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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 1: Well-Woman Visit

MCHbest Logo well-woman visit

Strategy. Health Literacy Interventions

Approach. Develop patient education videos to improve health literacy surrounding use of preventive care services.

Source. Robert Wood Johnson Foundation's What Works for Health (WWFH) Database

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Overview. Health literacy is the degree to which people have the capacity to obtain, process, and understand basic health information and services required to make appropriate health decisions (Ratzan 2000). Low levels of health literacy are associated with limited health-related knowledge, poor health outcomes, and behaviors such as limited use of preventive care (AHRQ-Berkman 2011, AHRQ-Berkman 2004), as well as higher health care costs and expenditures (Eichler 2009).

Evidence. Moderate to Scientifically Rigorous. There is some evidence that interventions designed to address limited health literacy increase health-related knowledge (Perazzo 2017, Brainard 2016, Brijnath 2016, Jacobs 2014a*, Manafo 2012*, DeWalt 2009, Pignone 2005) and comprehension (Sheridan 2011), and improve adherence to treatment (Perazzo 2017, Miller 2016). Additional evidence is needed to confirm effects and determine which interventions are most effective. Health literacy interventions that combine multiple approaches (e.g., written and visual materials that are easy to read and understand, video tutorials, health literacy training for physicians, and in-person patient assessments) appear to increase patients’ comprehension and appropriate use of health care (Sheridan 2011). Read more in the WWFH database report. Read more about WWFH's evidence ratings. (*Links to citations can be accessed through the WWFH database).

Target Audience. Patients.

Outcome. Percent of women, ages 18 through 44, with a preventive medical visit in the past year.

Examples from the Field. Access descriptions of current ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Develop patient education videos to improve health literacy surrounding use of preventive care services,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of women, ages 18 through 44, in the state who have watched patient education video.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of women, ages 18 through 44, in the state who have watched patient education video.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of women who report increase in health literacy surrounding preventive care services after watching educational video.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of women who report increase in health literacy surrounding preventive care services after watching educational video.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


 

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.