Good Questions for Good Health

doctor

A Program to Improve Health Literacy of MOW Clients
Table of Contents
  1. Toolkit Overview: “Good Questions for Good Health – A program to Improve Health Literacy of MOW Clients”
    • Provides overview of health literacy and instructions for implementing the Good Questions for Good Health Program.
  2. Coach Recruitment Flyer
  3. Coach Training Materials
  4. Videos
    1. How to Coach for Health Literacy (Homebound and Congregate setting)
    2. Video 1: ” Three Little Questions Your Health Care Professional Wants You to Ask”
    3. Video 2: “How to Make Sure You Get Answers to Good Questions for Good Health”
    4. MOW Clients and Coaches Talk About the Value of Health Literacy on Wheels
  5. Print Program Materials
    1. GQ4GH Calendar Template
    2. GQ4GH Notepad Template
    3. GQ4GH Brochure Template
    4. Program Evaluation
    5. Newsletters

Toolkit Overview

Have you ever had the experience of waiting an hour to see your doctor? Then you have 5 rushed minutes with her, and when it’s all over, you don’t know anything more than you did when you went in? If you’ve had that experience, then you should be interested in health literacy.Have you ever looked at all the pill bottles for the 4 or 5 medications you are taking, and realized that you don’t know what all of them are for, or what would happen if you stopped taking them? If you’ve had that experience, then you should be interested in health literacy.Have you ever tried to look up the treatment options for one of your conditions online? And when you look online you realize there are dozens of conflicting opinions about what treatment you should be taking? If you left that experience more confused and uncertain than when you began, then you should be interested in health literacy. If you experienced these difficulties, imagine what it must be like for your older MOW clients who may have vision, hearing, and cognitive impairments.Welcome to the toolkit for implementing the health literacy program called Good Questions for Good Health. In this program, Meals on Wheels and congregate volunteers and staff serve as coaches to help improve the health literacy of older adults.Using this toolkit you can become a certified health literacy coach for your Meals on Wheels clients. You will find that adding a short health literacy component to your nutritional services will be much appreciated by your clients and by your community. In addition, you’ll find that it enhances your own Meals on Wheels experience.Good Questions for Good Health aims to improve the health literacy skills of your Meals on Wheels (MOW) or congregate dining clients. Good Questions for Good Health is based on research which demonstrates that it does work. The testing research was conducted by the University of Georgia and funded by the National Institutes of Health. We designed Good Questions for Good Health to be easy to use, to take very little time for MOW drivers and volunteers, and to enhance the meal delivery experience for volunteers and staff as well as clients. It can be implemented in congregate dining sites as well as home-bound programs.This toolkit includes everything you need to implement the program. All the videos are included in this tool kit as well as templates for all the paper materials, which can be branded with your program’s logo. The toolkit is organized around the steps you will follow to implement. We describe the minimal level of implementation which will produce outcomes. We encourage you to do more than that minimal level of coaching and to adapt it to the unique characteristics of your program.

Why is health literacy such an important skill for older adults?

The typical 75-year old has three chronic health conditions and takes five prescription drugs. She needs good health information and must have the skills to find it and understand it. Yet national assessments find that almost 40% of adults over 65 lack even the basic functional health literacy skills to help them navigate our complex medical system. These measurements only examine ability to understand printed health information but we know that older adults report that they get most of their health information from talking with their health care providers. This program focuses on interactional health literacy and teaches your clients to ask three simple questions of their health care providers:

  1. What is my main problem?
  2. What do I need to do about it?
  3. Why is it important for me to do that?

Asking these “good questions for good health” will improve your client’s health and is a simple way your program can make a difference in their lives.

In the next sections, we describe how to implement this program. It has been used by nine different MOW programs in Georgia in both rural and urban communities and in both home-bound and congregate dining programs. We are confident that it can work in your program.

Note, the process we describe below is not the only way that your program might choose to implement Good Questions for Good Health. For example, in a congregate site, you might adapt the materials for a series of one-hour group activities. But the process we describe below conforms to the system that we are most confident will improve the health literacy of your clients.

Step One-Recruit Health Literacy Coaches

Coaches can be recruited from volunteers and/or staff. Volunteers who have been with your program for some time and who see their clients at least once a month are ideal. Staff might be more appropriate coaches for congregate dining programs. You could describe the program at a meeting of volunteers and let them sign up or you could identify those who you believe would be interested and would be excellent coaches. You will need to explain the program and the responsibilities and commitments of the coaches at a meeting or in letters. We have included an example of a recruitment flyer that we used. Some benefits you can use to sell the program are:

  • Improve their own communication and literacy skills
  • Help clients improve their health
  • Deepen the relationship with clients.

Coaches need to commit to:

  • Continuing with the MOW program for 3 months
  • Participating in a two hour training session
  • Coaching up to 5 clients three times over 3 months

Step Two-Train the Coaches

We recommend a two hour session to train the coaches. We have provided a set of PowerPoint slides to assist with the training. We also include the “How to Coach for Health Literacy” video which models the coaching process. Practice is very important to give the coaches confidence in their ability to deliver the program. During training, each coach should have an opportunity to role play a coaching session. It would be helpful to check in with the coaches as they conduct the program to answer questions and to offer encouragement.

Step Three-Coaches Implement the Program

We recommend that each coach identify up to five clients to work with. The clients who will benefit most can see and hear okay and have no serious cognitive impairments. The Good Questions for Good Health program is designed to integrate with the normal meal delivery or congregate dining schedule. In the first month, the coach introduces Good Questions for Good Health, delivers the paper materials, and shows the first video, “Three Little Questions Your Health Care Professional Wants You to Ask“. The coaches for homebound clients will need to be supplied with portable DVD players to show the videos.In the second month, the coaches will prepare their clients for an upcoming appointment with their health care provider by conducting a coaching session which includes writing down the questions that the clients want answered. See sample GQ4GH questions notepad.In the third month, the coaches will discuss the client’s experience using Good Questions for Good Health and show video two, “How to Make Sure You Get Answers to Good Questions for Good Health” which focuses on barriers that the clients may discover and ways to overcome them. In addition, the coaches will conduct another coaching session incorporating ways to overcome barriers.This three month implementation is the minimum length of time necessary to achieve strong benefits for your clients, but the program could continue much longer if coaches and clients are interested. If you wish to evaluate the program, we have included a simple assessment tool you can use at the end of the three months. It would be best to mail these questionnaires to the clients, conduct the interviews by phone, or have a volunteer or staff member other than the coach administer the questionnaire.This toolkit contains some enhancements to the program that may be used if appropriate to your program. We produced monthly newsletters for the coaches to keep them motivated, remind them of the month’s activities, and provide recognition for their efforts. We have included a file of the newsletters and encourage you to use any of the articles in your programs. Also included is a video testimonial from a client describing her experience with the program and how it has helped her with medical visits.The following is a list of all the resources found in the toolkit:

  1. Coach Recruitment Flyer
  2. Videos
    1. How to Coach for Health Literacy (Homebound and Congregate setting)
    2. Video 1: ” Three Little Questions Your Health Care Professional Wants You to Ask”
    3. Video 2: “How to Make Sure You Get Answers to Good Questions for Good Health”
    4. MOW Clients and Coaches Talk About the Value of Health Literacy on Wheels
  3. Coach Training Materials
  4. Print Program Materials
    1. GQ4GH Calendar Template
    2. GQ4GH Notepad Template
    3. GQ4GH Brochure Template
    4. Program Evaluation
    5. Newsletters