Thesis: Fall 2011 Final Review

Submitted for Fall 2011 Final Review


Research Question

What are the attributes and behaviors of a communication system that supports pregnant teens with low health literacy to maintain healthy eating habits?

  • What are the potential leverage points in the activities of pregnant teens for reinforcement of dietary recommendations?
  • What are the available tools and appropriate interventions for continued feedback and encouragement?
  • How could a system designed for social support facilitate adherence of pregnant teens with low health literacy?

Definition of Health Literacy
The Institute of Medicine’s 2004 report, Health Literacy: A Prescription to End the Confusion, accepts the definition as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. This definition encompasses the variety of contexts within which individuals will encounter healthcare information. An individual’s capacity is mediated by “education, and its adequacy is affected by culture, language, and the characteristics of health-related settings.” [2004]

For this design study:

  • Health literacy will be investigated in conjunction with social support, health communication, and information design research
  • Basic and below basic health literacy are referred to as low health literacy.
  • Maintaining prenatal nutrition is a preventative task defined as self-care management.

Health Literacy Crisis: According to the 2003 National Assessment of Adult Literacy, nearly 9 out of 10 adults have difficulty using the everyday health information that is routinely available in health care facilities, retail outlets, media, and communities. Health literacy encompasses a broader range of concerns than literacy, which refers to a person’s ability to read, write, and understand verbal and written language in their native tongue. Literacy and health literacy are related but not interchangeable. Health literacy involves a range of stakeholders and experts, including designers due to the manufacture and distribution of messages and materials in health communication.

Risk to Patients and Healthcare Providers: Patients with low literacy are less likely to adhere to recommendations given by their health care provider. With the model shifting to patient-centered care, the patient’s responsibility in managing their health has increased; however, less than effective communication and reliance on jargon-laden written materials can confuse or exhaust people. It is imperative that patients are provided with comprehensible and useful information to lower unnecessary health consequences and costs. Maternal health literacy is of great concern due to the dominant role women play in their children and families’ health. [Puchner, 1995]

Teen Pregnancy: Though the statistics show a decline in the teen pregnancy since the early 1990s, the United States still has the largest percentage of teen mothers of any developed country in the world. The numbers are disproportionately higher in lower socioeconomic areas and amongst minorities, which also demonstrate lower health literacy rates. Much of the communication I have reviewed in regards to teen pregnancy is about prevention. The cultural debate around the issue seems to focus on who is to blame or praise—from sex education to the MTV reality series Teen Mom—rather than supporting teens that are already expecting. By focusing on this particular demographic, I am highlighting a population that is often neglected but if addressed could have long-term positive effects for the teens, their families, and their children.

Health Literacy Research Gap: Health literacy research often focuses on patient education and readability of health materials. Though this work has advanced knowledge, it fails to address a wider range of literacy skills and the social or cultural contexts that affect health literacy. Patients are often viewed as isolated individuals; however, social support research suggests that relationships have the ability to buffer and alleviate the pressures of health consequences that low health literacy presents. Aligning health literacy with social support can lead to new possibilities in health communication.


  • Appropriation of health information and data from existing materials
  • Focus on pregnant teens from 16-18 years old
  • Focus on patients’ low health literacy skills
  • System will be conceptualized with prototypical studies

  • Most pregnant women have intrinsic motivation to maintain their health.
  • Prenatal nutrition has an effect on the health of the unborn child[ren].
  • Effective communication and support is integral for patient adherence
  • My exploration will generate transferable ideas beyond the scope of prenatal nutrition.



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