Breakout Sessions

Sinai Urban Health Institute (SUHI) has more than twenty years of experience implementing community health worker (CHW) interventions. Our mission is to eliminate social and health inequities by connecting communities, individuals, and providers via the integration of a CHW workforce. SUHI does this by supporting organizations in the hiring and training of CHWs. In early 2020, the Chicago Department of Public Health and the Chicago Cook Workforce Partnership created the COVID Contact Tracing Corps (Corps) to support contact tracing. As a lead collaborator, CROWD trained and onboarded a 600-person workforce. Now in its second year, the Corps is addressing vaccine hesitancy across the city. The Corps is a diverse group of community members hired directly from 31 Chicago neighborhoods that are designated high economic hardship areas and disproportionately impacted by COVID-19 . Thus providing a means of investing in these communities in addition to promoting health equity and providing  an employment pathway into the public health arena. Creating an equitable and inclusive training program that addressed various literacy levels and life experiences of the members was critical in standing up the Corps. CROWD developed a curriculum that combined best practices from the CHW Core Consensus Project (C3), community feedback, and culturally appropriate content to break down the complexities of medical jargon and empower Corps members to confidently address vaccine hesitancy with the individuals they are in contact with. To ensure that Corps members have adequate and ongoing support, CROWD established weekly communities of practice (CoP) meetings. These virtual sessions create an environment where Corps members share learnings and best practices to overcome challenges they encounter in their daily work. CROWD’s culturally competent training and CoP approach has been vital in building trust, increasing compliance with vaccine recommendations, and establishing an ongoing and open line of communication with Corps members.

Student-driven initiatives can play a vital role in ensuring a more accessible and health literate system of care. To bridge the disparities in health literacy in local and national communities, we founded the Health Education and Literacy Organization (HELO) at the University of Florida. We provide opportunities to students, particularly those interested in the health professions, to serve our Gainesville community by improving access to health information and editing medical documents for plain language adherence, readability, and usability. We also advocate for initiatives that improve the quality and accessibility of care, including cultural competence and healthcare tailored to underserved communities. 

Ensuring healthcare professionals are knowledgeable about the impact limited health literacy has on health outcomes and how to apply health literate strategies is crucial to transform quality and safety in care settings. While many organizational efforts to address health literacy have focused on hospital settings, few have focused on primary care. An interactive training intervention was developed, implemented, and evaluated for 25 primary care clinics. This included an online educational module, in-person application activities, and a sustainability plan to continue skill building, reinforce behaviors and support practice. Using a descriptive pre- and post-training design, three survey measures were used to rate health literacy knowledge, behaviors, and confidence levels of over 475 primary care staff. The interactive training intervention improved primary care staff’s knowledge, behaviors, and confidence in using health literacy strategies with patients and families. In this session, we explore how to develop effective health literacy training for primary care staff.  

Mental health challenges are known to negatively impact populations that are also at risk for health literacy limitations, including those in rural areas and with low income. Those same populations are often difficult to reach, especially with digital resources. To overcome this barrier, a collaborative team of plain language writers and mental health adapted an existing print material, How to M.O.V.E. Toward Emotional Wellness, into an online interactive module, developed a companion module, How to L.I.F.T. Your Spirits during COVID-19 and Other Hard Times, and equipped community influencers to facilitate sharing of this content. Plain language writers worked with digital designers to produce content in digital format. Audio and visual text were carefully crafted to ensure the content was optimally readable, understandable, and actionable. Two methods of field testing with community members helped shape final content and ensure that the module was easy to navigate and visually appealing. Individuals with limited health literacy were intentionally included in these sessions. To address limitations in access to digital technology or skills to use it, the team produced facilitator guides that any community leader can use to deliver this content. Guides include use for virtual and in-person delivery of the content with both groups and individuals. Trusted community leaders at local libraries, adult education programs, and churches received the tools to help users in person as well as online groups. The facilitator guides are especially helpful when conducting group sessions or when assisting those who do not interact with digital learning independently . The modules and facilitator guides facilitate access to mental health promotion material among a population with known challenges in mental health, health literacy, and digital access. These resources are freely available for any outreach designed to improve emotional wellness and can thus be widely adopted to address this important health issue.

