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The Value of Looking through Soda Straws*

I have been very impatient with the narrow view of some health literacy
researchers who, as if looking through a soda straw,  focus on only a single
factor in a persons’ capacity to use information for health, usually reading
skill. Or who focus only on the clinical encounter. Or only on patients with
chronic disease.  Or only on plain language. Experts at the International
Roundtable on Health Literacy at University of British Columbia last month
could not agree on a definition or a measure of health literacy. I’ve called
for a broader view.
But maybe I’m wrong.
This week I was in Bozeman, MT working with the public health nurses and
social workers who staff the Thrive Partnership home visiting program.
They are the cutting edge of promoting maternal health literacy. It has been
my honor to work with them since 2004. This time we worked on practical
approaches to empower parents.
In this community, promoting health literacy and empowering parents is
part of a county-wide  coordinated effort to strengthen vulnerable families.
The collaboration addresses the entire Web of Interaction that affects MCH
and maternal health literacy.
Thrive, voted Bozeman’s best non-profit, under the tireless, gentle, powerful
direction of executive director Deborah Neuman, has over 26 years forged a
collaboration to promote maternal child health as the foundation for a healthy
society in Gallatin County.  Neuman has received a growing number of  requests
from around the country for help to replicate the collaboration that extends
well beyond the usual public health players. For example, two banks contributed
space for our 2-day workshop. The Hilton hotel comp’d rooms and breakfasts for
the trainers.
Neuman credits the soda-straw view of each partner as the active ingredient in
the success of the Thrive model of coordinated collaboration.  She says a common
broad view would cause the collaboration to degenerate to groupthink. She points
out that the social workers in my workshop are employed by Thrive; they were
hired for their ability to engage parents. The nurses in the workshop are employed
by the health department and hired for their clinical expertise. The PHNs and MSWs
work with the same families. They are acutely aware and respectful of each others’
expertise. They closely coordinate their efforts with each other, healthcare providers,
the hospital, the schools, food banks, day care providers, , the Bozeman Adult Literacy
and Education service, et al.  Both the Health Department and the agency use the
Life Skills Progression to monitor their effectiveness and family progress.  Ten years
of LSP data (soon to be published) show remarkable results,with effectiveness increasing
over time as the coalition grew and collaboration deepened.
Rather than of a common broad view, Neuman says, what works is all those soda
straws trained on the needs and strengths of the same vulnerable families to find
the combination of supports that empower each family  to function as fully as possible
as part of the Gallatin County society.  It seems many narrow views together cover the
broad view without sacrificing the depth of understanding one gets looking through a
soda straw.  ss

*Credit for the soda straw analogy goes to Linda Wollesen, author of the LSP
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