In an interview with NewPublicHealth last year, Yvette Roubideaux, MD, MPH, head of the Indian Health Service, spoke about the need for "cultural humility" as stakeholders and partners work to improve healthier lifestyles in cultural and ethnic communities throughout the United States. A five-year-old program in Prince Georges County, Md., does just that. Building on the quinceañera, the traditional coming of age party for many fifteen-year-old girls of Latino heritage, Mis Quince Años (“My Fifteen Years”) is a program run by the county’s Parks and Recreation Department that offers writing and speaking seminars and teaches the girls about health and fitness, their culture, college preparation and provides service programs in their communities.

>>Read more about the program in the Washington Post.

Students at the Yale School of Public Health teamed up with fellow classmates at the university’s School of Art to develop original public health posters. The goal was to provoke awareness, stimulate thought and change behavior on health issues such as obesity, breast cancer screening, and self-respect and child development.

The posters were the idea of School of Public Health Assistant Professor Catherine Yeckel, who challenged students to apply and translate theoretical scientific knowledge into a public health campaign to educate the public on a specific health topic.

“The progression from complex to simple communication, letting the image speak, was probably the most powerful insight for all the groups,” says Yeckel. “In my mind, gaining this insight becomes the launching point for tackling a public-health campaign and movement.”

Fourteen pairs of public health/art students worked together. The Connecticut State Office of Health Reform and Innovation will display the posters beginning in July, and a tour of other communities is expected after that.

View the online exhibit.

Bonus view: The World Health Organization has just released a video to raise awareness about malaria called T3 (Test. Treat. Track) that, like the Yale posters, uses few words but imparts a powerful message.

Weigh In: What messages have been effective in your community?

CDC Says Plane Scare Unlikely to Have Been Monkey Pox

Investigators from The Centers for Disease Control and Prevention boarded a plane to examine—and then release—a woman with a rash who arrived back in the US from Uganda late last week. The immediate concern had been monkey pox, a sometimes fatal infectious disease that is similar to smallpox, but CDC investigators say her symptoms were not consistent with the illness. News sources say her rash was likely the result of bed bug bites

Read an interview with the screen writer and an advisor to the film “Contagion”

Low Literacy in Math and Reading Can Lead to Medication Dosing Errors by Parents

Parents with math skills at the third grade level or below were five times more likely to measure the wrong dose of medication for their child than those with skills at the sixth grade level or higher, according to a study presented at the Pediatric Academic Societies (PAS) annual meeting in Boston.

Researchers say dosing liquid medications correctly can be especially confusing because parents have to read and understand dosing for different ages and weights and understand the measurement markings on dosing cups, droppers and syringes.

Read more on health literacy.

Text Messaging May Help Increase Immunization Rates

A new study by researchers at the Columbia University Mailman School of Public Health found that text message reminders to parents about flu vaccinations may help boost the number of children vaccinated. The study was published in the Journal of the American Medical Association and followed 9,213 children and adolescents ages six months to 18 years—primarily from minority households. Parents of children assigned to the text-message intervention received up to five weekly texts providing educational information and instructions on where the vaccinations were administered. Everyone in the study received an automated telephone reminder, and access to informational flyers posted at the study sites.

At the end of the study, a higher proportion of children and adolescents in the intervention group (43.6 percent) than in the control group (39.9 percent) had been vaccinated against the flu.

Read about text messaging interventions in public health.

Kids in Neighborhoods with Biking and Walking Trails Exercise More

Children living in a neighborhood designed with a special bike trail were three times as likely as those in a traditional neighborhood to engage in vigorous physical activity, according to new research presented at the American Heart Association’s Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2012 Scientific Sessions.

Researchers compared two low-income neighborhoods in Chattanooga, Tenn. One had a specially-designed, two-mile, extra-wide trail for biking and walking that connected public housing and single-family residences to a school, library, recreational facility, and park and retail shops. The other area has traditional homes, public housing, a new school, a park and an older, regular-width sidewalk. Researchers found that there was more vigorous activity in former community in the park and along the new trail, including jogging and bike riding. Read more on healthy communities.

Department of Labor Announces Grants to Help Young Offenders Rejoin Communities

The Department of Labor has announced $20 million in grants to provide employment-related training and support services to youth who have been involved in the juvenile justice system. The grants will be used to fund programs including workforce development, education and training, case management, mentoring, and community-wide violence reduction.

Women Often Don’t Feel Chest Pain with Heart Attacks

Women, especially younger ones, are more likely than men to have a heart attack that isn't accompanied by chest pain or discomfort, according to a new study in the Journal of the American Medical Association. The lack of symptoms can result in delayed medical care and differences in treatment that may help explain why women in the study were also more likely to die of their heart attacks, according to the researchers. Younger women with no chest pain were almost 20 percent more likely to die than men. According to the study, instead of chest pain, some people having a heart attack may instead have unexplained shortness of breath, or pain in other areas, such as the jaw, neck, arms, back and stomach. Read more on heart health.

