HCPs can learn how to improve their communication skills within a low health literacy setting. Strategies to overcome language-related and cultural barriers to care include the use of qualified medical interpreters, telephone services and the use of trained, bilingual clinicians and staff. HCPs should also seek to understand patient culture and health beliefs. Advanced communication strategies include encouraging questions, using pictographs and other risk communication tools, providing instructions in both written and spoken formats, teach-back and teach-to-goal modalities. More specific strategies can be used to encourage the formation of health literate health care organizations to reduce the burden of literacy on patients. Additional approaches for helping patients manage their medications include the use of medcards, pill charts, pill cards, and pill boxes. These strategies are especially important when new medicines are added, the dosage of an existing medicine changes, or the appearance of a medicine changes. Illustrated daily medication schedules (such as pill charts) have also been shown to help patients remember indications and dosing of their medication, leading to improved self-efficacy and adherence. This activity will describe the challenges confronting HCPs when caring for patients with low health literacy and will teach communication strategies to overcome these difficulties.

This activity is part of the Health Literacy Knowledge Self-Assessment, one of two maintenance of certification (MOC) activities, developed by the Agency for Healthcare Research and Quality (AHRQ) through a contract with the University of Colorado, Denver and its subcontractor the University of North Carolina (contract # 290-2007-10008 Task Order 10). The MOC activities are part of AHRQ’s health literacy program to promote health literate health care organizations that make it easier for patients to understand health information and navigate health care systems.

Click here to complete An Updated Overview of Health Literacy, activity I, of the activity set.

Learning Objectives
At the end of this educational activity, participants should be able to

1. Describe the different types of questions patients may ask and how these question types vary by health literacy level
2. Discuss how providers can use the office visit to encourage questions and improve communication
3. Review how to use teach-to-goal techniques
4. Explain how teach-back works
5. Describe barriers to the effective implementation of communication strategies

Disclosures of Relevant Financial Relationships
In accordance with the ACCME Standards for Commercial Support^SM, OptumHealth Education requires all those involved in the development of activity content to disclose their relevant financial relationships. An individual has a relevant financial relationship if such person (or their spouse/partner) has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the activity content over which the individual has control.
OptumHealth Education ensures that the content is independent of commercial bias.

Activity Planners
Diane Cempellin DNP, MSHA, RN
Director Clinical Programs
Healthcare Transformation, UnitedHealth Group Alliances

Sarah Chart-Hart, RN
Senior Director
OptumHealth Education

Rebecca Gleason, RN, CCM
Activity Manager
OptumHealth Education

Ann McKnight, BA
Sr. Project Manager II
UnitedHealth Group Alliances

V. Silverstein, MD
Eagle Creek Medical Communications

Patricia Walsh, RN, BAS
Director, Clinical Programs
Healthcare Transformation, UnitedHealth Group Alliances

Activity Planner Disclosures
Ms Cempellin, Ms Chart, Ms Gleason, Ms McKnight and Ms Walsh reported that they are employees of and own stock in UnitedHealth Group.
Dr Silverstein has nothing to report.

Method of Participation
There are no fees for participating in or receiving credit for this activity.
For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

Participants will receive a certificate upon successful completion of the activity, which includes the following:

• Completing the entire activity
• Completing the Pre- and Post-Activity Assessments, Activity Evaluation, and Application for Certificate of Credit form

You must be logged into your account to participate in this activity. Get started by clicking “Begin” and viewing the “CE Info”; then follow the prompts at the bottom of the screen. At the end of the activity, you will be able to view, save, or print your certificate of participation. The Area of Practice you indicated in your profile corresponds with your certificate type. A complete listing of all of your activities can be found under “My Account”, “My Activities.”

Accreditation Statement
This activity has been planned and implemented by OptumHealth Education and UnitedHealthcare Medicare & Retirement. OptumHealth Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Credit Designation Statements
Physicians
OptumHealth Education designates this enduring activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses
The participant will be awarded up to 1.00 contact hour(s) of credit for attendance and completion of supplemental materials.

Attendance
A certificate of attendance will be provided to learners upon completion of activity requirements, enabling participants to register with licensing boards or associations that have not been pre-approved for credits. To apply for credit types not listed above, participants should use the procedure established by the specific organization to which you wish you apply credit.

Method for Calculating CE Credit
CE credit was calculated by the complexity of content.

Provided By
This activity is jointly provided by OptumHealth Education and UnitedHealthcare Medicare & Retirement.

Commercial Support
There was no commercial support received for this activity.

Hardware/Software Requirements
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