Public Health Community Advisory – Health Literacy Nebraska (HLNE) brings together interested stakeholders to develop and implement projects focused on improving the health literacy of all Nebraskans. An HLNE workgroup presented a poster on the idea of adding health literacy screening questions to the Nebraska BRFSS at the Spring 2013 Institute for Healthcare Advancement national health literacy conference in Irvine, California. It was learned there that Kansas had included three (3) health literacy screener questions on the 2012 KS-BRFSS. The HLNE workgroup submitted the necessary application to the Nebraska Department of Health and Human Services and used grant funds from the National Cancer Coalition to cover the costs associated with state added BRFSS instrument items. The application was approved and three health literacy screener questions (with wording changed from the Kansas items) were added for the Nebraska BRFSS survey Pass A & B for 2014 and 2015.

The following results are from the data analyses of responses in 2014 (2015 results pending):

• When asked the question, “how confident are you in your ability to fill out health forms yourself?” 34% of the Nebraska respondents lacked confidence and 66% responded that they did not lack confidence in their ability to fill out health forms overall (N=20,778).
• When asked the question, “How often is health information written in a way that is easy for you to understand?,” 27% of the respondents disagreed that written health information is always or nearly always easy to understand and 73% stated that it is easy to understand (N=20,755).
• When asked the question, “How often do you have someone help you read health information?”, 11% of the respondents stated that they always or nearly always get help reading health information and 89% do not get help reading health information (N=21,042).

This was the first time that Nebraska polled respondents about understanding health information. Although the majority of Nebraska BRFSS respondents in 2014 stated that they did not lack confidence in their ability to fill out health forms overall, that it is easy to understand written health information, and that they do not get help reading health information, there are those identified that do need assistance. This has ramifications for both clinical health care providers and public health practitioners going forward. This project,and similar ones in other states, have served as a precursor for the current CDC’s health literacy screening optional module for the national BRFSS. These health literacy efforts in Kansas and Nebraska have raised the CDC’s awareness of the need to include health literacy screening questions in the BRFSS to learn baseline data across the United States.

This article was written by Denise H. Britigan, PhD, MA, CHES Director, Office of Community Engagement, Academic Affairs Assistant Professor, College of Public Health, Dept. Health Promotion, Social & Behavioral Health, University of Nebraska Medical Center.