We’re surrounded by health information from the evening news, the social media channels we engage with and the websites we visit. Regrettably, the COVID-19 pandemic has been described as a “perfect storm” for misinformation to take hold, and where health information is concerned, misinformation may cost people their lives. According to research cited in a call to action by April Joy Damian and Joseph J. Gallo of the Johns Hopkins Bloomberg School of Public Health, several key factors drive individual and collective belief in health-related misinformation and one of the most important is low health literacy. (Damian & Gallo, 2020) It’s no surprise since it’s well documented in the scientific literature that low health literacy is associated with worse health outcomes and less use of health care services including preventive health services. (Berkman et al., 2011). This presentation will discuss the current understanding of misinformation and disinformation then share strategies and resources for addressing health misinformation to advance health literacy.

When communicating with healthcare providers, the use of patient portals are more common than picking up the phone and calling healthcare facilities. Non-Native English Speaker's (NNES's) face a variety of challenges in accessing and using patient portals to communicate with practitioners. To support these unique challenges and allow NNES's to build health and digital literacy skills we developed a MyChart-like patient portal for students to develop digital fluency, build English language skills and practice health communication at the same time. Students can access a website in which they can practice processes they would complete in a patient portal: confirming appointments, requesting prescription refills, requesting appointments, checking demographic information, reviewing balances owed, and contacting their doctors with non-urgent health issues. The website was developed using Weebly's free website builder and contains no real-life patient data. Students can complete scavenger hunts to find which medications a patient is currently taking or view future appointments in various specialties. Students can also practice various workflows within the patient portal (request refills, schedule appointments, etc.). By talking through the development, implementation, instruction, and assessment of using a mocked-up patient portal in with NNES in health literacy classroom you will come away with ideas and tools for mitigating digital health literacy challenges and a better understanding of how to teach these needed skills.

Engaging youth, parents, and health professionals as community stakeholders throughout the design process of game-based interventions is crucial to the development of effective interventions that positively influencing health behaviors. This session will discuss the participatory design approach of involving youth and parents in the creating of two game-based interventions MedSMA℞T Families and OutSMA℞T Cancer targeted at improving opioid safety in homes and cancer prevention respectively. The MedSMA℞T Families intervention involves the use of a serious game (MedSMA℞T: Adventures in PharmaCity) and a Family Medication Safety Plan to facilitate opioid medication safety communication among youth, parents, pharmacists, and other healthcare providers. MedSMA℞T: Adventures in PharmaCity, is an evidence-based serious game intervention that has been shown to improve adolescents’ knowledge about opioid safety. OutSMA℞T Cancer,” is a serious game intended to educate youth on cancer basics and prevention. This session will involve a detailed description of the sequential and systematic process of obtaining input from youth, parents, and healthcare professionals to guide iterative refinement of these game-based interventions that have been used to promote parent-teen communication regarding opioid safety and cancer prevention. We first conducted several studies to understand the specific knowledge gaps and educational preferences of teens using surveys, focus groups and in-depth interviews with teens, parents, and healthcare professionals. Our study findings elucidated perspectives of youth in Wisconsin and nationally through the development of a youth advisory board. Youth identified parents and other family members as important educational sources for medication and health information. Obtaining input from community stakeholders has provided important considerations for future dissemination and implementation in homes, schools, and clinic settings which will ensure buy in and uptake of these interventions. This presentation will demonstrate how similar techniques can be applied to the creation of future digital health interventions through a participatory design approach with community stakeholders.

Efforts to engage various types of communities in the development, implementation and distribution of effective and low-cost health resources are complicated by challenges understanding the diverse needs of patients, families, care partners, and clinicians. How can we develop clear, empathic, and trusted patient educationd and resources that reflect people’s lived experiences, meet their informational needs and concerns, and consider their resources and abilities? And how might we use technology to ensure these co-designed resources can be delivered in ways that optimize learning, can easily be shared with care partners, and learn if they improve the patient and clinician experiences and outcomes? One strategy is to use human centered design to learn from these stakeholders throughout the resource development process. Despite evidence that education that combines visual and auditory channels in the brain is more likely than static education to lead to meaningful learning (Cognitive Theory of Multimedia Learning), health education materials are frequently created using text-only formats. However multimedia is increasingly user friendly and affordable, and this modality circumvents literacy, reading grade level, and other challenges posed by text resources. Additionally, multimedia resources make it easy to create feedback loops, so organizations can continually learn what resources are engaging and effective. This presentation will focus on efficient and affordable methods to create video and multimedia resources that can be distributed and tracked digitally and foster collaboration between clinicians, patients and families. These methods also improve documentation and build patient-clinician relationships and trust. Good things happen when patients and care partners inform the design and content of health materials, and when clinicians and care providers help us understand where the disconnects happen. Hear about the types of insights gleaned when listening to and observing stakeholders -- and how to start moving beyond text.

