HealthEd Blog

Tweet Your Way Into 68 Million Hearts During High Blood Pressure Awareness Month

 

If you’re reading this, chances are you’ve also spent some time today on Facebook, Twitter, and maybe even YouTube^T.

And if you were paying attention, there’s also a good chance someone you follow posted or tweeted about High Blood Pressure Awareness Month, designated for the month of May. Did you notice?

If you did, it may have led you to the American Heart Association (AHA) Web site  where some pretty cool stuff is going on. The AHA is currently running a campaign to create and upload your own video on your heart-healthy eating habits. The creator of the video that receives the most votes will receive $500 in AHA merchandise.

Why is it so important to pay attention? Well, that video could reach a lot of hearts. About 1 in 3 US adults—an estimated 68 million—has high blood pressure (also known as hypertension). This increases the risk for heart disease, stroke, congestive heart failure, and kidney disease.

Men are at greater risk for high blood pressure if they are over 45 years old. For women the risk is higher if they are older than 65 years old. African Americans develop high blood pressure more often, and earlier than whites and Mexican Americans.

There are some easy steps to help prevent high blood pressure this May, and all year long. Maintain a healthy diet low in saturated fat, sodium, and cholesterol. Get regular exercise, quit smoking, and limit alcohol to help lower your blood pressure. That’s 139 characters of great advice, perfect for Tweeting.

Now that you’re in the know, what are you going to do about it?

Designate one day this May to make just 1 post or tweet on your favorite social networking site to spread the word on high blood pressure and you can educate millions of people. Don’t forget your doctor, too – it’s important to talk with your doctor about your health and get regular screenings.

The average Facebook user has about 190 friends and the average Twitter user has 127 followers– that’s a lot of hearts.

Michelle Yered
Senior Account Executive
HealthEd

 

 

The Health Education Difference

 Proven success is an eye-catching brand claim. This simple statement can instantly add credibility for a brand and build trust with patients and healthcare providers with a mere 2 words. This claim is always substantiated by the brand’s clinical research; however, as a health educator, I often question whether or not the results are sustainable long-term behavior. 

I would argue that partnering claims with the support of health education can lead to sustained health behavior changes. Here's why.

I discovered health education while I was coaching consumers of a well-known weight-loss brand on the basics of nutrition and the brand-focused weight-loss products. I felt that despite all my efforts, the end result for consumers was not life changing. Consumers could use the brand’s products and achieve success, but market research showed that few consumers could sustain the weight loss over the long term. 

Proven success was the brand claim. I felt challenged with this because I believed that the slogan overpromised. In my experience, the claim was based on short-term results, and using the products did not result in the behavior changes necessary to lead to sustainable weight loss for the consumers. At this moment, I recognized the need for health education—and with that, my educational approach was transformed. I started to recognize that arming consumers with nutrition knowledge was not nearly enough. Consumers simply needed more in order to understand the information and then be able to act upon it to achieve long-term success.

Applying the health education learnings and a theoretical behavior change framework helped me overcome these challenges and changed the outcomes. This change not only affected the consumers in supporting their behavior changes but also helped to grow the brand. Consumers gained the ability to self-recognize and to strategize a personalized approach to dealing with nutrition and weight issues that was sustainable over time. The brand gained heightened perceptions of results that could potentially lead to a larger market share. 

Health education made the difference. There are many opportunities to apply this to healthcare products and related consumer goods. To take advantage of these opportunities and make a difference for the consumers of your brand, a health education approach may be key to proven longer-term success.   

 

Laura Catalusci
Specialist, Health Education

Wrapping Up American Heart Month—Some Parting Thoughts on Chocolate

No need to feel guilty after eating all those Valentine’s Day chocolates. Chocolate is good for your heart.

YES, you read that right.

In recent years, a lot of attention has been paid to the health benefits of chocolate. But it’s not just any type of chocolate—certain forms of chocolate are better for your health than others. The determining factor is the cocoa content—70% or higher. If you aren’t sure about which chocolate is “healthy,” look for bars with:

• 70% cocoa (or more)

• Pure

• Dark

• Unprocessed on the label

So, what is in chocolate that makes it good for you?

Dark chocolate is a good source of cocoa phenols, a group of important antioxidants also known as flavonoids. Less processed, or darker, chocolates tend to have higher levels of flavonoids. It is the addition of ingredients such as sugar and fat (and caramel and nougat—all that other good stuff!) that makes most chocolate bars not healthy. It’s not the cocoa itself. In fact, cocoa powder, which comes from the cacao bean, is very nutritious. It can provide many health benefits, including helping to reduce a person’s risk for heart disease.

What exactly are some of the health benefits?

