Occupational therapist Helen Osborne advocates for health literacy

By Sandy Keefe

As founder and president of Health Literacy Consulting in Natick, MA, Helen Osborne, MEd, OTR/L, focuses on health literacy—helping health professionals and health care organizations communicate in ways patients, families and employees can understand. Her firm offers a free monthly e-newsletter; workshops and keynote presentations; plain language writing and editing services; and health tips, articles, books and audio CDs on the topic. She has written four books; her seminal work, Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, may well be the most important reference on the topic of health literacy today.

Osborne had never heard the term health literacy before an article in the Boston Globe caught her eye in December 1995. "I read an excerpt describing a JAMA article about health literacy," she explained. "I was fascinated to learn almost 50 percent of adults have difficulty reading and understanding health information. With an OT background and a graduate degree in education, I've always been at the intersection of health and education, so the concept certainly intrigued me."

Osborne was a chief of psychiatric rehabilitation services at a hospital in Boston at the time, treating patients from different cultures, with different diagnoses and a number of different mental health issues.

"Once I learned about health literacy, I looked around at all my 'gorgeous' (or so I thought) worksheets where I had chosen great fonts and layouts, and knew my patients couldn't benefit from them," she said. "I realized I needed to do something about the gap between what I wanted to teach, and what they were able to understand."

When Osborne searched for relevant information on health literacy, she was surprised to see how little was available.

"I was in a position of influence, but I didn't know what to do to improve the health literature for our population," she admitted. "I read everything I could find that might make a difference. I quickly discovered I had to go outside the health care industry to learn what to do. This started a journey which led to my creating a business focused solely on health literacy."

Creating a National Holiday

Determined to bring health literacy to public awareness, Osborne spearheaded a worldwide campaign to raise awareness about the importance of understandable health information.

"I had to learn all these business principles in order to develop and grow my business," she said. "One thing I did know was people don't pay to fix a problem they don't know they have! I was in a mentee program (for professional speakers) at the time, and someone talked with us about creating your own holiday. She had created a national holiday on self-esteem, and it dawned on me I could create one for health literacy.

"When I came up with the idea for Health Literacy Month, I posted a query on a health literacy listserv (online discussion group) I had been co-moderating for awhile," said Osborne. "I wrote about my idea for a national holiday centered on health literacy and asked, 'How does that sound?' Within the hour, I had nearly 50 responses, all telling me it was a great idea and asking, 'What are you going to do about it?' This month has been the most powerful tool you can imagine for increasing the awareness of health literacy."

Osborne took a deep breath and went to work. "I set up a 'cyber committee' and started planning events and publicity," she recalled. "Health Literacy Month has just completed its ninth year, with events being held on five continents. There's really nothing special about October as the time for health literacy, because we miscommunicate all year long. But a holiday like this creates a sense of urgency to focus awareness on a cause such as health literacy. I already have bookings for October 2008 because of that."

Today, Osborne's extensive client list includes such organizations as Blue Cross Blue Shield of Massachusetts, the Centers for Disease Control (CDC), Merck Pharmaceutical Company, Harvard Medical School, Health Care for All, and VNA of South Central Connecticut. As an example of her work, a recent VNA workshop included an overview about health literacy, eight ways to improve communication, and ways to take action on health literacy.

A Varied Background

The roles that Osborne filled over the years provide the foundation for her work with health literacy.

"As an occupational therapist, I treated many patients with limited literacy and language skills, as well as those who were older, from other cultures, or had trouble hearing, seeing and remembering," she described. "As a department manager, I know what it is like to run patient education programs with not enough time, money or other needed resources. And as a patient and family member, I am well aware of how hard it is to listen and remember when feeling scared, sick and overwhelmed."

Those backgrounds have served her well since she opened her business in 1996.

"I'm glad I'm an OT as well as a speaker and consultant at this point," she said. "I'm delighted I have real-life clinical experiences to share with my audiences. My solutions are very practical, don't cost much and don't require much time. I've learned to be a good steward of resources because of my therapy background."

Osborne described her health literacy work in part as an application of activity analysis.

"I've learned to build on a series of small successes, and that concept is inherent within our OT profession," she said. "As OTs, we can look at the big picture and break it down into increments, so that we can celebrate incremental changes."

An Enduring Passion

Health literacy is Osborne's way of making a difference in the world.

"I don't see just one or two solutions to any given issue; I see infinite possibilities," she explained. "That creativity is something I've always valued as part of my OT profession. Health literacy has struck my passion in ways nothing else ever had. Twelve years later, that passion has never waned."

For more information: Visit Helen Osborne online at www.healthliteracy.com

Sandy Keefe, MSN, RN, is health care manager at Camp Costanoan, a year-round camp for children and adults with developmental and physical disabilities in Cupertino, CA.