In April 2021, the 21st Century Cures Act mandated that health care providers offer patients and their caregivers real-time access to their clinical notes using online patient portals. In this session, we will highlight the benefits and challenges of sharing providers’ admission and daily progress notes with families at the bedside during their child’s hospital stay. We will highlight differences and similarities in experiences with note access from families across the health literacy spectrum. Finally, we will engage session participants in practical strategies to share clinical notes to most effectively engage children and families in their care while mitigating negative effects on the workload of providers.

As healthcare providers rely increasingly on telehealth, health care portals, and wireless monitoring devices, patients are required to have basic digital skills in order to participate fully in health care options. Those without these skills are often from groups already poorly served by the health care community, and who will fall further behind in being able to access health care options. A social determinant of health, digital health literacy is a need that must be addressed if racial equity in health care is to be achieved. Northstar digital literacy assessments and educational materials provide patients with the skills they need to fully participate in health care opportunities, aid in searching for, and finding, reliable health care information online, and access test results and health history via health care portals. Northstar currently has nearly 2,000 subscriber locations such as libraries, adult education, and businesses in 49 states and 5 countries with more sites joining weekly. Healthcare patient advocates and Adult Basic Education professionals have approached Literacy Minnesota about adding digital healthcare literacy skills specifically to Northstar. This spring, we will release an assessment that determines if patients have the digital skills needed to access telehealth. Used in conjunction with instructor led curricula and self-directed online learning on basic digital skills such as using the internet, email, and using a mouse, Northstar can aid organizations in determining who would benefit from digital instruction, and provide resources to aid in that growth. Join us to learn about how Northstar can help close the equity gap in healthcare services for your patients and learners. We will discuss features available in both our free and low-cost versions, including assessments, instructor-led curricula, self-directed online practice, and reports. Find out how you and your organization can help close the digital literacy gap for patients and learners!

In the journey to become an equitable, health literate healthcare organization, Children’s Wisconsin’s Health Literacy Task Force (HLTF) made the case through safety and quality. An evaluation of patient safety events, which looked for health literacy failures in these events, allowed them to describe the impact of health literate communication on patient safety. Themes from these events aided in the prioritization of health literacy safety practices and demonstrated the need for incorporating health literacy practices. Additional programs focused on improving employee health literacy training to increase health literacy knowledge, behaviors, and confidence, and a health literacy-focused asthma education initiative, demonstrated the impact a focus on systematic health literate communication could have. These programs and lessons learned have set the foundation for current efforts to improve medication safety within the organization. Medication safety improvement has begun with collection of baseline data and a pilot program in the Emergency Department. Join this session to learn about how improvement opportunities were identified, projects were initiated to promote clear communication, and how to develop future improvement opportunities by connecting to organizational priorities to improve health outcomes equitably. A discussion of how these opportunities exist in your organization and a how to use a framework to track progress will be provided

Millions of people use social networking sites (SNSs), making them an increasingly popular method for individuals to use as a resource and share health information (FDA, 2018; Laranjo et al., 2015). Due to this popularity, SNSs have become a breeding ground for the rapid spread of misinformation. Recently, Facebook has come under fire for its role in promoting angry, sensationalized, polarizing content. SNSs like Facebook prioritize posts with high levels of user engagement and utilize an algorithm that shows users similar content, allowing misinformation to thrive in the absence of easily accessible, credible information (Suarez-Lledo & Alvarez-Galvez, 2021; Murthy, 2021). With the spread of misinformation on SNSs, professionals providing bona fide health information must be present to provide a counterpoint to inaccurate information (Murthy, 2021). This is why I developed @BIPOC_MentalHealth on Instagram; to share evidence-based strategies and interventions tailored for BIPOC communities to increase mental health literacy. This presentation demonstrates how SNSs can promote mental health literacy by disseminating factual, culturally congruent, targeted messages about  mental health, especially for users who experience significant health disparities, lack access to mental health care, and seek information online. The @BIPOC_MentalHealth account utilizes science communication strategies to provide accurate information about mental health and promote mental health literacy. The content on the account consists of informational posts about mental disorders, self-care, psychotherapy, how to access treatment, and the impact of racism and prejudice on mental health. Since the account’s creation in February 2021, it has grown to over 2,000 followers, ranging from ages 13-65+, located in five countries, with 5.3% of the followers in Madison, WI. This presentation will discuss communicating evidence-based information to a lay audience, digital growth, professional ethics, handling hostile responses, and resisting the lure of sensational pop-psychology posts on a platform that prioritizes highly emotional, polarizing content.
 