Cocoa has many potential heart-health benefits. It may help:

• Lower LDL cholesterol (the bad kind)

• Reduce the risk for blood clots

• Increase blood flow to the arteries

• Lower high blood pressure

In addition to health benefits related to your heart, cocoa can also boost your mood, boost cognitive performance, and provide important minerals, such as calcium and potassium. Flavonoids are also being studied for the role they play in helping to both prevent cancer and reduce the growth of cancer cells.

So keep enjoying your chocolate…guilt free!

 

Rita Williams, MS, CHES
Senior Health Educator, Health Education

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

 

Return on Education – It’s ROI, With The “WHY”

 

Multichannel measurement is not all about ROI, according to an article in PharmaVoice’s January 2012 edition. We couldn’t agree more. Understanding the softer, qualitative metrics, such as patient engagement, brand awareness, and intent to ask, can yield valuable information about how to optimize campaigns.

So, we asked ourselves, how can we measure the why? The answer was to develop a unique measurement approach, called ROE^TM (Return on Education), to help us understand how education and brand promotion drive business and health outcomes. In essence, how do these programs effectively change patient behaviors?

The ROE framework starts with an assessment of educational impact opportunities—a baseline of patients’ attitudes, behaviors, knowledge, and skills related to their condition and its treatment—that reveals diverse patient segments at various points along their disease and treatment journeys.

We then evaluate how shifts in patients’ knowledge, attitudes, behaviors, and skills achieve the desired actions. Do patients intend to speak with their healthcare providers about the brand? Are they actively requesting it? Are they given prescriptions, and if so, do they fill them and adhere to treatment over time?

But recording desired actions alone is not enough—you need to understand the “WHY behind ROI.” Only when we connect patients’ attitudinal drivers and barriers to a desired action can we truly know what motivated patients to act in the first place. This is the key to maximizing business and health outcomes through all phases of the patient journey—from awareness to consideration, to initiation, to adherence/attrition, and, finally, to advocacy or reinitiation.

How can you measure health outcomes, you ask? ROE incorporates outcome surveys (eg, those of HEDIS and the National Committee for Quality Assurance [NCQA]) to determine if an educational effort directly resulted in positive health outcomes.

The ROE framework now serves as the basis of all our measurement planning and informs optimization of relationship marketing and digital initiatives so maximal success is achieved for both patient and brand.

 

Barbara Haimowitz, PhD
Vice President,
Marketing Analytics
HealthEd

Overweight Women Avoid Healthcare Visits

I was a precocious child. For example, when I was 5 years old, I changed my name—ever so slightly but enough to make a difference. A couple of years later, I canceled an appointment with my pediatrician. I didn’t want my doctor to talk with me about being overweight. Getting on the scale caused me great anxiety; visiting the doctor made me self-conscious and uncomfortable. Dr. Adelman told me I was too chubby and had to lose weight. Yet he always offered me a lollipop before I left the office. With every subsequent visit, I thought he was going to embarrass me about my weight. The emotional pain became so great that I avoided my appointment rather than be subjected to my doctor’s judgmental comments. Fast-forward 40+ years. I was still avoiding well-care visits. Getting on a scale still conjures up feelings of embarrassment, loss of self-control, and disappointment.

If only I ate in moderation and exercised regularly—but I do not. While I have not recently experienced the judgmental comments or nonverbal communications of my doctors and nurses, I internalized the comments and reactions of my pediatrician. As an adult, I practiced the same unhealthy behavior of many overweight women who have ignored their health due to stigma and shame. For them, that point in a doctor visit—stepping on the scale—is associated with intense negative emotions that keep too many people who are overweight and obese from obtaining proper preventive healthcare.

Treatment includes treating all people with respect

Two points I find interesting on the topic of obesity are that weight counseling in the primary care setting has decreased ¹ and that there is a need to educate healthcare providers about treating obese people with respect and dignity.

At a recent conference on obesity, it was reported that physicians have not found weight counseling to be effective—one reason for the reduction in time spent on this intervention. This decrease in counseling time is occurring despite an increase in patient visits for diabetes, hypertension, and other obesity-related issues. A Healthy People 2020 goal has been set to increase the proportion of obese-adult office visits that include counseling and education on losing weight and living a healthy lifestyle. But are physicians and other healthcare providers equipped to counsel these patients? Do they have effective tools and the resources to guide their patients about weight loss?

At the obesity conference, Christopher N. Sciamanna, MD, from the Penn State University College of Medicine, said that physicians must have effective tools, including Web sites and programs, to guide the treatment of obese patients. He added that physicians need education on what to say and do to help obese patients.¹ Weight counseling is not adequately addressed with a few quick statements emphasizing that a patient’s diabetes, cardiovascular disease, or arthritis will be further compromised if he or she does not lose weight. In the absence of knowing what to say and in feeling defeated because of the ineffectiveness of what has been offered, has the course of action for physicians been to say and do less?

