Making healthy choices for children — add good eyesight and good health literacy to your skill set

Continuing the conversation about health literacy

Children are attracted to colourful drinks at their sports events. To know what these sports drinks contain, parents and coaches need good eyesight to read the small font on the label. And they need good health literacy to understand the many words for sugar and to use the information for healthy choices.

Moira Smith, Dentist and Lead Researcher in an Otago University study of children aged 10–12 years, found that children associate the sugar-sweetened and caffeinated drinks with sport and with our sports stars. Clever marketing indeed. The characteristics of the drinks — the colour, the taste, the image — are attractive, so they make it difficult for children to follow nutrition guidelines. The drinks are associated with poor health outcomes such as obesity and dental decay.

Clever marketing of food and drink at sports events is tough for parents. They need to be smart about what children perceive as ‘good for them’ — our elite sports people drink them, don’t they? Reading the label’s only the beginning. Applying what they know about sugar and caffeine to actions that promote healthy choices for their family is the hard bit. Moira Smith’s study found that New Zealand needs ‘improved public health mechanisms to support healthy beverage choices’.

Read more about this New Zealand study in Appetite journal, Vol 81, 1 October 2014, pp 209-217 

Or read local reports of the study here:

http://www.radionz.co.nz/news/national/251764/sport-energy-drinks-hurting-kids

http://www.otago.ac.nz/news/news/otago076680.html

http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11306299

What’s going on in New Zealand to improve literacy?

UNESCO[i] declared 8 September International Literacy Day in 1966. The purpose of celebrating this day each year is to remind the international community that literacy for all makes a healthy society — socially, politically, mentally, and physically healthy, that is.

Almost 50 years after the first Literacy Day, many countries still struggle with basic education and literacy. Our friend Sandra Fisher-Martins[ii] tells a story about how written information affects the lives of people who can’t read. Listen to Sandra’s story about her neighbour Mr Domingos in her TED talk. 

And in New Zealand and Australia, many people in our own adult communities find daily information difficult to take in and use.

Find out what’s being done to improve adult literacy by subscribing to the valuable newsletters at Workbase New Zealand. As a not-for-profit trust, they support organisations and people to build literacy, language, numeracy, and communication skills for a modern economy and society.

Workbase brings literacy to people at their workplace. They know that people’s general health, their safety at work and their economic status is closely linked to their literacy. You can read Susan Reid’s informative blog about health literacy, and subscribe to Workbase’s monthly health literacy newsletter.

At Write Limited we help writers in organisations small and large apply plain language techniques to their information. Writers may have a higher level of literacy than the thousands of readers they write for. Our plain language solutions help writers make health information, financial information, legal information, any information easier to read, take in and use. Our newsletters will show you how.

---

[i] UNESCO is the United Nations Educational, Scientific, and Cultural Organization

[ii] Sandra Fisher-Martins established Claro in Portugal

Write's top five blogs for 2013

Which of our blog posts did you click most last year? We blog about all kinds of topics. The value of clear writing — financially and philosophically. Grammar — everyone wants to know about the debates and the options. Financial literacy. Language usability. Books from our shelves. Our own pet peeves.

Here’s the 2013 hit parade — the top five posts from our blog Write Clearly.

1. Think like a Tui ad!
Yeah, right. No, really! Tui ads are short, succinct, and perfectly pitched to their audience, says Lynda Harris. But what’s special about the one that she posted on Tui’s DIY billboard at their factory?
Read how to think like a Tui ad 

2. Do you take your lists with or without semicolons?
Anne-Marie Chisnall describes the science behind readability and visual clutter.
Read more about more readability and visual clutter

3. A conversation about health literacy
In our 'Conversations' blog series, Rosie Knight talks to health providers about the techniques they use to make sure that communication with their patients works well both ways. She also delves into why health literacy improves patient outcomes, and saves health dollars. In this conversation Rosie talks to Lorna Bingham, Diabetes Nurse Specialist.
Read Rosie's conversation with Lorna Bingham

4. Poor writing is not sustainable
Too many New Zealand businesses don't realise the huge impact that unsustainable business practices are having on their bottom line. Diana Burns quotes sustainability consultant Annette Lusk. And Diana writes that sustainable writing has a huge impact on profits.
Read more about making business writing sustainable