In this session, we will explore a number of ways that written health communication can better meet the needs of all people. We will explore the following: Understanding how plain language connects to anti-oppressive communication practices Framing work through a lens of cultural humility, (especially if one’s identities are part of dominant culture groups) Challenging racist, heteropatriarchal, and ableist norms embedded in written content Centering the knowledge and expertise of communities around health communication We’ll discuss a variety of examples from the health field related to these themes and consider what advances we can make in our own practices moving forward.

The goal of “Dialing In: Telehealth as a Tool for Health Equity” is to explore the changing landscape of telehealth over the last two years and how it can be utilized as a tool to work towards health equity. The intersection of telehealth, providing health and wellness related services virtually, and health equity, ensuring each person can achieve their own optimal health and breaking down any barriers impeding their access and success, creates an opportunity for positive change. By evaluating data from the rapid implementation of telehealth, we can avoid the pitfalls of the last two years and make telehealth even better. During pandemic, as regulations were lifted, practitioners were able to open telehealth services to a much wider swath of the population. Hear data about telehealth utilization and learn how it has worked for BIPOC communities, LGBTQIA+ health care, and older adult care. Listen to examples of practitioners and organizations who have leveraged telehealth to serve underserved populations and to make strides towards health equity.  Discover best practices, lessons learned, and possible future uses for telehealth in many settings. Learn about ways to utilize community partnerships to maximize impact. Discuss ways to employ telehealth in your community in a more equitable way. Gain tools to make telehealth work better for your community.

Health care professionals and other adults can play a key role in the health and development of youth. However, there are unique challenges and barriers that young people face in accessing and receiving health services because of their stage in life - many of which are related to their unique needs and perceptions. During this innovative teen-facilitated workshop, trained PATCH Teen Educators will share their accurate and authentic insights into the concerns, preferences and realities that impact the healthcare experiences of today’s youth. Their intent is to educate, engage, and empower health care providers on ways to better connect with teens and prioritize the needs of young people.

Families often contact ABC for Health in stressful situations. Part of our role is to carefully listen to expressed concerns, help the family understand how ABC may be able to help, and identify which issues may need a referral for additional assistance. An essential part of helping families is guided by "asking the right questions" and collecting the answers and best information to help connect a family to appropriate help and health resources. In this interactive session, we'll review best family interviewing practices, especially at intake or first encounter. Knowing which questions to ask – and why we're asking them – helps build a trusted relationship while also improving access to coverage. We'll discuss our approach of Precision Patient Advocacy as we carefully listen to and assess family health coverage needs, and identify the options that open and close doors to possible health insurance or coverage. We'll also identify important coverage deadlines and pivot points, to help prevent coverage loss or disruption. We'll discuss warm hand-offs and referral best practices to best serve clients. Finally, we'll discuss how we build the expectation of staying engaged with the family. Participants will review family stories and practice asking the right questions. ABC for Health has over 27 years of experience serving low-income clients with health benefits counseling service needs. ABC's staff provide direct client assistance to address social and racial justice issues related to health care coverage and services. This includes amplifying efforts to address systemic barriers to health care and drivers of social determinants of health. ABC's experienced staff provide high quality complex case services, especially to families of children with special needs negatively impacted by health disparities. We maintain the expertise, ability, agility, and creativity necessary to apply solutions to health care access issues for underserved populations through economic fluctuations, like the pandemic.

