How does health literacy affect the health journey?
Here are some of the steps required in a health journey.
At each point, there are questions people may have, skills they need or tasks that must be done that may act as a barrier to accessing care.
1 Recognise the need to see a health professional
Questions people may have at this step
- Are these signs, symptoms or feelings normal for me?
- Can I do anything about it on my own or do I need to see someone?
Skills required for this step
- Understanding which symptoms to look out for
- Understanding self-management options
- Understanding the point at which you need to see a health professional
- Being able to find information about whether you should seek care
How we can make this step easier for people who may need our service?
- Make it clear in your service information what symptoms you usually treat and the types of care you provide.
- Provide information about other care options people may need (e.g. when to go to Emergency).
- Use teach-back to check that people you have already seen understand when they need to come back to your service or see another service.
2 Overcome barriers to seeking help
Questions people may have at this step
- What is going to happen if I use this service?
- Is it confidential?
- Is there support to help me? Or can I involve my own support people?
Skills required for this step
- It is difficult to list any skills here because health literacy may be one of many complex barriers to people seeking help. These include practical barriers such as lack of transport, cost, and access issues, to complex personal and social issues like stigma, trauma, racism, domestic abuse, and past negative experiences.
How we can make this step easier for people who may need our service?
- Find out what local transport support options there are in your area to refer people to.
- Make costs of your service (and any financial support available) clear in your service information.
- Make sure your service and care are culturally safe. Ask your peak body or local hospital or Primary Health Network about training options.
- Use recovery-oriented language language.
- Encourage people to bring a support person with them to your service.
3 Seek out available services and health professionals
Questions people may have at this step
- What’s available in my area?
- Can I get there?
- Am I eligible for this service?
- How do I go about finding services in my area?
Skills required for this step
- Being able to find good health information from different sources and determine if it is applicable to you
- Understanding what to search for
- Knowing who to ask questions to
- Understanding health services well enough to realise there is a service that could help you
How we can make this step easier for people who may need our service?
- Make your service information clear.
- Help people find other services they may need.
- Encourage people to ask questions about your service.
- Direct them to healthdirect as a source of trustworthy online information and to help them find services or call the 24-hour helpline.
4 Determine if that service meets their needs and the cost
Questions people may have at this step
- What does this health professional do?
- Is this the right health professional to see about my issue?
- Is this service going to be culturally appropriate?
- Does this service cost money?
- Will my health insurance cover any of the cost?
Skills required for this step
- Ability to find information
- Ability to ask questions
- Basic understanding of health issue to determine relevant services
How we can make this step easier for people who may need our service?
- Make your service information clear, including costs covered by Medicare or insurance.
- Tell people before they come to your service the type of care and follow up they can expect.
5 Coordinate different types of services
Questions people may have at this step
- Is there anything that I need to do or anyone else I need to see before I see this service?
- How long does it take for results of tests to get to providers?
- Will I need to organise transport?
- How does this service fit in with my life? Who will look after the kids? Can I change the appointment time?
Skills required for this step
- Ability and confidence to carry out multiple tasks and organise multiple appointments
- Ability to ask questions
- Motivation to carry on with health journey
How we can make this step easier for people who may need our service?
- Write down instructions for people about what they need to do to access a service.
- Include requirements (like referrals) in your service information.
- Tell people what options they have for attending, e.g. can they bring kids, how do they reschedule.
- Tell people what to expect after they see your service.
6 Go through different registration or referral processes for these services
Questions people may have at this step
- How do I book an appointment?
- What will I need to bring with me on the day?
- Do I need a referral?
- How do I get a referral?
- Are they taking new patients?
- How long is the wait list?
Skills required for this step
- Resources to book (phone, internet)
- Confidence to book appointment
- Ability to ask questions
- Understanding of how health systems work (referrals, waitlists)
- Ability to fill in forms
How we can make this step easier for people who may need our service?
- Offer to book appointments for people.
- Offer help to everyone to fill in forms.
- Tell people what they need to do before an appointment and what to expect afterwards.
7 Coordinate transport, parking, child care, what to bring to appointment
Questions people may have at this step
- Is there parking?
- Do I have to pay for it?
Skills required for this step
- Resources to drive (car, licence, money, friend or family to offer lift) or knowledge and confidence to use public transport
- Ability to ask questions
How we can make this step easier for people who may need our service?
- Tell people before they see your service about parking or other transport options available to them.
- Include parking information and public transport options in your service information.
- Include details about what to bring to an appointment in your service information.
8 Find the physical building this service is in, and then the right rooms
Questions people may have at this step
- How early should I arrive?
- Who do I ask for help if I get lost?
Skills required for this step
- Ability to navigate or familiarity with the service
- Ability to get around (walk or carer)
- Understanding of medical terminology to read signs
How we can make this step easier for people who may need our service?
- Make your signage easy to read using large signs and plain language.
- Include a map showing how to get to your service in your service information.
- Have people at the entrance of your service to help people navigate.
- Offer assistance to those who need help to get to a service (e.g. wheelchairs).
9 Make informed decisions about treatment options - shared decision making, asking questions, seeking information on health conditions
Questions people may have at this step
- What are my options?
- What will that mean for me? (cost, travel, quality of life, health outcomes, impact on family)
Skills required for this step
- Ability to ask questions
- Trust in health provider
- Ability to share in decision making
- Ability to understand health informationn
- Ability to apply health information and advice to personal situation
How we can make this step easier for people who may need our service?
- Use health literacy strategies to communicate.
- Use shared decision-making techniques or tools.
Team Activity
For a team activity, write down all the steps involved in a common health journey for consumers seeing your service. This could involve other services before or after they see yours.
For each step, consider actions you could take to make this step easier for people.
References
- Adapted from Victorian Primary Care Partnerships (PCP). (2017). Vic PCP Online Health Literacy Course.
Northern NSW Health Literacy Project acknowledges the traditional custodians of the lands across our region and pays respect to the Elders past, present and emerging. We recognise these lands were never ceded and acknowledge the continuation of culture and connection to land, sky and sea. We acknowledge Aboriginal and Torres Strait Islander peoples as Australia’s First Peoples and honour the rich diversity of the world’s oldest living cultures.