1. 4/9/2012
Workshop Ground Rules
 Turn cell phones off or to vibrate/silent
 Relax, be comfortable, be interactive
 Share experiences, thoughts and ideas
 Practice common conversational courtesy
 One person talking at a time
 Respect different ideas and view points
 Avoid rabbit trails and editorializing
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2. 4/9/2012
Workshop Outline
 Introductory sharing – “Know your audience”
 Preliminary information – “Connect the dots”
 Justification/need for the project
 Overall goal and objectives
 Experimental design & process evaluation
 Observations & preliminary findings
 Summary
Know the Audience
 Name and position/work area
 How many years in current position/work
area?
 Where you grew up?
 What states you have lived in as an adult?
 What you hope to get out of this workshop?
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3. 4/9/2012
Connect the Dots
 Conference Theme
 “Leveraging Partnerships to Improve the Health
of the Nation”
 Creating Healthy Communities CoP Goal
 “Provide resource support to improve
community health”
 Workshop focus area
 “Promoting Health Literacy with Inmates”
Connect the Dots
 Literacy
 Health Literacy
 Incarceration
 Recidivism - “a return to prison and/or jail as a
result of either a new conviction or a violation of
terms of supervision”; Recidivism rates vary
nationally:
 1 out of 2 (50%)
 2 out of 3 (66%)
 4 out of 5 (80%)
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4. 4/9/2012
Connect the Dots
 Health Literacy is the capacity/ability to obtain
(find), process (understand) and use (act on)
basic health information and services in order
to make appropriate health decisions.
 Health Literacy is the #1 predictor of health
outcomes – ahead of age, race, income,
education, and employment
Connecting More Dots
 Statement: “The true health of a community
is determined by how it treats its weakest and
most vulnerable members”
 Who are the vulnerable members? (NN/LM)
 Elderly (age 65+)
 Minority and immigrant populations
 Low income
 People with chronic mental and/or physical
health conditions
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5. 4/9/2012
Education, Income & Health
“Low education rates and inadequate income
contribute to premature death, chronic
disease, and spending on medical care.
Prioritizing education and economic
opportunity is an important strategy to save
lives, improve health, and reduce spending on
avoidable illnesses.” April 3, 2012
2012 County Health Rankings
Robert Wood Johnson Foundation – Public Health
http://www.rwjf.org/publichealth/product.jsp?id=74148
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6. 4/9/2012
Justification/Need
 Health literacy is the #1 predictor of health
outcomes
 Poor health literacy is associated with poor self
care management, high health care costs, and
low use of preventive services
 Inmates have low health literacy skills and high
incidence of chronic illnesses (80-90% vs 50%
for all US)
 Chronic illnesses account for 75% of all health
care expenditures and 70% of all deaths
Goal of the Project
To improve the health literacy, self-care
management skills and personal health care
decision-making of inmates incarcerated in
the county jail
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7. 4/9/2012
Objectives of the Project
 To enhance the capacity of inmates in their
understanding of locating, evaluating and
using basic health information
 To motivate inmates to take more
responsibility for their own health care
 To increase the inmate’s understanding of the
importance in seeking assistance from local
librarians after release
Experimental Design
 Announcing the project to inmates
 Signing Informed Consent forms
 Filling out Pre-Survey Questionnaires
 Distributing the following handouts:
 My Health Companion ©
 Staying Healthy Student Resource Book
 Coping with Stress Student Book
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8. 4/9/2012
Experimental Design (con’t)
 Receiving the following handouts (con’t):
 Talking with Your Doctor
 Seeking Drug Abuse Treatment: Know What to
Ask
 the List – Community Resources for Gallatin
County
 Attending formal classes 2.5 hrs/day – M, W, F
 Attending informal classes 2 hrs/day – T & Th
Experimental Design (con’t)
 Filling out Post-Survey Questionnaires one week
after completion of 11.5 hours of classes
 Modifying project protocol as needed
 Decreased class size from 12 to seven
 Changed laptops to desktops with headphones
 Reduced class time from two weeks to one week
 Promoted self-guided learning
 Maintained goal to reach 60-70 inmates with pilot
project
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9. 4/9/2012
Experimental Design (con’t)
 Health Information Literacy Offline System
(HILOS) – “internet-in-a-box”
 MedlinePlus
 Understanding Medical Words: A Tutorial from
the National Library of Medicine
 USDA SuperTracker
 Plain Language Medical Dictionary
 12 Power Point Presentations
 42 Videos
Experimental Design (con’t)
 Topics of 12 Module PPTs
 Computer Basics
 What is Health Literacy?
