“Involve your audience early and often” was the main theme of her guidelines for effective Web design, a message that is particularly apt for patient advocacy websites. To design a user-friendly website for patients, Therese Ingram Nissen recommended seeking consumer feedback at the beginning of the design process. Taking into account a patient’s health literacy is one more layer of complexity in the process of communicating a healthcare “road map” to the newly diagnosed patient. As a result, their disorder may progress more rapidly and further than it would in a highly literate patient who is able to engage in chronic disease management at an early stage. Such patients, who are mostly older, immigrant, and non-white, are “less likely to seek help early, complete forms correctly, follow medical regimens, keep appointments,” Raimondo said. Illiterate patients may feel stigmatized and be unwilling to confide that they cannot read what the doctor or receptionist hands them. It may not be obvious that a patient cannot understand a brochure written at a high school level. Illiterate or barely literate adults have coping mechanisms for navigating in a literate world.
The lack of health literacy in the population has medical consequences. Health-related materials written at the high school level are entirely out of the reach of the 20% of the population who read at a 5th-grade level or below. For example, while the average adult reads at an 8th-grade level, most health-related materials are written at a high school level or higher, meaning they are too difficult for the average adult to comprehend. It is the provider’s responsibility not only to appreciate the psychological process by which a patient apprehends his or her diagnosis, but also to assess the patient’s health literacy.Įven average literacy is generally insufficient to understand medical materials. She cautioned about the danger of a healthcare provider overestimating a newly diagnosed patient’s ability to understand medical information. While all patients need to process information about their diagnosis emotionally, many patients may be at a disadvantage if they have low health literacy, according to Paula Raimondo.
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