HealthJuly 12, 2023

Patient education, diversity, and trust: Debunking myths about what patients want

For payers, patient education is a key factor in engaging members, but it is not enough to simply offer health and wellness content. Many organizations face a barrier in establishing trust with members. Understanding their experiences to date and what they want from health education in the future is vital to making those connections.

Patient attitudes toward health questions and education

In a 2022 online survey1 of 1,000 people who had had a health encounter within the past 12 months:

  • Nearly half of the respondents said they did not get all their questions answered during their provider encounter.
  • 80% often or sometimes had follow-up questions.
  • 80% said that if they were to receive patient education, they would be more satisfied with their care, and 68% reported that receiving patient education would make them more likely to return to that healthcare provider.

Health equity: Are all groups having their questions answered?

All non-white ethnicities surveyed were more likely than white patients to report still having questions following an encounter with a healthcare provider. The precise breakdown by ethnicity of patients leaving healthcare encounters expressing a desire for more information was:

  • African American: 40%
  • Asian: 36%
  • Latino: 31%
  • Caucasian: 25%

“For underrepresented communities the desire to have more access to educational content is powerful,” says Evan T. Heigert, creative director for patient engagement at Wolters Kluwer, Health. “One of the things we have to understand is that there’s different context to the needs of each patient, sometimes driven by cultural perspectives, past medical experiences, or even their physical or cognitive abilities.”

Understanding ethnic and generational differences in healthcare preferences

The survey also reveals that:

  • While 10% of Caucasian patients say they don’t have time in an encounter to ask all of their questions, that number rises to 13% for Hispanic or Latino patients.
  • Asian and Latino patients were much more likely to prefer educational videos to other forms of patient education.
    • Overall, 13% of people ranked videos from their provider as their preferred medium of education, but for Hispanic/Latino patients that number soars to 21%.
  • 65% of African American patients – notably higher than any other group – said they would find it very valuable to receive educational materials on their health.
  • 53% of patients 56 and older were less likely to be offered educational materials by healthcare providers.
    • Unlike younger age cohorts, patients over 56 were less likely to consider access to educational materials an incentive to return to a particular provider.
  • Contrary to popular belief, people do not expect to get all their wellness info from TikTok: Less than 10% of respondents in all age groups said they prefer social media for health information, and only 15% of those 18-34 preferred lifestyle websites, with the numbers lower in all other age groups.

The primary takeaway for Heigert is that there is no one-size-fits-all approach to engaging patients or members. He points to the importance of offering personalization and the ability to self-select the level of content as members engage with wellness portals, care managers, or other educational options.

As an example, he cites UpToDate® engagement programs (formerly Emmi®) and their approach to mobility and exercise. When educational materials recommend exercise for patients, “maybe they’re in a wheelchair, maybe they are using a walker, so it doesn’t mean run around the block for them. It means do some stretching or do some water aerobics. By allowing that self-selection, we can help target and make content and action plans that are more supportive and actionable for different types of experiences.”

Balancing personalization and trust

Personalizing health education content means “a user is able to get the level of information that they find helpful at that moment,” Heigert explains. “That’s where you build trust with patients – by not inundating them with too much information at once and finding that perfect balance of where they are in their journey.”

While most members are used to brands targeting ads and personalizing content to them, Heigert warns that when it comes to healthcare providers and health plans, there is a delicate balance to providing what the patient-consumer wants and not overstepping a line.

“Some communities have a sense of distrust of health organizations that already comes into play. I think you need to find that authentic opening to start those conversations, and then that self-guided approach to education can be so powerful,” he says.

Proactively offering options of different educational media and delivery options, different topics including nutrition and stress management, as well as personal condition-specific content, all serves to help the patient find the information they might otherwise not have the time or the presence of mind to ask for during in-person care visits.

“If my insurer comes to me and says, ‘Hey, we want to make sure that you’re finding these wellness and health opportunities. What would you find most beneficial?’ Letting people build their own curriculum while also recommending content and bringing them into that decision-making process is so important,” Heigert says. “It’s helping patients have better conversations with their provider but stepping into it in a more nuanced way without scaring the audience that you’re trying to reach.”

How DEI helps build trusted health information sources

Nurturing a more personalized educational journey can support “payer goals of building a relationship over time,” Heigert says, noting that members will begin to feel comfortable and confident that instead of going to less reliable search sites, they can return to their health plan or care management site for help building health knowledge and making care decisions.

For historically underrepresented communities, an important element of that can be seeing themselves represented in the educational materials being shared.

“We can’t solve that across the board, but one thing we can do through patient education that uses diversity and understanding what challenges patients have from various communities, using voices of people from their communities, is that we can almost serve as a proxy for those clinicians and care teams that do represent those underrepresented perspectives in healthcare,” Heigert explains.

He has been working with the UpToDate engagement team on diversity, equity, and inclusion (DEI) initiatives “to address cultural bias head on in an evidence-based and honest way” in patient education and engagement materials. That includes:

  • Increasing and varying the visual representation of patients and clinicians.
  • Employing voice-over artists from different cultures to reflect different experiences.
  • Using gender-neutral terminology and images.
  • Accounting for wide variety of socio-economic realities in content.
  • Offering greater technical accessibility.

There are misperceptions that low health literacy stems from patients having difficulty understanding certain concepts or topics, Heigert says, but it can often originate with “lack of trust because they don’t see clinicians and care teams that represent their experiences. Certainly, we want to show through visuals, through the words we use, and the context a lot of different experiences across gender realities and across racial and ethnic realities and other experiences. But we also need to make it actionable for them, too.”

Is clinician burnout a factor?

One question that always comes up with patient education: Will a better-informed patient mean fewer questions, and thus less time and burden on clinicians and other healthcare providers?

While many expect that providing access to patient education will eliminate some of these lingering treatment questions and potential doubts or dissatisfaction patients might have with their healthcare experience, Heigert notes that there’s another way to look at that “numbers game.”

“Because they’ve had that education, they have more confidence in the baseline understanding of what’s going on with their health and their conditions and their options,” he explains. “So, they can ask much more pointed, nuanced questions of their provider in that space. It’s less about the quantity of questions being asked and more about the quality.”

Learn more about member education and engagement solutions for care management and download the whitepaper “Filling the healthcare education gap: A care management opportunity” to get five key takeaways from the Wolters Kluwer consumer survey.

Download the whitepaper

  1. Wolters Kluwer. n= 1,034 US patients. November 2022. Data on file.
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