Improving Interactive Health Literacy Skills of Older Adults: Lessons Learned From Formative Organizational Research With Community Partners.

BACKGROUND: Meals on Wheels (MOW) organizations are ideal community partners for delivering social support relating to health information exchange for vulnerable and home-bound older adults. OBJECTIVES: This article illustrates how formative organizational evaluation can be used to adapt health literacy interventions delivered by community partners. METHODS: Key informant interviews and ethnographic observations were conducted as part of a formative organizational evaluation of potential community partners. LESSONS LEARNED: The observed brevity of volunteer-client interaction led program planners to incorporate substantial emphasis on communicating with older adults into the health literacy coach training curriculum. Ethnographic observations made clear that program materials had to be portable and fit it in with the mobile nature of MOW delivery. CONCLUSIONS: Formative organizational research can greatly increase the chance of successful implementation of public health interventions when those interventions will be implemented in partnerships with community-based organizations in diverse settings and with varying practices.

Associations between older adults' spoken interactive health literacy and selected health care and health communication outcomes.

Recent trends in the conceptualization of health literacy lead toward expansive notions of health literacy as social practice, rather than as a narrower cognitive capacity to understand health-related texts and materials. These expansive and complex constructions of health literacy demand tools for assessing individuals' propensities to actively seek information in their interactions with health care professionals and other health information sources. This study proposes a measure of this information-exchange component of health literacy and examines its capacity to predict outcomes and processes such as satisfaction with health care and comprehension of spoken health messages. Results for this sample ( n = 334) of low socioeconomic status older adults (mean age = 74.70 years) reveal that indices derived from the Measure of Interactive Health Literacy (MIHL) do contribute unique variance-apart from document-based health-literacy--on several criterion measures such as satisfaction with health care services. Comprehension checking improved health message listening comprehension, but for White participants only. These findings invite further investigations of interactive health literacy involving different populations, message topics, and elicitation methods.