Health Information Literacy:
The Miami Dade College Medical Library Experience

Carla Levesque

Which is the strongest predictor of an individual's health status: age, income, literacy skills, employment status, education level, or ethnicity? Believe it or not, according to the Partnership for Clear Health Communication, limited literacy skills are the strongest predictor.

The Library at the Medical Center Campus of Miami Dade College (MDC) first became interested in the topic of health information literacy in the fall of 2003 after a teleconference was offered by the Medical Library Association (MLA) titled Reading Between the Lines: Focusing on Health Information Literacy. Recognizing the importance of the principles expressed during this conference, we began our journey to incorporate the principles of health information literacy into the curriculum at the Medical Center Campus.

As defined by the MLA, health information literacy is “the set of abilities needed to recognize a health information need; identify likely information sources and use them to retrieve relevant information; assess the quality of the information and its applicability to a specific situation; and analyze, understand, and use the information to make good health decisions.”

Challenges

Several challenges face health care educators and health care professionals in ensuring that their students and patients are health information literate. For one, The National Adult Literacy Survey showed that approximately 48 percent of American adults read at or below the eighth-grade level. However, most health materials are written at a tenth-grade level or above. This means that close to half of the United States population doesn't understand consent forms, prescription instructions, and other health education materials.

Another challenge is the source that people are using to obtain their health information. The internet has become the primary source of health information. A recent study by The Pew Internet and American Life Project found that 72 percent of internet searchers surveyed expressed trust in most or all of the information they found online. Sixty-eight percent said that this information affected their health choices. Therefore, information found on an unknown website may override information provided by a physician, a nurse educator, a medical librarian, or another health care professional.

Finally, many consumers have poor evaluation skills in distinguishing between reliable information and unreliable information available on the internet. One study published in the British Medical Journal observed that none of the participants checked About Us sections, disclaimers, or disclosure statements from websites that they used. The participants usually chose one of the first results that came up, and very few could even remember the name of the web page they used after closing out of the internet.

Action Steps

Health information literacy is of importance to everyone, since we will all encounter health problems and need to seek health information in our own life or for the lives of our family and friends. However, for students preparing to work in the health care field, this topic is essential for providing the proper patient education.

There are many steps that health care professionals can take to address these challenges. Some examples include

• writing and identifying quality health education materials written at various literacy levels and in various formats to accommodate different learning styles;
• effectively communicating and sharing vital information with colleagues;
• using plain language rather than medical jargon; and
• instructing consumers to evaluate health education materials.

Incorporation Into Curriculum

For the initial start-up of this project, the library wanted to target the most appropriate group of students. Recognizing that nurses are often the ones who provide patient education in a health care setting, MDC decided to start its project with the graduating nursing students. At MDC, a Nursing Leadership class is required during the last session before a student graduates from the program. As the college catalog describes it, “This course provides the student with the theoretical and clinical knowledge necessary for actualization of the role of the registered professional nurse, with emphasis on delegation and supervision.” This seemed to be the most appropriate time to reach the students so that they would value the importance of this information and be able to retain it for use in the workplace.

During the fall session of 2004-2005, the library presented its ideas to the nursing faculty who teach the leadership class. They expressed interest in having a health information literacy component incorporated into their class. During the spring session of 2004-2005, the library implemented this project by creating a Health Information Literacy PowerPoint and teaching it to three Nursing Leadership classes, a total of approximately 80 students.

Results and Future Expansion

Initial feedback has been positive. The faculty and several students mentioned how useful they found the information. Some suggested that this content be taught earlier in the nursing program.

Based on this feedback, MDC developed some ideas for future expansion of the project:

• Incorporate the health information literacy PowerPoint into the program guides available from the library's website. These guides offer students a one-stop comprehensive place to go for all of their information needs, from locating books, media, and periodicals to identifying recommended websites, professional associations, and critical-thinking exercises.
• Offer open-door workshops for any faculty, staff, or students who have an interest.
• Integrate health information literacy into other programs' curricula. MDC's Medical Center Campus offers 16 Associate in Science degrees; nursing is one of them. MDC believes that all of the programs would benefit from this project. In addition, many of these programs offer some of their courses online via WebCT. To ensure that distance students receive the same instruction as traditional students, the library has begun to incorporate a library module into some of the programs' WebCT courses. Health Information Literacy needs to be included as well.

For more information, contact:

Carla Levesque
Faculty Librarian
Medical Center Campus
Miami Dade College
(305) 237-4342