Patient counseling materials: The effect of patient health literacy on the comprehension of printed prescription drug information.

BACKGROUND: Counseling patients with written materials relies equally on patients' health literacy to understand their disease and its treatment, and the written materials' effectiveness communicating clearly in accessible and actionable ways. Only about 12% of the US population is adequately health literate. OBJECTIVES: To explore the impact of reducing the health literacy demands of written patient health information. METHODS: 805 patients were screened for health literacy, and recruited for balanced cohorts of adequate and low literacy, and high and normal blood pressure. Half of each patient cohort received either standard or "health literacy-friendly" drug summaries (i.e. Patient Package Inserts, or PPIs or "leaflets") along with a standardized health literacy assessment scale. RESULTS: The literacy-friendly drug summary improved comprehension of drug-related information overall from 50% to 71% correct responses. Adequate literacy patients improved from 58% correct to 90%, while lower literacy patients improved from 42% to 52% correct in response to the health literacy-friendly PPIs. CONCLUSIONS: Health literacy demands require special attention in developing and using written drug summary materials. Additionally, pharmacists should be provided additional information and counseling support materials to facilitate communications with low health literacy level patients.

Confidence in vaccination: a parent model.

Although vaccination has been heralded as one of the 10 greatest public health achievements, how parents differ in their views about vaccination is not well understood. A deeper understanding of these attitudes and beliefs may improve the effectiveness of vaccine communications. In this mailed survey of U.S. parents in January 2001 (return response rate 49%), parental confidence in vaccination was very high, although there was significant variation among parents. Using multivariate analyses to group and profile parents, 90% of parents (n=1820) were classified into one of four distinct parent groups: (1) "Vaccine Believer" parents who were convinced of the benefit of vaccination; (2) "Cautious" parents noteworthy for a high emotional investment in their child; (3) "Relaxed" parents characterized by a less involved parenting style and some skepticism about vaccines; and (4) "Unconvinced" parents distinguished by their distrust of vaccinations and vaccination policy. These findings suggest that messages that are customized to parents' attitudes and beliefs may improve their understanding and acceptance of vaccination.