As per the Affordable Care Act (ACA), health literacy can be defined as, “ The ability of an individual to make informed decisions with respect to obtain, communicate, process, and understand information pertaining to healthcare” Based on the annual report published by the ACA, only 12% of the US adult population is considered to be proficient in health literacy while 1/3rd of the population suffers from healthcare illiteracy and suffer from making common health decisions Based on the same report, more than 75% of patients suffer from healthcare associated decisions since most patients tend to forget more than half of the information shared Low health literacy is often associated with many problems such as low decision making capabilities, inability to practice preventive health, unable to locate health services, and inability to understand or comprehend complex medical forms or decisions (Batterham, et al. 4). Hmong culture does not perceive medical or healthcare utilization in the absence of any symptoms or do not consider it important to consult a physician in case of severe signs or symptoms Hmong culture has significant mistrust and disbelief for western medicine which has a profound effect on early diagnosis, preventive care, and medical intervention The low health literacy has been associated with poor health outcomes among the Hmong culture. Communication is considered a significant barrier in the Hmong culture and most often has an effect on patient decision making and informed consent. Although the Hmong culture reside within the US for over decades, they are less likely to access basic healthcare services and also lack the ability for screening of diseases such as hypertension, heart disease, and diabetes (Wynia, et al. 110). In a recent report, more than 95% of Hmong people considered healthcare provider’s decision as a harm to their personal health and also do not consider preventive care as a mode for better health outcome. The Hmong culture have the inability to communicate, process, or understand various medical interventions and also lack the ability to question the provider’ s diagnosis or judgement (Heinrich 220).
Strategies for Healthcare Literacy among Hmong Culture
The Hmong culture are known to have mistrust and lack of confidence in western medicine and healthcare provider’s decision on diagnosis, treatment, and management
Based on current evidence and guideline recommendations for health literacy the following strategies have been proposed for the Hmong Culture:
Promotion of informed and clear healthcare promotion activities
Inclusion of health-based and nurse-led teaching methods for Hmong patients
Use of tech-based platforms for interactive engagement of Hmong patients
Inclusion of ‘Tech-back’ or ‘Show me’ methods to enhance patient understanding
Include clear, precise, and concise communication for better understanding of patients
Patient-centric information and sharing across platforms (Print, Web, and Tech-based)
(Collier, Munger, & Moua. 80).
Interventions for Healthcare Literacy
The six key interventions of successful patient awareness and education with respect to health literacy include:
Inclusion of a Hmong interpreter for clear understanding and healthcare decision making (Santos et al. 99-104).
The use of patient-centric information leaflets, brochures, and posters written in Hmong language for clear understanding and communication (Shaw, et al. 11).
Include family dynamics such as clan leader, religious leader, mother, and father in all communications with respect to diagnosis, treatment, and management ‘
Nurses involved in health literacy for Hmong individuals would undergo special training with respect to communication, body language, eye contact, and verbal or non-verbal gestures (Thorburn, Sheryl et al. 765-66).
Use of information technology such as mobile applications and internet surfing would be implemented for enhanced communication and clear understanding
Since Hmong’s do not believe in HCPs, it is advised to have a special induction and training program for them to understand the concepts of healthcare diagnosis, treatment, and management (Santos et al. 99-104).
Patient-centric information, education, training, and awareness are the key strategies for a successful healthcare literacy achievement among the Hmong culture
References
Batterham RW, et al. (2016). Health literacy: applying current concepts to improve health services and reduce health inequalities. Public Health. 132:3-12. Print.
Collier AF, Munger M, Moua YK. (2012). Hmong mental health needs assessment: a community-based partnership in a small mid-Western community. Am J Community Psychol. 49(1-2):73-86.
Heinrich C (2012). Health literacy: the sixth vital sign. J Am Acad Nurse Pract. 24(4):218-23.
SANTOS, MARICEL G. et al. (2014). ESL Participation as a Mechanism for Advancing Health Literacy in Immigrant Communities. Journal of health communication. 89–105. PMC. Web.
SHAW, SUSAN J. et al. (2012). Chronic Disease Self-Management and Health Literacy in Four Ethnic Groups. Journal of health communication. 67–81. Web.
Thorburn, Sheryl et al. (2013). We Don’t Talk about It’ and Other Interpersonal Influences on Hmong Women’s Breast and Cervical Cancer Screening Decisions. Health Education Research 28.5 760–771. PMC. Web.
Wynia, Matthew K., and Chandra Y. Osborn. (2010). Health Literacy and Communication Quality in Health Care Organizations. Journal of health communication 15.Suppl 2. 102–115. Web.
