• Creating a Generation of Health-Literate Adolescents

    Allison Gertel-Rosenberg Jul 25, 2018

    Nemours_Allison Gertel-RosenbergFor many people, interacting with the healthcare system can be daunting. The paperwork, the jargon, the myriad treatment options, the complicated insurance procedures, and the sheer size and complexity of it all can be difficult to navigate for just about anybody.

    But for teenagers who are preparing to engage with the healthcare system on their own for the first time, the experience can be thoroughly bewildering. What type of doctor do I need to see? Where exactly do I go for care? How do I make an appointment? What are all these forms? How am I going to pay for this? What is my family history? How often should I take these pills?

    If adolescents can be engaged, educated, and empowered to manage their own health care, then providers can focus on providing exactly the care those patients need and want, at the right time and in the right setting.

    Recognizing this potential, Nemours Children’s Health System developed a program, Navigating the Health Care System, to inspire and encourage adolescents to be their own healthcare advocates.

    Our hope, reinforced by the literature, is that as their health literacy increases, young people will be more likely to seek preventive services and will be healthier when they enter the healthcare system. They then will remain healthier and have lower rates of preventable hospital and emergency department visits, resulting in lower overall healthcare costs.

    Covering Vital Topics

    Our program, which incorporates national and state education standards, was piloted and refined in collaboration with schools and other community sites in Delaware.

    Topics covered include primary and specialty care, insurance, family history, logistics of medical visits, and more. Information is shared via four 45-minute modules that can be delivered in various settings, from high school classrooms to after-school clubs to community-based organizational settings. The education takes place through helpful and appropriate tools, including student workbooks, PowerPoint presentations, group activities, and videos.

    In three academic years of testing involving nearly 2,900 students, teenagers showed significant knowledge gains—an average of almost 20 percentage points. In addition, students and participating high school teachers reported high levels of satisfaction with the curriculum.

    Expanding the Audience

    Given these results, Nemours launched a national expansion of the curriculum. While we recognize that many of the students will never receive clinical care from Nemours, we are committed to creating a new generation of educated health consumers. In this endeavor, we are providing free materials, training, and assistance to partners that are interested in implementing the curriculum anywhere in the country. 

    The results seen in Delaware have continued in the pilot phase of our national expansion. About 900 students from three states (Wisconsin, Illinois, and Texas) participated in the four-module course. On average, students’  knowledge increased from 65 percent pre-course to 81 percent post-course.

    Nemours plans to continue to spread and scale the course in new states. School districts, communities, health systems, health plans, and others that are interested in implementing the no-cost curriculum can contact NTHCS@nemours.org or visit the program website to learn more.


    Allison Gertel-Rosenberg is operational vice president, National Prevention and Practice, Nemours Children’s Health System, Wilmington, Del.

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