NHTSA Launches a Crash Test Dummy Simulating a Ten Year Old Child

The National Highway Traffic Safety Administration (NHTSA) has unveiled a crash test dummy that simulates a ten year old. The dummy will be used to evaluate the growing number of child safety and booster seats for children weighing more than 65 pounds.

According to NHTSA, the new dummy’s debut follows more stringent child safety seat recommendations issued by the agency last year that encourages parents and caregivers to keep children in a car seat with a harness for as long as possible, up to the height and weight specifications of the seat. The agency’s updated child seat guidance also recommends that children ride in a booster seat until they are big enough to fit in a seat belt properly, which is typically when the child is somewhere between 8-12 years old and about 4 feet 9 inches tall. Read more on transportation safety.

NIDA Creates Easy-to-Read Website on Drug Abuse

A new, easy-to-read website on drug abuse designed for adults with a low reading literacy level (eighth grade or below) has been posted by the National Institute on Drug Abuse (NIDA). The site provides plain language information on drug abuse prevention and treatment and is also a resource for adult literacy educators. Features include a simple design, audio accompaniment for most text, large text size and animated videos that explain how drugs affect the brain.

"Drug abuse and addiction affects people of all reading levels, yet there are no websites with drug abuse information created specifically for adults with limited literacy," said NIDA Director Dr. Nora D. Volkow. "We hope this new site will inform a large segment of our population who may not have otherwise received potentially life-saving information." Read more on health literacy.

Measles at the Super Bowl?

The American Academy of Pediatrics (AAP) sent out an advisory yesterday that the Indiana State Department of Health is tracking two confirmed and two probable cases of measles in the state, including one person who attended Super Bowl festivities at the Super Bowl village in Indianapolis on Feb. 3.

The American Academy of Pediatrics, the American Academy of Family Physicians, and the Centers for Disease Control and Prevention recommend children be vaccinated against measles at age one, and again at four to six years of age before entering kindergarten.

"The vaccine is very effective, which is why we don’t see many cases of measles in the U.S. today," said Dr. Block. "But the virus is still out there, and people who are not immunized—including infants who are too young to be immunized—are at risk. Measles can be deadly. High rates of immunization in the community help to slow the transmission of diseases like measles, protecting everyone."

Read more news on vaccines.

HHS Issues Rule on Making Private Health Insurance Benefits Easy to Understand

Under a rule announced yesterday by the U.S. Department of Health and Human Services (HHS), health insurers must provide consumers with clear, consistent and comparable summary information about their health plan benefits and coverage. The new explanations will be available about the end of September and will benefit the 150 million Americans who currently have health insurance, according to HHS.

The new rule will provide consumers two important documents to help understand their health insurance choices, including a short, easy-to-understand summary of benefits and a uniform glossary of terms commonly used in health insurance coverage, such as “deductible” and “co-payment.” Read more on access to health care.

The journal Health Affairs has released a new report on health literacy. The article authors include U.S. Department of Health and Human Services Assistant Secretary for Health Howard Koh, former Center for Medicare and Medicaid Services Director Donald Berwick, and Carolyn Clancy, Director of the Agency for Health Research and Quality. The authors conclude, “the promises of medical research, health information technology, and advances in health care coverage and delivery cannot be realized if our nation does not simultaneously address the challenge of limited health literacy. The federal initiatives of the past few years, combined with a growing commitment to health literate organizations and systems change, can help the nation tackle health literacy and ultimately help us all lead longer, healthier lives.”

According to the report, tens of millions of Americans have limited health literacy—a health issue, that the authors say has, until recently, been relegated to the sidelines. Federal policy initiatives include the National Action Plan to Improve Health Literacy, released in 2010 and the Plain Writing Act of 2010.

Several organizations and government agencies have created useful health literacy resources:

• HHS Overview of Health Literacy
• CDC Health Literacy blog
• Health Literacy Missouri
• Resources from the National Library of Medicine
• Resources from the American Medical Association
• Updated review of health literacy resources and issues from the Agency for Health Care Research and Quality

>>Read our earlier Q&A with HHS's Linda Harris and ARHQ's Cindy Brach, also two of the study authors, on efforts to improve health literacy.

The Centers for Disease Control and Prevention (CDC) launched a home page redesign yesterday that reflects the growing use of social media to access health information. The home page now prominently features the agency’s Twitter and Facebook feeds.

Additional changes include:

• More browser compatibility
• Brighter colors, as well as improved display to accommodate the growing number of people accessing the page on mobile devices
• A new “Outbreaks” module that will continually update information on disease outbreaks—a valuable tool for people who don’t rely on other frequently updated sites such as Twitter and Facebook.

