CRN
Cancer Communication Research Center
Blog

When a patient enters a hospital or medical clinic, are there simple, clear signs telling them where to go? Are they able to navigate and fill out required forms? Can they read and understand medical records, educational materials, and treatment instructions?

I am currently taking a health literacy class that is increasing my awareness of the complexity of the written and spoken health environment. I find that I am beginning to delve deeper into understanding the challenges and potential opportunities that a patient may encounter during interactions within medical centers and when interpreting health information from a number of sources.

People are often expected to have a range of skills in addition to reading, including the ability to manipulate and understand concepts such as numbers and risk, in order to fully navigate the healthcare system. Unfortunately, research has found that the complexity of many health materials, including resources for cancer patients, surpasses the health literacy skills of many Americans and leaves them unable to fully interpret the information at hand. This disparity has led to poor outcomes and low perceptions of coordinated care for cancer patients with low health literacy.

It requires somewhat of a perspective shift to fully understand the challenges of the written health environment. As researchers and doctors become established in the health world, certain terms and phrases may become commonplace and familiar. However, to patients, written or spoken communication containing numbers, complex terms, and long sentences may create an overwhelming amount of information to process. When grappling with the concept of risk in life or death treatment options, this information overload may be even more distressing.

As I am learning, it requires some practice to step back and disentangle the different aspects of language and identify the ways in which words, numbers, and charts can be expressed in more approachable terms. The exercise is also a reflexive one as it requires not just examining the literacy skills of patients, but turning the mirror around and examining the communication skills (written or spoken) of the person expressing the information. Understanding the assumptions we bring in expressing and researching health communication materials can serve to benefit both our own knowledge and that of patients and community members. As promising research in this field grows, I am eager to see how future studies continue to make health literacy a key component of cancer research and education.

Rachel Faulkenberry
Harvard University
2011 CCRC Doctoral Fellow

Written by CCRC at 13:04

Public understanding of science and public belief in the credibility of scientists take a hit every once in a while. Cases of misconduct in cancer research are very unusual but when they do occur, they can make for the sorts of stories that journalists and their editors find impossible to ignore. Such is the case with the recent scandal at Duke University (The Economist, September 10, 2011, page 91-92) concerning an approach for predicting which chemotherapies are most effective for individual lung, breast, or ovarian cancer patients. Despite the fact that large majorities of cancer researchers do credible work, this is the sort of startling case that can give the whole profession a black eye.

Jim Dearing
Director/PI, CCRC
KPCO

Written by CCRC at 13:04

When does the study of innovation implementation happen?

I know of lots of studies of implementation that focus on a time frame past the time of adoption. That means that dissemination of an innovation occurs, some potential adopters in fact adopt, and then some of those in fact implement. And we then may study that time frame of implementation.

Most work in implementation science that I currently see, however, is something different. It is the study of implementation prior to the attempt to disseminate an innovation. This is the study of what study site implementers do with an innovation, for the objective of understanding quality of implementation, degree of fidelity, and robustness of an innovation as implemented at multiple sites. Very often, this is not implementation as a result of a voluntary adoption decision, but rather implementation as a result of a site opting in to being part of a study so that external validity of the innovation can be assessed. It's an important, prior step along the path toward understanding if an innovation should then be broadly disseminated so that subsequent diffusion outcome variables such as adoption and implementation and sustainability can be studied under real-world conditions.

I expect that those researchers who use the term mean both "stage 1" implementation and "stage 2" implementation both when they refer to implementation science. But rarely do they clarify this processual distinction.

Jim Dearing
Director/PI, CCRC
KPCO

Written by CCRC at 13:05

Will the current interest in dissemination, diffusion, and implementation research and practice last?

Previously, federal agency interest in these topics have ebbed and flowed (mostly ebbed). But the current high salience is broadly represented across federal agencies, and is developing legs in graduate training programs at prestigious institutions. Both trends suggest longetivity. Case in point: The just-concluded Global Implementation Conference in Washington DC was by all accounts wildly successful in attendance. In this first year for the meeting, nearly 800 registrants participated.

Jim Dearing
Director/PI, CCRC
KPCO

Written by CCRC at 13:06

The expansion and apparent resiliency of university-level degree programs and certificates in the study and practice of dissemination, diffusion, and implementation is striking. Check out the offerings from the University of California San Francisco in its IDS (Implementation and Dissemination Science) Programs. Great training programs and classes, with top-notch faculty who have long practical experience in issues such as AIDS prevention and strong academic credentials as continual contributors to DD&I literature.

Jim Dearing
Director/PI, CCRC
KPCO

Written by CCRC at 13:06

Tags

Latest Comments

Archive