I have been very impatient with the narrow view of some health literacy researchers who, as if looking through a soda straw, focus on only a single factor in a persons’ capacity to use information for health, usually reading skill. Or who focus only on the clinical encounter. Or only on patients with chronic disease. Or only on plain language. Experts at the International Roundtable on Health Literacy at University of British Columbia last month could not agree on a definition or a measure of health literacy. I’ve called for a broader view.
But maybe I’m wrong.
This week I was in Bozeman, MT working with the public health nurses and social workers who staff the Thrive Partnership home visiting program. They are the cutting edge of promoting maternal health literacy. It has been my honor to work with them since 2004. This time we worked on practical approaches to empower parents.
In this community, promoting health literacy and empowering parents is part of a county-wide coordinated effort to strengthen vulnerable families. The collaboration addresses the entire Web of Interaction that affects MCH and maternal health literacy.
Thrive, voted Bozeman’s best non-profit, under the tireless, gentle, powerful direction of executive director Deborah Neuman, has over 26 years forged a collaboration to promote maternal child health as the foundation for a healthy society in Gallatin County. Neuman has received a growing number of requests from around the country for help to replicate the collaboration that extends well beyond the usual public health players. For example, two banks contributed space for our 2-day workshop. The Hilton hotel comp’d rooms and breakfasts for the trainers.
Neuman credits the soda-straw view of each partner as the active ingredient in the success of the Thrive model of coordinated collaboration. She says a common broad view would cause the collaboration to degenerate to groupthink. She points out that the social workers in my workshop are employed by Thrive; they were hired for their ability to engage parents. The nurses in the workshop are employed by the health department and hired for their clinical expertise. The PHNs and MSWs work with the same families. They are acutely aware and respectful of each others’ expertise. They closely coordinate their efforts with each other, healthcare providers, the hospital, the schools, food banks, day care providers, , the Bozeman Adult Literacy and Education service, et al. Both the Health Department and the agency use the Life Skills Progression to monitor their effectiveness and family progress. Ten years of LSP data (soon to be published) show remarkable results,with effectiveness increasing over time as the coalition grew and collaboration deepened.
Rather than of a common broad view, Neuman says, what works is all those soda straws trained on the needs and strengths of the same vulnerable families to find the combination of supports that empower each family to function as fully as possible as part of the Gallatin County society. It seems many narrow views together cover the broad view without sacrificing the depth of understanding one gets looking through a soda straw. ss
*Credit for the soda straw analogy goes to Linda Wollesen, author of the LSP