Think of health literacy as an array of skills that enable a person to use information and services to enhance health. Using information for health implies ability to obtain, process and understand the information; and beyond that, to make meaning from it and apply it in context for personal benefit. Using information further implies motivation – attitudes and beliefs that generate the interest and passion required for decision making, action, and especially for change.
Think of a health literate mother as one who can:
·Express her needs and her child’s needs. She says what is wrong or missing; describes symptoms, feelings and facts.
·Describe her best possible desired outcome. She says what she wants.
·Articulate her concerns. She says what is not working, what is in the way, what she fears.
·Notice supports. She says what is helping, what has worked previously, who will help.
·Participate in decision-making. She asks questions, weighs options, and considers consequences.
·Take action toward achieving her desired outcome. She plans and takes one baby step after another toward her vision of personal and family health.
To promote a mother’s health literacy means to empower her to use information and services to exert increasing control over her personal and family health.
In my research, a surprisingly high proportion of depressed mothers who practiced reflection with their home visitors sought treatment for their depression. In a sample of 704 mothers who participated in home visitation for 12-18 months, 101 (14%) were depressed throughout the service period; of these 69% were in treatment at least some of the time. Compare that to previous reports of 20% of persistent cases obtaining treatment. Of parents who developed symptoms during service (n= 50, 9%), 62% obtained treatment (n= 31), exceeding a previously reported rate of a 13.5% for emergent cases.
Seeking treatment for one’s own depression demonstrates multiple health literacy skills (e.g.) obtaining and understanding information; planning, problem solving, appointment-making, decision-making, and action-taking). It demonstrates motivation strong enough to overcome depression and multiple barriers to care (e.g. stigma; lack of insurance, transportation, child care). These skills and motivations are the makings of an “activated patient” taking responsibility for her health and her child’s health. They are the marks of a health literate mother.
Institute of Medicine. (2004). Health literacy: A prescription to end confusion. Committee on Health Literacy, Board of Neuroscience and Behavioral Health. Nielsen-Bohlman, A.M. & Kendig, D.A. (Eds.). Washington, DC: National Academies Press.
Nutbeam, D. (1998). Health Promotion Glossary. Health Promotion International, 13(4), 349-364.
Nutbeam, D. (2008). The evolving concept of health literacy. Social Science & Medicine, 67, 2072-2078.
Emerald, David (2006). The Power of TED* The Empowerment Dynamic. Polaris Publishing, Bainbridge Is, WA.