Caring for patients with obesity

I started writing this blog when I read a statistic about the high number of women who avoid well-care visits because of the embarrassment and shame they feel about their weight. The case study I read mentioned a healthcare provider rolling her eyes when recording the patient’s weight. The article described a patient’s humiliation when the scale stopped at 350 pounds and the dressing gown was too small. I went on to read more about the challenges of treating people with obesity and realized what a learning curve it is. However, a core tenet of caring for any patient is respect; and in the case of obesity, a few basic considerations have been described in an article from the National Institutes of Health and the Weight-control Information Network (WIN). Excerpts from the article are listed below. To read the full article, go to Medical Care for Patients with Obesity.²

· Have suitable equipment and supplies on hand to improve patient access to care.

· Create a positive, open, and comfortable office space.

o    Provide reading materials in the waiting room that focus on healthy habits‚ rather than physical looks or being “thin.”

· Use medical devices that can correctly assess patients with obesity.

o    Use large adult blood pressure cuffs or thigh cuffs on patients with an upper-arm circumference greater than 34 cm.

· Be respectful when talking about the patient’s weight.

o    Weigh patients in a private area and only when medically needed.

o    Record weight without comments.

· Offer well-care services.

o    Allow enough time during office visits to provide well-care services.

· Promote healthy behaviors.

o    Ask patients if they want to talk about weight loss. If they want to talk about losing weight‚ let them know that a weight loss of 5 to 7 percent of body weight may lower their chance of developing diabetes. Work with patients to establish realistic goals.

o    Start small. Encourage patients to start with simple goals such as walking for 10 minutes‚ three times a day. Once they achieve this goal‚ they can build on it.

o    Offer patients information and referrals to registered dietitians‚ other health providers‚ and support groups‚ as needed.

o    Promote self-acceptance and encourage patients to lead full and active lives.

 References: 1. Sciamanna C, et al. Decline in U.S. physician lifestyle counseling during the obesity epidemic. OBESITY 2011; ABSTRACT 28-OR. 2. Medical Care for Patients with Obesity. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health. NIH Publication No. 03–5335. February 2003. Updated July 2011. 

Ide Mills, LCSW
Senior Vice President, Health Education
HealthEd

 

 

 



Using Models and Theories to Drive Behavior Change

While reading recently about the US Department of Agriculture's new MyPlate campaign, I couldn’t help but wonder... This is an important message, but will a campaign that focuses only on awareness and the "how to" actually make a difference in the US obesity epidemic? Will it get the American public to eat better?

One of the first things we as health educators learn about behavior change—a core focus of our profession—is that increasing knowledge is only the first step. On its own, knowledge is not enough to cause the behavior change “tipping point” that Malcolm Gladwell describes so well in his best-selling book.

An educational piece, program, or intervention must address the barriers, motivators, and other influences that are keeping the individual or community from moving toward the behavior we wish for them to adopt. This is where models and theories of behavior change come in.

Why use theories and models?

Theories and models are important because they are backed by research and evidence. They also help make our jobs easier and more effective by serving as a road map for the steps we need to take. And they help keep health educators accountable when we evaluate the outcomes of tactics or programs.

When developing educational materials, programs, or campaigns, it is critical that theories and models serve as a foundation and weave throughout all aspects of our work. Otherwise, we simply develop content based on intuition rather than evidence. Using intuition alone can result in a campaign that may waste resources because it will have little chance of creating real behavior change.

Example

Social cognitive theory (SCT) is a popular theory often used in behavior change programs. Its main focus is on how people and their social and physical environments influence each other to affect behavior. Programs that use SCT:

• Inspire people to believe that they have the ability to change their behavior
• Help people understand why changing a certain behavior is in their own best interest
• Explain to people how their current behavior is affecting their health
• Provide people with relevant and accurate information about the behavior and its impact
• Explain to people how they have control over their behavior
• Help identify personal, social, and environmental barriers to behavior change
• Assist with developing a plan on how to overcome the barriers

Behavior-change programs that incorporate SCT also:

• Provide examples and success stories of those who have successfully changed their behavior
• Teach the skills necessary to achieve the desired behavior change
• Encourage people to reach out for support from family, friends, and others
• Focus on incremental changes
• Reward each milestone of change

Learn more

If you would like to learn more about theories and models and their application, a terrific, free downloadable book called Theories at a Glance is available from the National Cancer Institute.

Dominika Samojlik, MPH, CHES 
Community Manager, Health Education
HealthEd

 

 

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