By Helen Osborne, M.Ed., OTR/L
President of Health Literacy Consulting
On Call Magazine, June 5, 2008

Making health information clear is not always easy. Getting this information to the people who need it can be even harder. Sometimes, the best way of doing both is to form a community coalition.

Reaching a broader audience

Jan Potter works as a communication specialist at Partnership for Health and Accountability, a division of the Georgia Hospital Association. In Potter’s opinion, community coalitions are the only way that real change happens. She says that when people from multiple genres, groups, or points of view build a broad base of information together, you have a “win-win-win” situation.

Potter is currently working with a coalition she initiated consisting of the Georgia Hospital Association and the public library system in Georgia. The idea is to broadly distribute the patient safety and community health information she already creates for hospitals to a broader audience. first considered collaborating with grocery stores and then decided that libraries might be a better match for distributing information about wide-ranging topics such as MRSA, immunization, birth defects, and thyroid awareness.

To start, asked her local librarian who to contact at the statewide level. Eventually, she met with the person who’s in charge of all of Georgia’s library districts. Working together, they developed systems for sharing health information. Now, hundreds of libraries use some or all of the newsletters, booklets, bookmarks, bulletin boards, and other health materials that Potter creates.

The value of mutual benefits

Julie McKinney also wanted to reach a larger audience. She was working as coordinator of the Well Woman program at the East Boston Neighborhood Health Center and wanted to invite about 100 underinsured women over the age of 50 to participate in a free program of mammograms, pap smears, and health education.

To get help in reaching women who might be interested, McKinney spoke with the literacy director at the East Boston Harborside Community Center. In addition to working together to enroll students in the Well Woman program, they later collaborated on other projects, including clinicians speaking at literacy classes and adult literacy students interning at entry-level health center jobs. McKinney says the coalition worked because both partners “saw, recognized, and capitalized on” mutual benefits.

Getting the message out there

Regardless of what your health topics are or who you are trying to reach, Potter and McKinney offer suggestions on how you can get your message across by working with a community-based coalition.

Define the problem you are trying to solve. Before approaching any outside agency, Potter recommends doing your “homework” and having a clear sense of what you hope to accomplish. She recommends answering these questions yourself before contacting others:

• What are you trying to do?
• Who can do it?
• Why are you trying to do this?
• Where can this best be done?
• When does it need to be done?

You can begin by building on existing relationships like the one that existed between the East Boston Neighborhood Health Center and the East Boston Harborside Community Center. Or you can make new connections with services you already know, as Potter did working with her local library. Coalitions can include any combination of interested parties — healthcare facilities, patients and their families, literacy teachers and students, pharmacists, local business owners, national pharmaceutical companies, colleges and universities, social service organizations, and representatives of the media.

Create clear expectations. By their very nature, coalitions bring together people not used to working with one another. You are more likely to accomplish the intended goals when you first agree on expectations. Here are some ways to do that:

• Decide if, when, and how often to meet. Everyone’s time is precious. Potter tries to minimize or avoid in-person meetings as they take so much time. Instead, she and coalition members do most of their work by phone, email, and online portal (website).
• Be sensitive to organizational differences. McKinney recognizes there may be strong “cultural” differences between health and literacy programs. For instance, she says that health professionals tend to communicate by focusing on facts while literacy educators look more toward process. Likewise, the work worlds of these groups are not always the same. Healthcare clinicians usually work full-time at one organization while literacy tutors (paid or volunteer) may work part-time at several programs. To bridge these differences, McKinney recommends that health professionals seek out literacy program administrators who support their teachers doing coalition work.
• Agree on how to disagree. Potter’s philosophy for coalition building is that everyone is treated equally. She often works with partners ranging from small rural hospitals to large national programs such as the CDC, which is based in Georgia. Potter’s policy is to “take something from everyone, but nobody gets everything they want.” In her experience, this policy helps build “buy-in” from all participants and keeps projects moving toward intended goals.

Start with a simple swap. McKinney recommends starting coalitions with a simple exchange or swap of information and services. This might be having someone from the health center speak to literacy students, or having literacy students do a hospital “walk-through” with clinicians to assess the readability of signs. Coalition partners can also collaborate on professional development such as having clinicians teach teachers about health or teachers teach clinicians ways to communicate with patients who have limited literacy or language skills.

Evaluate. “Evaluation is an important part of the puzzle,” says Potter. At the very beginning, think in terms of how you will evaluate your coalition work.  For example, you can do a simple survey using a free online product like “Survey Monkey”. The evaluation piece can be an important part of achieving buy-in with your partners. Ask your partners up front what questions should be asked and how you should evaluate your work.

While obviously knows the importance of surveying many users, she also is interested in the experience of just one. Her feeling about coalition projects is that “If one person’s life changes, even if I don’t know that person, I’m happy.”

Ways to learn more:

is a consultant with World Education in Boston. You can reach her by email at jmckinney@worlded.org

is a communication specialist at the Partnership for Health and Accountability, a division of the Georgia Hospital Association. You can email her at jpotter@gha.org. You can access many health resources she created at www.gha.org/pha.

Healthcare organizations can find local literacy programs using these directories:

• ProLiteracy Worldwide, “How to Find a Literacy Program.” http://www.proliteracy.org/locator/
• The National Institute for Literacy, “America’s Literacy Directory.” http://www.literacydirectory.org/

Health Literacy Month can be a focus for a health literacy coalition. You can find examples and learn how to participate at http://www.healthliteracymonth.org

Helen Osborne, MEd, OTR/L, is president of Health Literacy Consulting. She received two “Gold 2008 Plain Language awards from NIH for her work on the National Cancer Institute booklets “Radiation and You” and “Chemotherapy and You.” Her column appeared regularly in On Call. You can contact her by e-mail at Helen@healthliteracy.com.