The aging and evolving racial and ethnic composition of the U.S. population has the United States in the midst of a profound demographic shift and health care organizations face many issues as they move to address and adapt to this change. In their drive to adequately serve increasingly diverse communities, health care organizations are searching for approaches that will enable them to provide information and service to all persons, regardless of age, race, cultural background, or language skills, in a manner that facilitates understanding and use of that information to make appropriate health decisions. To better understand how the dynamic forces operating in health care today impact the delivery of services in a way that is health literate, culturally competent, and in an appropriate language for patients and their families, the National Academies of Sciences, Engineering, and Medicine conducted a public workshop on the integration of health literacy, cultural competency, and language access services. Participants discussed skills and competencies needed for effective health communication, including health literacy, cultural competency, and language access services; interventions and strategies for integration; and differing perspectives such as providers and systems, patients and families, communities, and payers. This report summarizes the presentations and discussions from the workshop.

Health literacy, cultural competence, and language access services are distinct but inextricably linked concepts for delivering equitable care to all members of the increasingly diverse population of the United States. These concepts are linked, but they developed via different paths, and each has its own unique focus with regard to enabling every individual to obtain the ability to process and understand basic health information and services needed to make appropriate health care decisions. Fragmentation of these disciplines has impeded implementation of relevant measures for quality improvement and accountability. To foster an integrated approach to health literacy, cultural competency, and language access services, the Roundtable on Health Literacy initiated a project with three components: a commissioned paper to propose a framework for integrating measurements of health literacy, cultural competency, and language access; a workshop to review and discuss the framework; and a second commissioned paper that will provide a roadmap for integrating health literacy, cultural competency, and language access services as well as a revised measurement framework. Held on May 4, 2017, the workshop explored the quality performance measures for integration of health literacy, cultural competence, and language access services. This publication summarizes the presentations and discussions from the workshop.

While health literacy is a relatively new multidisciplinary field, it is vital to the successful engagement with and communication of health with patients, caregivers, and the public. This book ‘New Directions in Health Literacy Research, Theory, and Practice’ provides an introduction to health literacy research and practice and highlights similar scholarship in related disciplines. The book is organized as follows: the first chapter explains the still-evolving definition of health literacy; the next three chapters discuss developments and new directions in health literacy research, then a further two chapters are devoted to developments and new directions in health literacy theory. Two chapters explore health literacy interventions for vulnerable populations; four chapters cover health literacy leadership efforts; six chapters describe developments and new directions in disciplines that are similar to health literacy; and six chapters portray diverse health literacy practices. A preface from Richard Carmona M.D., the former U.S. Surgeon General, is included in the book. Although the book is intended primarily for health literacy researchers, practitioners and students, the diverse topics and approaches covered will be of interest to all healthcare and public health researchers, practitioners, and students, as well as scholars in related fields, such as health communication, science communication, consumer health informatics, library science, health disparities, and mass communication. As Dr. Carmona concludes in his preface: ‘This is essential reading for all health practitioners.’

Health literacy-the ability for individuals to obtain, process, and understand basic health information and services to facilitate appropriate health decisions-is increasingly recognized as an important facet of health care and health outcomes. Although research on health literacy has grown tremendously in the past decade, there is no widely agreed-upon framework for health literacy as a determinant of health outcomes. Most instruments focus on assessing an individual's health literacy, yet the scope of health literacy reaches far beyond an individual's skills and abilities. Health literacy occurs in the context of the health care system, and therefore measures of health literacy must also assess the demands and complexities of the health care systems with which patients interact. For example, measures are needed to determine how well the system has been organized so that it can be navigated by individuals with different levels of health literacy and how well health organizations are doing at making health information understandable and actionable. To examine what is known about measures of health literacy, the Institute of Medicine convened a workshop. The workshop, summarized in this volume, reviews the current status of measures of health literacy, including those used in the health care setting; discusses possible surrogate measures that might be used to assess health literacy; and explores ways in which health literacy measures can be used to assess patient-centered approaches to care.

