According to the Center for Healthcare Strategies, nine out of 10 US adults struggle with health literacy. Limited health literacy tends to have greater prevalence in marginalized communities, including older adults, people with lower income levels, the uninsured, and Black, Latino, and American Indian/Alaskan Native populations.
Simply providing patient health education doesn’t solve the issue of inequality in health literacy. Educational materials – whether printed or multimedia – should be created with an intentional effort toward health diversity, equity, and inclusion (DE&I). Materials that reflect a broad range of patients and patient experiences – including races/ethnicities, ages, genders, sexual orientations, family structures, abilities, and socioeconomic statuses – have been shown to:
- Increase medical accuracy of the information presented.
- Build trust among a greater cross-section of patients.
- Help providers and payers build better relationships as their patient and member demographics change.
What is diversity in healthcare initiatives?
One simple way to think of DE&I is the metaphor of a party. With the patient as your potential party guest, each layer of intentional representation and involvement takes them further from outsider to the warmly welcomed center of attention:
Diversity
Think of this step as being invited to the party and seeing people you recognize already there. Some patients have never seen anyone who looks like them in healthcare educational resources. Start by celebrating your patient population’s differences and representing as broad and varied a sampling of them as possible.
Equity
Next, make space at the party for your guests to enjoy themselves – providing opportunities for people to dance, play games, and quiet space to talk, depending on their preferences. It isn’t enough to have diverse representation in your content, you need to deliver that content effectively to all patients and consumers regardless of potential limitations to access they may encounter.
Inclusion
In the final phase, your guest needs a chance to express themselves; for example, selecting their own songs for the party playlist. Educational materials need to be personalized and actionable enough to be practical and actually used by patients.
Developing representation and diversity in healthcare materials
The design team behind Wolters Kluwer’s UpToDate® Patient Engagement solutions has first-hand experience with the challenges of creating more diverse representation in patient-facing materials. UpToDate® Educate patient education features more than 8,000 leaflets and nearly 300 videos to help consumers understand anatomy, medications, procedures, and conditions.
UpToDate provides solutions that help you consciously work toward the broadest variety of experiences and perspectives so that the materials do not become repetitive visually and the storytelling is richer and more medically accurate.
The ways we do this include:
- Custom design that varies skin, eye, and hair color; hair texture; and even subtleties of nail and lip tones in patient illustrations.
- Showcasing a wide range of clinician and patient experiences.
- Using diversity to augment clinical accuracy; for example, showing how a skin disease might manifest differently on varying skin tones.
- Employing voice-over from different cultures to reflect different experiences: A viewer is more likely to trust a voice that comes from their own community.
How can we make health education more accessible?
In order to create greater equity among patients, diversity in healthcare initiatives and education should be more accessible. This is a two-pronged effort:
- Making materials easier for all patients to obtain, regardless of barriers they may face.
- Providing materials that are easier for patients to consume and absorb, so they are more likely to retain the information and less likely to feel alienated by it.
Healthcare education is largely delivered in digital formats, which creates a variety of opportunities to improve experiences and equity across patient populations:
- Comply with standards for Web Content Accessibility Guidelines (WCAG).
- Ensure all video content has closed captioning with variable text size and provide transcripts to audio.
- Add ARIA labels to all visual content so that screen readers can share what is being shown.
The goal is make content access better for those with varying abilities, and to go beyond this by simplifying and improving the patient education experience for entire patient populations.
The same applies to how content is designed to be consumed and understood. Agency for Healthcare and Research Quality (AHRQ) guidelines can serve as a roadmap to clarifying complex clinical information for patients and members. To improve health literacy, best practices include:
- Using a conversational tone and commonly understood words in educational materials.
- Keeping written materials at or around a fifth-grade reading level.
- Whenever possible, providing materials in other language options, in addition to English and Spanish, to reach as many patient populations as possible.
Can diversity in healthcare initiatives make education more personal and actionable?
Patients and members tend to feel more empowered as members of the care team when they feel engaged and included. Broadening inclusive representation in patient education can help patients and plan members see themselves in the decision-making process. For example:
Gender and sexual orientation
Patient depictions in artwork can be non-gender-specific when warranted by using silhouettes or partial figures. This would be appropriate when discussing cervical cancer. For example, instead of showing a woman’s figure, use a partial figure to be inclusive of transgender or non-binary audiences who are also affected by the disease.
Ranges of age and mobility
Patient education often recommends exercise or movement. Depicting that only as a young, able-bodied, or fit person running around the block doesn’t recognize the varying physical abilities of many patients. The materials should also offer tips and options of different levels of activity for the elderly, disabled, and those with limited options to exercise outdoors, so patients can self-select what they are comfortable with.
Socio-economic realities
Healthcare educational materials should offer practical advice and be sensitive to the range of economic realities patients or members may face. For example, instead of simply instructing members to set up a telehealth appointment, materials might first remind them to connect to Wi-Fi to avoid data usage costs.
Ultimately the content within patient education should make people feel represented, and also give them clear actions they can take as the next steps in their health journey.
Learn more about UpToDate Educate multimedia patient education solutions.