"Emphasizing Twitter and Facebook is important," says Karen Morrione, senior advisor for research and strategy in the electronic media branch at CDC, “because our guiding vision is to make sure our information is credible but also that our information is available where people are actually spending time. We want to make sure they have access to us no matter how they’re accessing us."

The page also has done away with some of the clutter of the previous version. “We wanted a much more modern look and I think we got it,” says Morrione.

The top of the page, which once had rotating stories, now has just one feature that will change regularly. (Today’s feature links to a video on exercising in spite of arthritis pain—a timely update, given a study published last week in the CDC’s Morbidity and Mortality Report that found that pain keeps many of the 50 million people in the U.S. with arthritis from exercising.)

The stories that once rotated at the top of the page are now located to the left of the home page and will change frequently. Current stories include ones on holiday road safety and lead hazards in some holiday toys.

Last year, CDC.gov received over 550 million page views, and the most popular topics included the agency’s A-Z search function, navigable from the home page, BMI calculators and salmonella. Early next year CDC will release an iPad app to make it easier for health professionals to share data with consumers.

CDC is asking users to take a survey and let them know what you think about the new changes.

>>BONUS Recommended Reading: The U.S. Department of Health and Human Services offers a guide to writing and designing easy-to-use health websites. Read the guide here.

>>Weigh in: What other public health websites might benefit from a redesign and what changes would you suggest?

Nearly 9 out of 10 adults have difficulty using the health information from doctor’s offices, hospitals, online and in the media, according to background in the National Action Plan to Improve Health Literacy. People with low health literacy are more likely to skip medical screenings, end up in the emergency room and struggle with chronic conditions. As more people gain access to preventive services through the Affordable Care Act (ACA), now is a critical time to reduce the burden of complexity in the healthcare system and beyond.

NewPublicHealth spoke with Linda Harris, Ph.D., Health Communication and eHealth Team Lead in the U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion (ODPHP) and Cindy Brach, MPP., Senior Health Policy Researcher for the Agency for Healthcare Research and Quality (AHRQ) about efforts to improve health literacy. ODPHP will co-host a Health Literacy Month Twitter chat on health literacy’s role in promoting prevention provisions in the health care reform law. Learn more about the chat and join the discussion on October 20 at 2 p.m. EST, using the hashtag #healthlit.

NewPublicHealth: Tell us about the burden of health literacy and the impact it has on the health of our nation.

Cindy Brach: We have a population that does, by and large, not have the skills needed to function in the current healthcare environment. Only about 12% of Americans, according to national data, are proficient in health literacy. In fact, all of us struggle at one time or another; it may be because we’re sick or we’re stressed or it may be because we have trouble reading or understanding medical concepts, but we struggle with the health information that’s presented to us.

There is a mismatch between the skills that American adults have and the demands the healthcare environment makes on people – to navigate the system, to parse out what is being said to them [by healthcare providers], and to read those dense documents that have critical medical instructions. What we strive to do when we talk about improving health literacy is to not only try and raise individual’s abilities and skills through adult education and other programs, but also to reduce the complexity of the health information and the navigation that is required for patients to be able to get the healthcare they need.

Linda Harris: I would remind us that related to the ACA, about 32 million Americans, half of whom have limited health literacy, will be eligible for free preventive services through ACA coverage in 2014. It’s a very specific population that we’re aiming to assist in reducing their burden, if possible, before the coverage begins.

Difficulty With Health Literacy Increases Death Rates for Patients With Heart Failure

A study of over 1,500 patients published in the Journal of the American Medical Association found that death rates and hospitalizations were higher for patients with low health literacy—aka, limited ability to understand key health information.

Diabetes Testing Drops for Poor, Minorities, Inner-City Residents

Testing of blood sugar, eyes and feet among poor adults with diabetes age 40 and above, dropped from 39% to 23% between 2002 and 2007, according to data from the Agency for Health Care Quality and Research.

Web-Based information Helps Low-Income Individuals Increase Fruit and Vegetable Consumption

A study in the Journal of the American Dietetic Association comparing internet learning vs. classroom or mail-based education about fruit and vegetable intake found an advantage for those using the internet.

FDA to Host Workshop to Help Improve Safety of Reusable Medical Devices

On June 8 and 9, the Food and Drug Administration will host a stakeholder meeting toward reducing disease transmission from reused medical devices, such as endoscopes. The risk of acquiring an infection is low, according to the agency, but needs some improvement.

Too Many College-Age Students Unaware of Heart Disease Risks

A new survey by the American Heart Association finds the lifestyles of many young adults ages 18-24 put them at risk for heart disease and stroke.