Part 6. Discussion
It is now widely accepted that health literacy reaches beyond the ability of the individual patient. It is about the communication skills of the health practitioners a patient is interacting with, and the ability of other stakeholders, such as health organisations and media, to provide health information and services in ways that are appropriate for that individual (Institute of Medicine 2004). Health literacy is therefore a product of the convergence of numerous factors and stakeholders (Rudd et al 2007; Koh et al 2012).
In order to reduce the number of serious skin infections and skin infections requiring hospitalisation there needs to be improved prevention and treatment of skin conditions by parents and caregivers at home as well as more timely access to primary health care. Improving the health literacy skills and knowledge (in relation to skin infections) of parents and caregivers will contribute to improved prevention and treatment of skin infections in children. The aim of the present research was to identify and assess the effectiveness of health literacy interventions for strengthening the prevention and management of skin infections in Māori children less than 15 years of age. This was achieved through identifying health literacy barriers and facilitators, highlighting interventions, and demonstrating how health literacy might be increased in order to improve outcomes associated with skin infections.
Health practitioners play a key role in building health literacy with parents and caregivers by involving, engaging with, and empowering parents and caregivers to learn more about skin infections. The parents and caregivers who participated in this research were motivated to do so because they wanted more information and advice about all types of common skin infections, how to prevent and manage infections for their children, and where to access health services and advice. Responding to this demand from parents and caregivers is a health literacy opportunity.
Skin infection resources for parents and caregivers that can be used by health practitioners to build health literacy skills and knowledge were developed and trialled during the project. Parents and caregivers were very receptive to the resources and the discussions these generated with health practitioners. Using resources in this way can make a significant contribution to building health literacy.
Guidance about how to use the resources to building health literacy with parents and caregivers was also provided for health practitioners. While there was awareness amongst health practitioners of the value of good resources for parents and caregivers, there was less awareness of how health practitioners need to use resources (or other strategies) to build health literacy. Unfortunately, little feedback was received on the guidance resources for health practitioners and more investigation is needed to determine whether the guidance was effective, plus when and why health practitioners did not implement it.
43
Health guidance and advice for parents and caregivers needs to be easily accessible if parents and caregivers are to receive the regular and sustained support needed to build health literacy skills and knowledge for skin infections. PHNs, community health workers, and similar health practitioners are accessible to parents, caregivers and children and ideally placed to help improve health literacy. Schools also provide an important access point for building health literacy amongst children, and supporting the health literacy of parents and caregivers.