This workshop will showcase the unique digital strategies implemented in Milwaukee to provide the community with a trusted source for COVID-19 information and resources. Initially launched under the auspices of Milwaukee’s Unified Emergency Operations Center to promote COVID testing in 2020, the website was expanded to include vaccine updates and other health topics such as health insurance enrollment, flu and immunizations. A critical factor in the website’s success is that it was created and is supported by a Black and women-owned marketing firm based in Milwaukee’s Harambee neighborhood. INPOWER, working with the Milwaukee Health Care Partnership, has overseen the creative development of HealthyMKE’s multilingual, literacy-friendly health education resources; incorporating the ‘voice of the community,’ with culturally-informed and relevant copy and images. These resources empower users to go from “awareness to action” in their healthcare journey in a way that prioritizes inclusion and racial equity. Participants will learn about the unique community and creative partnerships that helped leverage this body of work and generated an award-winning COVID vaccine campaign, “Authentic Voices.”

Our “new normal,” a pandemic that has catalyzed telehealth, working remotely and helping people over the phone and video, has given us the opportunity to explore and integrate new tools and techniques for comprehension and successful use of health insurance that can be of great benefit to audiences who may have low literacy skills or for whom English is not a first language. Our talk will include descriptions in how we coach clients, patients, or consumers on using technology such as Zoom for the first time as well as firsthand accounts of successful uptakes of that technology that resulted in a positive outcome. We will also explore successful techniques in how to explain health insurance literacy concepts within the constraints of said technology in a compassionate, warm way. Our efforts have allowed us to help consumers find, sign up for, understand, and use their coverage. The presenters come from federally-certified Health Insurance Navigator organizations and have many years of experience working with consumers to explain health insurance literacy concepts and support successful enrollment and retention of coverage. We predominately serve low resource populations to help sign up for and use publicly available health insurance However the pandemic has brought a help sign up for and use publicly available health insurance. However, the pandemic has brought a multitude of barriers for work that was traditionally all done in person. Over the last few years, we have experimented with and developed successful tools for helping consumers better comprehend the enrollment process and how to best use their plans, even when done virtually. We have found that careful planning and instruction of how to use digital tools can both enhance and improve the consumer’s ability to comprehend complex topics, which is essential when clients may have low literacy skills or language barriers.

In a wide range of settings, from the private market exchanges to Medicare Advantage and Part D plans to employer-sponsored insurance, people increasingly have choices to make about their health insurance.  At the same time, more and more of these options involve higher deductibles and out-of-pocket cost exposure.  Dr Sydnor will share current research on the challenges people face navigating their options for health insurance and understanding the cost-sharing impacts of their choices.  He will further discuss approaches to clarifying the consequences of cost-sharing options that can help both individuals and plan designers better navigate this potential dizzying array of options. 

A significant amount of research on the outcomes of the COVID-19 pandemic has focused on incidence of disease and mortality. A lesser studied outcome of the pandemic has focused on forgone care, defined as needing healthcare for something other than COVID-19 and not receiving such care because of the pandemic. In spring (April 1 through June 30) 2020 the Medicare national rate of forgone was 19.3 percent and fell to 7.6 percent in the summer (July 1 through October 31) and 6 percent in the fall (November 1 through January 31, 2021). After Federal waiver of Medicare telehealth reimbursement and coverage policies, the national rate of usage dramatically increased over the same time period to 44.6 percent in the summer and 45.4 percent in the fall. Though use of national telehealth use increased, there were higher barriers to access for certain subgroups including: 1) individuals 75 years and older (compared to less than 65 years and 65-74 years); 2) males (compared to females); 3) individuals who were black (compared to white and Hispanic); 4) individuals dwelling in rural (compared to urban) areas; 5) individuals living in the south (compared to northeast, midwest and west); 6) individuals with income below the Federal poverty 7) non-English speaking individuals (compared to English); 8) individuals enrolled in Medicaid (compared to Medicare-only); and 9) individuals with Medicare Advantage (compared to Fee-for-Service). In most cases these barriers were positively correlated with higher reported rates of forgone care. In addition, barriers were identified depending on the modality of telehealth use, such as computer, tablet or phone. These results have important policy implications on how to target future telehealth resources, including interventions to reduce barriers to access and forgone care and inform decisions on whether temporary COVID-19 waivers should remain on a permanent basis.