The American Psychiatric Association Publishing Textbook of Psychiatry, first published more than 30 years ago, is a landmark text with a legacy of sound scholarship, expert knowledge, and effective pedagogy. Thoroughly revised and featuring new authors and content, the seventh edition raises the bar, adding age-related, cultural, societal, and population considerations in the practice of psychiatry to the authoritative text that generations of students, residents, and clinicians have heretofore relied upon. The book first focuses on foundational knowledge, with chapters on psychiatric interviewing, diagnostic formulation, developmental assessment, laboratory testing and neuroimaging, and ethical and legal aspects of clinical psychiatry, and then proceeds to a full presentation of psychiatric disorders in alignment with DSM-5. The third section offers an overview of treatment strategies and methods in present-day psychiatry, a combination of evidence-based biological interventions and psychotherapies, and gives a clear sense of exciting new directions in psychiatric therapeutics. The final section of the textbook is focused on the care of special patient populations, including women; children and adolescents; lesbian, gay, bisexual, and transgender individuals; older adults; and culturally diverse individuals. Many topics are new to this volume, including the following: Suicide risk assessment, a critically important subject, is addressed in a new chapter that provides the reader with up-to-date knowledge needed to conduct a thorough, attuned, and accurate psychiatric interview in line with best practices. A new chapter on the social determinants of mental health has been added, reflecting an increased emphasis on populations whose specific concerns have been historically underappreciated in American psychiatry, and illuminating factors that influence mental health needs and barriers to care in specific patient populations. Precision psychiatry, an integrative approach that pulls together the scientific foundation of the discipline and recent technological advances and directs them toward closing the gap between discovery and clinical translation, is explored in a new chapter. E-health strategies in mental health have become increasingly available to psychiatrists and other health professionals, especially in the mobile and monitoring spheres. A new chapter offers insights into these intriguing new options for delivering treatment. A chapter on complementary and integrative therapies explores the integration of conventional medicine with alternative treatments for which there is an evidence base, providing an overview of nutrients, phytomedicines, hormones, mind--body practices, and electromagnetic treatments. With features such as key clinical points and recommended readings for further study, The American Psychiatric Association Publishing Textbook of Psychiatry is a comprehensive course book, an indispensable reference, and the ultimate resource for clinical care.

To receive the greatest value for health care, it is important to focus on issues of quality and disparity, and the ability of individuals to make appropriate decisions based on basic health knowledge and services. The Forum on the Science of Health Care Quality Improvement and Implementation, the Roundtable on Health Disparities, and the Roundtable on Health Literacy jointly convened the workshop "Toward Health Equity and Patient-Centeredness: Integrating Health Literacy, Disparities Reduction, and Quality Improvement" to address these concerns. During this workshop, speakers and participants explored how equity in care delivered and a focus on patients could be improved.

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“Health literacy is the ultimate global currency of health and well-being. Without health literacy, medicine fails, public health fails, and people pay the cost for these failures with their lives. As this book goes to press, the world is confronted by the COVID-19 pandemic. Improving health literacy becomes increasingly important if we are to successfully confront the challenges that stress our systems of medicine and public health like never before.” (Richard H. Carmona, M.D., M.P.H., FACS, former Surgeon General of the United States, in his foreword to this book.) Two years ago, HTI published the book Health Literacy: New Directions in Research, Theory and Practice. Together with that earlier volume, this book: Health Literacy in Clinical Practice and Public Health: New Initiatives and Lessons Learned at the Intersection with other Disciplines, strives to enumerate and expand our understanding of the multidisciplinary connections which underpin the field of health literacy. The book’s balance between research and practice is a response to the feedback the editors received about the previous publication, which focused more on HL theory and research. With reports of specific health literacy research initiatives and interventions, particularly in clinical practice and public health, the book covers contemporary health literacy research and practice and is divided into three sections. Section one explores health literacy’s capacity to foster progress in clinical practice and public health; section two provides insights into health literacy initiatives and lessons learned from diverse healthcare stakeholders; and section three examines health literacy’s similarities with – and differences from – related health research disciplines. The book sets the practice and research of health literacy on an evidence-based, thoughtful, effective, efficient, and applied course. As Dr Richard Carmona says in his foreword: “It is enthusiastically recommended for all health and medical practitioners and researchers.”

Cultural Competence in Health Education and Health Promotion, 2nd edition, examines the importance of ethnic and cultural factors for community health practice. Edited and written by a stellar list of contributors who are experts in field, this book describes essential theories, models, and practices for working with race, ethnicity, gender, and social issues. The authors cover a wide range of topics including demographics, disparities, complementary and alternative medicine, spiritually grounded approaches, multicultural populations, culturally competent needs assessment and planning, communication, workforce, program planning, aging, sexual orientation, and future challenges. This edition has substantially expanded coverage on working with diverse groups, social determinants of health, spirituality, theoretical models for multicultural populations, planning and program evaluation, and aging, with new content includes coverage of disability and health literacy. This edition also reflects the latest standards for Certified Health Education Specialist certification and national standards on Culturally and Linguistically Appropriate Services (CLAS), from Department of Health and Human Services, Office of Minority Health