shop in New Brunswick, NJ, I couldn’t help but think, “Where is pharma?”

Yes, there were a couple of representatives from manufacturers like Bristol-Myers Squibb. But they were vastly outnumbered by their healthcare peers:

• Managed care organizations
• Large healthcare providers
• Physicians and researchers

Mobile is potentially the greatest opportunity for pharma to break out of its innovation funk. And “The Healthcare City,” as New Brunswick bills itself, would have been a great place for pharma to stoke its creative fires—right in the industry’s backyard.

It’s not as if patients aren’t asking for mobile solutions …

“We have the opportunity to drive an ‘Arab Spring’ in healthcare,” said blogger Casey Quinlan, author of Cancer for Christmas and an outspoken patient advocate. Quinlan, diagnosed with breast cancer in 2007, said there were not enough tools available to help her manage her disease and treatment side effects.

“If there had been an app that would have helped me manage my neutropenia (low white blood cell count) and anemia (low red or total blood cell count),” Quinlan told the audience, “I would have easily paid a couple hundred dollars for it.”

Amy Gurowitz, who is launching a learning community for people with MS, said she surveyed her beta testers about their use of tracker apps. Only one person reported using one. “They didn’t even know that these tools are out there,” Gurowitz said, suggesting there is a market for such tools if they can be promoted effectively to patients.

It’s not as if pharma companies are ignoring mobile opportunities…

To be fair, pharma has produced a growing number of mobile apps and tools. (Quick plug: You can read about some mobile pharma case studies in an earlier blog post I co-wrote with digital buddy Megan Beardsley). Some have been built for patients, while most target healthcare providers. 

Still, I’m not convinced that pharma is fully prepared for the coming mobile onslaught. And I’m not the only one.

At a conference break, I caught the attention of Paulo Machado, a leading voice in pharma innovation and the former Innovation Director at AstraZeneca. During our conversation, Paulo really helped crystallize pharma’s conundrum.

In essence, he said, pharma companies are manufacturers. And it’s much harder for manufacturers to evolve away from a product-centric mindset than it is for service providers—your payers, hospitals, clinics, and most other health organizations.

Paulo said that healthcare reform is driving service companies away from the fee-for-service model. “They actually have to run profitable businesses now,” he observed.

Translation: Payers, not pharma, may end up leading the charge into mobile health.

Any tool that helps patients improve outcomes and lower costs will be mission-critical

Sure enough, later in the day Michael Monson, SVP Performance & Innovation at the Visiting Nurse Service of New York (VNSNY), encouraged mobile health entrepreneurs to bring him innovative ideas… like, now.

Headquartered in Manhattan, VNSNY is the country’s largest not-for-profit home healthcare service. It is both a provider and a payer. Monson explained that innovation is a large component of the company’s strategic approach. As healthcare evolves in the US, mobile seems to be a major way forward.

 “We really like using behavioral science,” Monson said, referencing partner Welldoc, which is running a mobile adherence pilot for VNSNY with diabetes patients. Welldoc was in the news recently when Ford announced a beta test in which diabetic drivers could “ask” their cars to check their blood glucose levels. The Ford beta is being powered by a Welldoc wireless health monitoring platform.

It’s innovations like these—“software devices that enhance consumers’ lives,” Monson said—that are going to power the future of mobile health.

Mobilization can work for pharma too

The economic rewards for innovation certainly favor companies like Monson’s. But I believe pharma also needs to stand up and put the industry’s significant weight behind mobile health initiatives. Apps would be the logical place to start—they are the most “product-like” side of mobile—and the FDA already issued guidance for health apps this summer.

For pharma innovators interested in going mobile, some next steps should include:

• Familiarizing yourself with the FDA mobile app guidelines
• Getting outside the pharma space
  • Download and use some of the mobile tools that other healthcare organizations have built
  • Look for parallels that could be applicable to branded/unbranded product marketing

Finally, challenge your agencies to think blue sky—have them bring their strongest ideas for mobile to the table, and explore opportunities to pilot in 2012.

Jeff Greene
Director, Digital Strategy
HealthEd

 

 

A Health Educator’s Experience as a Patient

Informed, active, empowered—these characteristics describe the people I’ve worked with during my 30-year career as a certified clinical social worker and health educator. I have counseled people young and old during their acute, chronic, and life-threatening illnesses.

So will being “empowered,” “active,” and “informed” lead to better outcomes for me as I fight my illness? As a health educator, I should know how to be an “active patient,” right? I am certainly doing my best to actively participate in my health care, but it is challenging at times. I have new empathy for those who are frightened by their illness and have limited understanding and support. 

After my diagnosis, one of the first steps I took to actively participate in my medical care was to understand my illness and my treatment. This was more complicated than I thought. For instance, it took me 4 attempts to wrap my head around using a nebulizer and the medications. In the hospital I had three different respiratory therapists (RTs) who set up my inhalant medications each day. I had another RT once I got home. 

I had to ask each of them how the medications worked, the differences in the medications, and what I could expect from them. It would have been best if I told them I did not understand what they were saying. I should have asked them to use plain language. But I also realized that some clinicians are not skilled at this. Unfortunately, it wasn’t until I was at home that I received a clear explanation that helped me understand the hows and the whats of treatment. The visiting RT used an analogy and a visual image of what was happening in my lungs and how the medicine would help.

Learning more about my illness, I realized there were numerous resources to turn to—the Web, my family, and different members of my healthcare team. I just had to ask. However that is not a simple statement. What did I really want to know, and how would these answers make me more empowered? I searched the Web for clinical trial results related to my illness and wrote down questions about the treatment I may be eligible to receive. I had prepared a litany of questions citing the studies, the articles, and centers from where the information was gleaned. This made me feel more credible and prepared in case I was shot down for asking too many questions.

