Storytelling and health literacy: Creating meaningful communication

Tammy Pilisuk, MPH, BA

 As a public health educator who works in immunization education, Tammy Pilisuk, MPH, BA, confronts health literacy every day.  SurroundHealth asked her to share her opinions on how she helps make a difference.    

Tell me about the work you do.  I work in immunization education on a number of different campaigns targeted at parents, schools, the general public, community organizations, and health care professionals. The issues and priorities can—and do—change quickly in the immunization field.

What are the ways you feel the ripple effect of health literacy in your work?Immunization has a lot of science involved and it can be very complex information.  Misinformation abounds on the Internet and the popular press. Being able to break down technical information is really important. That means making it not only easy-to-understand, but relevant for different audiences, especially parents and the general public. 

So, how do you keep your immunization education simple, relevant and engaging? One powerful way is through  storytelling. Public health, like the medical community, has historically taken a very formal approach to explaining what immunizations do and why they’re important.  Many young parents today don’t relate to that. Real-life stories can be an important teaching tool. They resonate and leave a lasting impression in a way that abstract information does not.  For example, showing a video of a mother who lost her child to influenza is likely to be much more impactful than sharing abstract statistics. While both are important, the personal stories can make the statistics “come alive.” That emotion is what moves us and helps us remember.

Do you think health literacy as an issue is getting enough of a spotlight? Yes. I see that the issue has been elevated to the national forum and we have both a health literacy national action plan and a 2020 Healthy People Objective on health communication.  However, it is still a voluntary.  Some states and organizations are taking this and running with it. Others seem to be waiting. And, there is still some confusion on what health literacy means in a practical sense. I think this makes it challenging for some organizations to integrate new policies or practices into existing programs.

What is the confusion around health literacy?  I think when people talk about health literacy, they think of the reading level of a certain target population—usually a group with low literacy. Of course that’s really important. But it’s not the whole picture. My observation is that plain language writing and web communications are essential for all audiences. Much health communication remains fairly high-level. I think there’s an assumption that well-educated people will feel insulted by information that is too “simple.”  But, health literacy is not the same as literacy overall. Busy professionals typically have to sift through piles of information on a daily basis. How do you catch their attention when communicating something you want them to know or do? Moreover, any person faced with new or frightening medical news may find their ability to absorb new information nearing zero. You need to take those factors into account.  I believe health literacy is relevant for anyone who wants to communicate effectively with people at across the literacy spectrum.

What have been your top 2 or 3 resources in health literacy? The ones that I have used are Neilson Usability Testing. This is really useful because it explains how  testing draft materials with just 5 people can give enough information to make changes.  With limited budgets for formal focus group testing, it’s a good model.  I also really like Andy Goodman’s Why Bad Presentations Happen to Good Causes. And, I would also recommend the UC Berkeley Health Research for Action Health Communication Tips.  It provides the basics of putting together plain language communications.

What keeps you inspired?  Immunizations are in the news all of the time. What is most inspiring is the flip side of what is most frustrating:  It’s the challenge.  You see the need. You see that despite all of the scientific evidence that disproves the faulty claims, the misinformation continues to float around.  Dr. Paul Offit’s quote, “It is easy to scare. It is very hard to unscare” is so true.

Interview and blog by SurroundHealth blogger, Susan Eno Collins, MS, CHES, RD.  Susan is a Community Leader of SurroundHealth — a social network where health professionals from different backgrounds come together to learn from one another’s expertise and to share knowledge and resources.  Membership is free. Members of SurroundHealth share a passion for improving the health and well-being of communities and individuals.  We focus on a wide range of health issues such as health literacy, cultural humility, and behavior change strategies. 


About Susan Collins, MS, CHES, RD, SurroundHealth Blogger

I am Community Leader for SurroundHealth (, a social network where health professionals from different backgrounds come together to learn from one another's expertise and to share knowledge and resources. We share a passion for improving the health and well-being of communities and individuals. I am also a registered dietitian and certified health education specialist.
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