The Baby Basics Prenatal Health Literacy Program
From LiteracyTentWiki
The Baby Basics Prenatal Health Literacy Program has been doing patient education geared to those with lower literacy skills, and we've got some evaluation and research backing up what we're doing.
Baby Basics is a lower literacy prenatal guide written to a 3rd grade level at some clearly marked illustrated sections, and then to a 5th grade level in different sections that provide more comprehensive pregnancy information. The program works within the prenatal health center, and other community prenatal programs such as WIC and home visitors to coordinate the messages and materials in order to provide patient centered education to teach prenatal care information.
Working with the Literacy Assistance Center we have created a prenatal curriculum that folds health literacy skills into every activity (fyi: this curriculum is not appropriate for literacy providers, educators must have a health background)
- forming and asking questions to providers and other health care professionals,
- navigating the health care (and other systems),
- vocabulary in English that you will hear during labor and delivery and need to know.
We worked with Ob-Gyns and Midwives and provided them with additional tools (including lists of questions moms usually want to know at each apointment and page numbers for the answers in the Baby Basics books.) We also have a "planner" that has the same questions written for moms, a space for her to write questions and a space for doctors, nurses or midwives etc. to write down the answers.
We are training doctors and will be doing a CME on-line course shortly that shows them how to replicate the following scenario: Doctor: "we talked about constipation during pregnancy because you are uncomfortable. Here is the word written down. I've written in your planner that the Baby Basics book tells you 5 things to do for constipation and it is on page 64 so you can review it again when you get home, or with your home visitor, your mother etc. It does not say this in the book, but I am also going to write down the phone number for the Y where you can exercise which also helps" (Sorry pregnancy ain't pretty)
Now, In our evaluation (we observed doctor patient interaction with IRB approval) we found that doctors who simply noted the moms' questions or used their own judgement of what was important for moms to know, answered the questions briefly and wrote down page numbers in Baby Basics for her to review -- took no more time than a regular apointment.
Midwives, who used the teach back techniques that we had taught, opened the book, read pasages aloud, pointed to pictures, also wrote things down etc. did take significantly longer with each patient.
BUT... we built a waiting room Baby Basics Mom's club that used the curriculum, the power of group education, and a spectacular training by the Literacy Assistance Center to teach health educators how to really engage and empower their patients in their own health care. That support, which happened while the moms were waiting at the clinic anyway (sometimes up to 2 hours) made it ok that the Dr. didn't have much time, because the support was still there for the moms to develop questions, ask questions, get significant answers and learn new skills all at the same time.
Additional evaluation showed a rapid increase in patient satisfaction, and adherance to prenatal care. The next round of research will be looking at health outcomes among other things.
If you would like a copy of our evaluation or more comprehensive information about the program, feel free to email me off this listserve. You can also find more information on the What To Expect Website. I'm having a great time making this program work!!!!
Thanks, Lisa
Lisa Bernstein
Executive Director
The What To Expect Foundation
144 W. 80th Street
New York, NY 10024
212-712-9764
http://www.whattoexpect.org