5. Taking issue with issues (and other such euphemisms)
Diana Burns finds a kindred spirit in columnist Joe Bennett, with his attack on the word ‘provider’ (as in internet provider, education provider, and health provider). She reveals a trick we use at Write for generating ‘noun strings’, and why they are terrible things.
Read more about taking issue with issues
Click to tweet: Write’s top five blogs for 2013

Link teeth with our health

I had a conversation about health literacy with Dr Moira Smith. Moira is a research fellow and PhD candidate in public health at the University of Otago in Wellington (UOW) and Deputy Director of the Health Promotion and Policy Research Unit at UOW.

The link between the health of our teeth and the health of our bodies
Moira is a dentist who knows that our teeth and gums mirror the health of our bodies. With 20 years’ experience in clinical practice, and her public health hat on, Moira promotes a ‘life course approach’ to dental care. That is, we teach children how to look after their teeth, make healthy and informed choices about what we eat and drink, and see the dentist once a year as a normal part of our healthcare — for life.

In the past, we didn’t connect the health of our teeth with the health of our bodies. Now we’re learning that our oral health in childhood is our oral health for life. Looking after our teeth and gums is an investment with good returns. It’s cheaper for individuals and for New Zealand than getting our teeth filled. And it’s cheaper than treating whole body diseases like obesity and cardiovascular disease. Researchers say that the bacteria that cause plaque on our teeth are the same family as the bacteria that cause plaque in our blood vessels.

Families need good health literacy to make good choices about food and drink
Health literacy is the knowledge we use about our health and our environment to make decisions about how we live.

The choices families make about their food and drinks, and how those products are promoted through sport, are among Moira’s special interests in public health. She says ‘The health literacy of families is an important component in their choices about what to eat and drink.’ However, she is concerned for the public’s health, and for children’s health in particular, when the voice of a brand, fuelled by advertising and marketing, is bigger than a family’s health literacy voice.

Our food environments are society’s environments
Our ‘food environment’ is not just one thing. It’s a complex web of interactions. Politics and people’s behaviour play a part. Current government thinking is to provide more education about nutrition, then allow personal choice and an individual approach.

But the commercial environment doesn’t make it easy for people to take an individual approach. As a society, we still have a lot to learn about making healthy choices. Reading food labels for example, requires a high level of health literacy — and good eyesight to read the print. So here’s the gap. We need more than good health literacy to make decisions about what our bodies and our children need. We also need critical thinking and good media literacy, so that we can be discerning about the marketing and promotion of food and drinks.

Here are some of the factors that get in the way of families making healthy choices.

• Some regulations guide how manufacturers promote food, but the current regulations don’t make it easy for families to make healthy choices. 
• Nutrition information on food labels is often hard to read because of the font size and colour. 
• We’re trusting — ‘Food is on the supermarket shelf; therefore it must be OK’. 

View Moira’s talk at the University of Otago, Wellington, on New Zealand’s oral health 

Read the Ministry of Health’s health and nutrition guidelines for young people. 

Click to tweet: Link teeth with our health

For your health's sake, double-check the instructions

On Stuff today, Medical School researcher, Sonya Morgan, says that GPs need strategies to minimise the risk of communication problems. Some of our writing strategies work well for verbal consultations too. Such as thinking of the reader/listener by choosing words they'll be familiar with. 'Chunk and check' is a useful strategy in writing and speaking - giving information in small chunks, and giving the reader/listener time to take it in before giving new information.

The doctor-patient relationship is a shared responsibility. Patients need strategies to keep themselves safe too. Health providers are always busy, and waiting rooms can be intimidating, busy places.

Patients can double-check the instructions by using their own words to tell the doctor what they're going to do. And asking questions and writing down what they need to do will decrease everybody's risk.

A conversation about health literacy with Lorna Bingham, Diabetes Nurse Specialist and Nurse Practitioner candidate, Capital & Coast District Health Board

I had a conversation about health literacy with Lorna Bingham, Diabetes Nurse Specialist and Nurse Practitioner candidate, Capital & Coast District Health Board.

Lorna says that her goal for her patients is that they have the confidence and competence to manage their daily lives while living well with diabetes.

