Background
Health literacy is defined by the Health Quality and Safety Commission (HQSC) as:
"The degree to which individuals can obtain, process and understand health information and services they need to make appropriate health decisions" (New Zealand Guidelines Group, 2011).
In response to recommendations from research carried out by the New Zealand Guidelines Group the Commission funded a health literacy demonstration project. The overall purpose of the project was to develop, trial, and evaluate a health literacy learning package aimed initially at staff in two community pharmacies. The focus was on pharmacists and the way they communicate with consumers.
The Education, Training and Resources
Workbase, a not-for-profit organisation committed to improving the literacy, language and numeracy skills of people in New Zealand was selected as the training provider to complete a literature review4 and to develop a health literacy education and training package and resources. A ‘train-the trainer’ approach was developed to train the two lead pharmacists to deliver the training and resources to their teams. The training package for the demonstration project included:
- A one day education session about health literacy for the lead pharmacist (the trainer);
- A package of resources developed based on a universal precautions approach, together with evidence and feedback from the lead pharmacists about what they considered would be useful for them in their pharmacies. The package included: Trainer notes;
- Resources to support the training – quizzes and notes;
- A booklet and brochure outlining the three steps to health literacy;
- Step 1 – Find out what people know
- Step 2 – Build health literacy skills and knowledge
- Step 3 – Check you were clear (and if not go back to Step 2)
- A memo card about the three steps to health literacy;
- Follow-up telephone support to the lead pharmacists; and
- A follow-up on-site workshop with pharmacy staff.
Each of the two participating pharmacies differed in terms of their location, size and consumer base. The inclusion of two different pharmacies in the demonstration project provided an opportunity to learn from the experiences of the teams in each pharmacy to prepare a programme suitable for national roll-out.
The demonstration project ran for three months from mid-March until mid-June. Participating pharmacies continue to implement the training and work on health literacy.
The Evaluation Methods
The evaluation consisted of case studies of the two participating pharmacies and focussed on the activities, outputs and short-term outcomes of the demonstration project. Data for the evaluation were collected through:
- Review of documents;
- Pre- and post-demonstration site visits and observation, interviews with the pharmacist trainers and their teams, surveys of pharmacy staff, assessment of audiotaped interactions between consumers and pharmacy staff, and interviews with consumers; and
- A national survey of pharmacists about health literacy.