IOS Press is the publisher of Information Services and Use (ISU) as well as the book series, Studies in Health Technology and Informatics (SHTI). Currently in preparation for publication in 2020 is the volume, Health Literacy in Clinical Practice and Public Health: New Initiatives and Lessons Learned at the Intersection with Other Disciplines, co-edited by Robert A. Logan and Elliot R. Siegel. This is the second health literacy book published in the SHTI series; the first (published in 2017) contained papers deemed in scope for ISU that were co-published in a special issue [1].
Several of the health literacy interventions in clinical practice and public health as reported in the new SHTI book employ the use of communications tools and strategies, including contemporary information and/or communications technologies and resources. Nine reports were selected for co-publication in a Special Issue of ISU in 2019 [2]. The present Special Issue includes four additional papers from that SHTI volume, which were in development at the time.
But first, how is health literacy defined? A widely accepted definition is provided by the National Academies of Sciences, Engineering and Medicine’s (NASEM) Roundtable on Health Literacy: “the ability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment.” More recent definitions focus on the health system’s capacity to adjust to people’s complexities in addition to assisting consumer capabilities to understand medical information and navigate the health care delivery system. The newest definition, from the World Health Organizations, identifies health literacy as one of the social determinants of health.
We begin with a paper by Andrew Pleasant, Catina O’Leary and Richard Carmona that examines the global interest in health literacy which extends the earlier work of scholars and practitioners in the United States, driven in part by the World Health Organization (WHO) and a series of agenda setting international conferences. Among these are the Shanghai Declaration and the Nairobi Call to Action. The WHO conference recommendations embrace the use of information and communications technologies (ICT). The recommendations formulate a strategic framework to equitably improve health literacy by ensuring that public policies increase affordable access to ICT. Other recommended strategies include: a wider coverage of remote and underserved areas; building the ICT capacity of health professionals and communities; and maximizing the use of available ICT tools by consumers.
Also in this issue of ISU, Diane Levin-Zamir and Orna Baron-Epel address the status of health literacy in Israel, as digital health literacy is pursued at the forefront of health system innovation. Levin-Zamir and Baron-Epel describe the use of a Digital Information Prescription for people with newly diagnosed diseases such as diabetes, where patient care information and related tools (such as guides for navigating the health care delivery system) are sent to a home computer via email. A companion intervention, Text Messaging, additionally is evaluated within the same case study to promote healthy lifestyle and self-care and is found to contribute to better glycemic control. However, similar to other investigators in the earlier Special Issue [2], Levin-Zamir and Baron-Epel report persons with high health literacy accompanied by more frequent digital health information seeking may become exposed to or initiate searching for information on the internet that is at odds with accepted public health policy recommendations, such as benefits of childhood vaccination.
Meanwhile, a contemporary crisis of confidence in social institutions in many nations includes a lack of public trust in news media/journalism and healthcare/medicine. The aforementioned phenomenon of vaccine hesitancy is but one example where so-called ‘fake news’ may foster the dissemination of misinformation that produces poor decision-making by the public. A less overt influence is the public’s lack of understanding of science, sometimes exacerbated by public officials who promote a disdain for science in order to promote a political agenda. Against this backdrop, Ivan Oransky looks at the challenges confronting health journalism and the positive steps health and science journalists can take to improve their own standing, while advancing health literacy and healthy outcomes. Similarly, Catina O’Leary, Chris Casey, Diane Webb, Deborah Collyar and Andrew Pleasant address health communication companies as uniquely positioned to lead efforts to integrate best evidence health literacy and plain language practices into the clinical trial process, which is the ‘gold standard’ to identify the risks and benefits of new healthcare treatments and technologies. O’Leary et al. describe a program that uses health literacy principles as a mechanism to improve communication about and within health and medicine in order to rebuild public support for the health care system in general as well as boost participation in clinical trials.
Elliot R. Siegel, Ph.D., co-Editor-in-Chief, Information Services and Use
Robert A. Logan, Ph.D., Special Issue Guest Editor
