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Abstract Number: 1572

Developing a Health Literacy Universal Precautions Toolkit for Rheumatology

Leigh F. Callahan1, Victoria Hawk2, Kimberly A. Broucksou2, Betsy Hackney3, Deb MacDonald4, Lindsay Penny Prizer5, Beth L. Jonas6, Thomas K. Bauer7, Rima E. Rudd8, Cindy Brach9 and Darren Dewalt2, 1Thurston Arthritis Res Ctr, University of North Carolina, Chapel Hill, NC, 2Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, 3Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 4Thurston Arthritis Research Center, University of North Carolina Chapel Hill, Chapel Hill, NC, 5Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, 6Thurston Arthritis Research Ct, University of North Carolina at Chapel Hill, Chapel Hill, NC, 7Novant Health, Winston Salem, NC, 8Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA, 9Agency for Health Care Research and Quality, Agency for Health Care Research and Quality, Rockville, MD

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Health behaviors and health education

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Session Information

Session Title: Clinical Practice/Patient Care

Session Type: Abstract Submissions (ARHP)

Background/Purpose:

Research supports that health disparities exist between those with limited versus adequate literacy skills.  Limited health literacy is associated with medication errors, increased healthcare costs, and inadequate care for chronic health conditions.  In 2010, our team developed and tested a Health Literacy Universal Precautions Toolkit (HLUPTK) for use in primary care practices.  Studies in rheumatology have demonstrated a significant number of patients have low literacy.  The purpose of this project was to adapt the HLUPTK for use in rheumatology practices (HLUPTK-R).

Methods:

We reviewed the HLUPTK and its 20 tools to determine areas for adaptation, expansion and discipline specific customization.  An environmental scan was conducted to identify and assess existing health literacy tools, resources and well-designed education materials for use in the rheumatology setting.  Gaps in rheumatology specific materials were also identified. A discipline specific toolkit was developed and tested in 4 rheumatology practices of various size and locations (urban vs. rural).  A study team member visited all practices prior to testing. Over the 2-month testing period, practice staff reviewed the toolkit, conducted a health literacy assessment, and selected and tested a small-scale implementation of 2 or more tools.  Practices completed questionnaires and participated in conference calls with the study team pre- and post- testing.  They also completed Plan-Do-Study-Act (PDSA) worksheets for tested tools.  Based on practice feedback and the testing results, the toolkit was revised.

Results:

A new toolkit, HLUPTK-R, has been developed.  Rheumatology specific resources have been added including a teachback video focusing on a patient with rheumatoid arthritis, a rheumatology-specific plain language guide, medication aides and education materials designed for rheumatic diseases.  Based on feedback from the practices, the tools were shortened and reformatted.  In addition, 2 new tools were developed and included: one for communicating care to other physicians and another for planning small changes in the practice setting.  Furthermore based on key changes adopted by our practices, two new Quick Start guides were developed – one focused on patient encounters and the other on the practice setting.  The Quick Start guides are designed to introduce the practice to the concepts of health literacy and making small changes without the need for coaching that the more comprehensive HLUPTK-R appears to require.

Conclusion: This new toolkit offers clinicians and staff in rheumatology practices a step-by-step approach to improving healthcare for patients of all literacy levels using discipline specific examples and tools.  HLUPTK-R and quick start guides are now available for broader use and testing.


Disclosure:

L. F. Callahan,
None;

V. Hawk,
None;

K. A. Broucksou,
None;

B. Hackney,
None;

D. MacDonald,
None;

L. Penny Prizer,
None;

B. L. Jonas,
None;

T. K. Bauer,
None;

R. E. Rudd,
None;

C. Brach,
None;

D. Dewalt,
None.

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