Having recently completed a 10-week health literacy course in University College Cork, our Senior Health Promotion Officer Lynn Swinburne reflects on her learning and what we’re doing in the National Screening Service to improve health literacy.
By Lynn Swinburne, Senior Health Promotion Officer, National Screening Service
Improving health literacy about screening is essential to our equity work in the National Screening Service. Health literacy is not simply about the ability to read and understand health information; it’s about making it easy to find, understand and use our health services and advice across the lifespan. This is one of the goals of the HSE Communications Strategy 2023-2025.
Health literacy is a critical factor influencing public health outcomes, so much so that some now recognise health literacy as a determinant of health. In the context of population screening, health literacy allows people to:
- understand what screening is and who it is for
- have a clear understanding of the screening process and what it can and can’t do
- make an informed decision about taking part in screening
- access screening if they decide to take part
- understand what results mean and how to act on any follow-up needed.
Research tells us that around 4 in 10 adults in Ireland have limited health literacy; and that people with lower health literacy levels:
- have poorer health outcomes
- find it difficult to understand prescription labels or follow medical advice
- are less able to manage long-term health conditions
- are less likely to engage in preventive healthcare measures such as screening.
Understanding health literacy as a barrier to screening
People with limited health literacy are often those who do not take part in screening regularly or who have never taken part in screening and come from underserved communities. This can contribute to the widening of health inequities. To increase health literacy and to improve equity in screening, we must first understand how limited health literacy can be a barrier to screening.
Communicating about screening can be complex, making it difficult to understand. People with limited health literacy:
- may be unaware of the existence of population screening programmes or their purpose
- may not fully understand the concept of risk or the importance of early detection
- may want to take part in screening but may struggle to navigate the healthcare system, make appointments, understand how to prepare for screening, or understand the results they get
- may not speak English as their first language, adding another layer of complexity, as screening terminology and the concept of preventative health may not be easily understood
- may not have the confidence or skills to interact with healthcare services.
What we’re doing to increase health literacy in screening
Our communications play an important role in supporting people to choose screening. We know that providing accessible information and communicating clearly can increase trust and confidence in our screening programmes and improve outcomes for our screening participants.
Here are some of the things we’re doing to increase health literacy about screening:
- We use plain English in our communications with our screening participants, avoiding medical jargon and using visual aids where possible to explain important messages.
- We develop accessible information about our screening programmes, including easy-to-read and plain English resources, and photo and video stories.
- We provide information about our screening programmes in multiple languages.
- We include our Patient and Public Partnership representatives in our information development projects to ensure their voice is central to our work.
- We engage with local communities to build the capacity of community health workers to provide practical information and support about screening in their communities. Community health workers can play an important role in providing culturally appropriate education and support.
- We partner with communities to improve health literacy in screening. Our joint project with Pavee Point Traveller and Roma Centre aimed to improve knowledge and awareness about cancer prevention and screening programmes among the Traveller population. Travellers used their tradition of storytelling to support and encourage their community to take part in screening programmes.
- We engage in research to better understand and address knowledge gaps including a study to assess the needs of Disabled people in accessing our screening programmes.
- We support staff training on how to communicate clearly about screening, and to promote access and inclusion.
We also share our knowledge and learnings:
- We publish news reports about our projects, the resources we develop to increase health literacy and about our work to improve equity in screening.
- We’ve recently completed work with our colleagues in Solas, developing two e-learning modules on health literacy for health and social care professionals.
- We deliver workshops with our partners and stakeholders and provide updates about our service developments and projects.
- We’re working with European partners on a joint action initiative on cancer screening including coordinating and supporting activities to reduce inequalities in access to screening programmes, and developing and assessing methods for promoting informed choice, and improving health literacy and communications.
By implementing strategies to improve health literacy, such as simplifying communication, engaging with communities, and training our staff, we can continue to build trust and confidence in our screening programmes, empower people with the information they need to make informed choices about their health, and improve equity in screening.
Increasing health literacy is more than educating people about screening - it is a vital public health strategy that can lead to improved health and wellbeing outcomes for the populations we serve. By addressing health literacy needs we can enable more people to choose screening.