She assures them that they will be able to master the skills to do the daily tasks of diabetes and she supports them until they can.

Health literacy’s role in living well
Diabetes is a complex, long-term condition. It takes its toll over time, so protecting yourself and preventing complications is important.

Living with a long-term condition has two parts — managing the tasks of living well in your daily life, and managing the whole spectrum of your life.

To live well with diabetes requires good health literacy — to understand what diabetes is, what you have to do to take care of your body, and why that’s important.

Small steps every day and good conversations
Diabetes requires people’s attention every day. To support people in their daily tasks, Lorna teaches them about insulin and how to manage their medicines; she teaches them how to recognise problems early so the problems don’t become complications, how to solve them and, of course, how to live well with diabetes.

Lorna develops the health literacy of her patients by normalising the daily tasks of living with diabetes  — testing blood sugar levels, self-injecting, and balancing exercise and diet — and by supporting people while they practise. ‘ It’s important to normalise the daily tasks,’ Lorna says, ‘so that people know how to manage the problems that develop from time to time in any long-term condition.’

It takes time and practice to develop the knowledge, confidence, and competence to manage all aspects of diabetes in your daily life. Lorna believes that given adequate support most people with diabetes can manage most tasks well, most of the time.  It’s a matter of taking small steps, talking and waiting, drawing diagrams, and talking and waiting — and keeping the conversation going.


by Rosie Knight

A conversation about health literacy with diabetes nurse Sera Tapu-Ta'ala

I had a conversation about health literacy with Sera Tapu-Ta’ala, Diabetes Nurse Specialist at Kenepuru Hospital, Capital & Coast District Health Board.

Language is what connects families and communities. Dialogues and conversations in the respective Pacific languages is the ideal way in which Pacific people share tasks and support each other to manage a family member’s diabetes, or an individual themselves. Language is one key element in health literacy. It is critical to acknowledge that health literacy is a resource of a family and a community.

Sera’s work is predominantly within the Porirua area. She says that her visiting territory in Porirua is like a village. It has its own structure. Sera’s work in Porirua is shaped by the stories that tie its people to each other.

Stories are the Pacific way to share tasks and experiences. The families Sera visits are a resource—for information, teaching and learning, encouraging adherence and achieving goals. Family members are eyes and ears for each other. When Sera cares for someone with diabetes, she is developing the health literacy of the family.

The patients guide the learning
There’s a lot to learn when you have a long-term condition like diabetes. When Sera is working one-to-one with her patients, she asks open-ended questions, and lets her patients guide the learning. Not being ‘the teacher’ and giving them space to tell their stories lets patients do the learning.

When they talk about how impaired and unwell they feel, Sera interprets the tasks of managing diabetes, so that they develop the skills and knowledge to feel better. She writes down goals and targets, and uses diagrams to explain highs and lows. She uses the “teach back” strategy to seek clarity and to ensure an equal understanding and interpretation of a particular situation has been attained. She chooses language carefully. As a fluent Samoan speaker, she always uses the formal Samoan language for the older people, or those who prefer to speak in the Samoan language. People respond when the language you use is appropriate and simplified.

Spreading the word
Pacific churches play an integral part in the lives of most NZ-based Pacific people. Radio programs on the respective Pacific radios also have an important part. Sera now has a monthly slot on the Samoan radio in Wellington and hopes to extend time to other Pacific Radios. She knows that church is where the people are, and the radio is the means to reach them - so that’s where to take the messages.

— Rosie Knight


Go to our website for links to more blogs about health literacy

Read about our workshop Writing Health Information Clearly

Read about Rosie Knight
 

Don't make bad news worse

Early definitions of 'health literacy' focused on the reader's ability to understand and use health information - as we discussed back in June. Recent work brings the health practitioner who writes or gives the health information into the definition.

Later, I'm going to blog about the financial cost to the country of poor health literacy, but let Elspeth Murray tell you about the human cost of badly-presented health information. As Elspeth's poem 'This is bad enough' reminds us, when you get bad news about your health, you want health information that cares about you. It should be clear, relevant, up to date, and make the reader feel it's written for them.

Go to our website for links to more blogs about health literacy

Read about our workshop Writing Health Information Clearly