Imagine me worrying about not being taken seriously, being dismissed for asking questions! I am the person who helped her patients write the lists, showed them how to research their illnesses, and instilled them with a sense of confidence to talk with their healthcare providers (HCPs). Yes, I too was reticent. My little blue book of notes and questions bolstered my confidence and demonstrated to my nurse and doctor I was a partner in my care.

Thankfully, I do have the resources to help me take an active role in my healthcare. I am fortunate, but what about those that don’t have the internal or external resources… where do they turn? I hope they have the support of their doctors, nurses, social workers or other HCPs to figure out what to research, questions to ask, and the confidence in themselves to participate in their healthcare. The HCPs can be a strong ally when lost in a sea of foreign words and phrases that frighten any of us. I hope all HCPs incorporate analogies, visuals, and write out information as needed.

Other ways to learn is by teaching back what you were taught to demonstrate what you heard. While it is often used when a nurse teaches a skill or health related behavior—self injections, catheter care, or medication regimens—it can be useful in describing complicated medical information. The use of illustrations to describe body anatomy and mapping out a diagnostic workup and treatment plan is a fundamental step. This can be highly effective if medical information is new and learning is compromised due to heightened anxiety and stress.

My advice to other patients is to write down your questions and your thoughts about treatment relative to you. This reframes the issue from the abstract to you personally. Share what is important in your life with your healthcare team. It gives them a richer perspective on what is important to you and factors that you will consider in making your treatment decisions. Make note of your reactions to treatment—it improves your accuracy as a historian.

Being an informed patient and an active participant in my healthcare, I hope this plays a role in my treatment outcomes. However what is critically important is that I realize I have developed a deep trust in my doctors and my healthcare team. We have respect for each other and have built a partnership that I believe will contribute to a positive outcome.

Ide Mills 
Senior Vice President, Health Education
HealthEd

 

Of Mustaches and Men's Health

“What’s that fuzz under your nose?” “Is that a new look for you?” “Trying to bring back the Tom Selleck look?” “Is that the iconic Mr. Clean growing a mustache?”

Those are just a few comments men are hearing from their families, friends, and colleagues during November. And that’s the point—to get people talking about why men are growing mustaches this month.

Turning November into Movember

Movember is a global initiative to heighten awareness of men’s health issues. It began in Australia in 2003. In 2010 in the United States, 64,500 men and women joined Movember, and they raised $7.5 million. More and more people are talking about how important it is for men to pay closer attention to their health.  

Globally, Movember focuses on men’s health in general, which makes sense when you think of the number of men who are diagnosed with cancer, heart disease, diabetes, and mental illness. In addition to those men living with chronic or life-threatening illnesses, it critically important to heighten awareness of preventive health measures men can take. Movember’s primary focus, however, is raising awareness about and raising money for prostate cancer. 

Raising awareness for men’s health

According to a Movember study, the US campaign has successfully raised awareness of men’s health issues.  It has also convinced men to take a more proactive approach to their health. When Movember participants were surveyed:

• 96 of 100 spent time thinking about improving their general health
• 87 of 100 understood that their health depends on how well they take care of themselves
• 86 of 100 had a general checkup
• 77 of 100 discussed men’s health with their family, friends, or colleagues during Movember
• 64 of 100 worried about their general health
• 59 of 100 carried out personal research on men’s health issues during Movember

Despite this progress, the research shows that 1 of 2 men would rather ignore a health-related issue than go to a doctor.

Supporting Movember at HealthEd

riThis is HealthEd’s first year supporting the Movember movement. Several Mo Bros (as they are called) are growing mustaches, and their Mo Sistas are supporting their Mo Bros' trials and tribulations.

You know the initiative is taking hold when the women (and men) in the office have brought home the information to their spouses, partners, brothers, fathers, and sons. Some of these men have joined Movember and are growing mustaches too.

Last week a staff member brought her 12-year-old son to the office. He proudly shared that he knew all about Movember because his teacher was growing a mustache for the cause. It is important for all men, young and old, to talk about and take action when it comes to their health.

Learning is step 1

The first step is to learn about diseases that have a big impact on men, and how those conditions can affect men’s physical and emotional well-being. Men, and those who care about them, need to:

• Recognize the signs and symptoms of the disorders
• Learn about screening tests for early detection
• Make lifestyle changes to prevent or manage illnesses

Helping men take action is step 2

To move someone to action means changing his or her attitudes and beliefs. With its resources, open discussions, and support, the Movember movement can help men change their behaviors and improve their health by motivating them to:

• Go to regular well-care visits
• Perform appropriate self-exams
• Discuss health risk factors with their healthcare provider
• Eat a balanced diet
• Exercise regularly
• Stop smoking
• Limit their use of alcohol

At HealthEd, we apply the Health Belief model in educating our staff about men’s health issues. In the process of developing newsletters to share with staff, family, and friends, we consider the basic constructs of the model:

• Perceived susceptibility
• Perceived severity
• Perceived benefits
• Perceived barriers
• Cues to action
• Self-efficacy

Some people think that because we are a healthcare marketing agency, the staff is more aware than others of men’s health and health concerns in general. And that the men of HealthEd are being proactive in their care. While our men may have a heightened awareness of the issues, Movember can reinforce what our staff already knows and inspire them to take action for better health. 

Ide Mills 
Senior Vice President, Health Education
HealthEd