 My Health Companion © and Other Resources
 Advocacy and Self-Care
 Prevention and Screening
 Sexually Transmitted and Infectious Diseases
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10. 4/9/2012
Experimental Design (con’t)
 Topics of 12 Module PPTs (con’t)
 Tobacco Epidemic
 Mental Illness
 The Science of Addiction
 Nutrition
 Oral Health
 Library Resources
Observations - Target Population
 Addictive behaviors/substance abuse
 Mental illnesses
 History of unhealthy relationships
 Complex and chronic health conditions
 School dropouts/low literacy
 Sex offenders & violent offenders
 Minorities
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11. 4/9/2012
Observations - Classes
 Fragile population with frequent dropouts,
stop-outs and bail-outs
 Broad range of literacy, learning and
computer skills
 Broad range of interest and motivation
 Scheduling conflicts
 Many positive comments
Preliminary Findings
 “The health literacy class has already aided
me in helping my parents with their medical
issues.”
 “I know more about STDs and what I need to
do in order to maintain my health.”
 “Thank you for all the time the volunteers
gave to help us.”
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12. 4/9/2012
Summary – Key Components
 Pre- and post- questionnaires
 Access to desktop computers with 12
module PPTs and internet-in-a-box
(offline) system
 Handout materials
 My Health Companion ©
 Staying Healthy Student Resource Book
 Coping with Stress Student Book
Summary - Key Collaborators
 Gallatin County Detention Center (County Jail)
 Montana State University (Extension, College
of Nursing, & Library)
 Gallatin City-County Health Department
 Gallatin Mental Health Center
 Bozeman Public Library
 Healthy Roads Media
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13. 4/9/2012
Summary – Health Literacy
 Affordable Care Act (ACA) - March 2010
 National Action Plan to Improve Health
Literacy - May 2010
 Healthy People 2020 - Dec 2010
 National Prevention Strategy - June 2011
 Healthy and Safe Community Environments
 Clinical and Community Preventive Services
 Empowered People
 Elimination of Health Disparities
Improve the Health of the Nation
 Improve self-care management and health
care decision-making of inmates upon release
 Improve community public health
 Improve public safety
 Reduce health care costs
 Reduce recidivism
 Reduce health disparities
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14. 4/9/2012
Improve the Health of the Nation
 Prisoner reentry is a:
 Public safety issue
 Public health issue
 Housing and employment issue
 Family and community issue
 Education issue
 Minority and special needs issue
Acknowledgements
 National Library of Medicine, NIH, DHHS
 MedlinePlus
 Understanding Medical Words
 United States Department of Agriculture
 SuperTracker
 Taubman Health Sciences Library, University of
Michigan
 Plain Language Medical Dictionary
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15. 4/9/2012
Acknowledgements (con’t)
 Healthy Roads Media, Bozeman, MT
 39 videos
 Extension IT Specialist, Montana State
University
 ‘Internet-in-a-box offline system’
 National Network of Libraries of Medicine,
Pacific Northwest Region, University of Washington,
Seattle, Washington
Contact Information
David Young
Extension/College of Nursing
P.O. Box 172230
Bozeman, MT 50717-172230
E-mail: dyoung@montana.edu
Phone: (406) 994-5552
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16. 4/9/2012
Medical Library Association Health Literacy Consulting
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