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Consumer Education Initiatives in Financial and Health Literacy Task 4: Deliverable 4, Final Report

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Consumer Education Initiatives in Financial and Health Literacy Task 4: Deliverable 4, Final Report Consumer Education Initiatives in Financial and Health Literacy Task 4: Deliverable 4, Final Report December 6, 2010 Submitted To: Office of the Assistant Secretary for Planning and Evaluation U.S. Department of Health and Human Services Alana Landey and Gretchen Lehman, Project Officers Submitted From: American Institutes for Research Elizabeth Frentzel Deepa Ganachari Megan Bookhout Marilyn Moon Julia Galdo Sandra Robinson . Consumer Education Initiatives in Financial and Health Literacy: Final Report Contents EXECUTIVE SUMMARY ......................................................................................................... II Lessons Learned Relating to Target Audiences........................................................................ ii Lessons Learned Relating to Disseminating Information........................................................iii Lessons Learned Relating To the Source of the Initiative....................................................... iv Next Steps ................................................................................................................................iv 1.0 INTRODUCTION................................................................................................................ 1 Terms and Definitions............................................................................................................... 2 2.0 POLICY CONTEXT ........................................................................................................... 2 Financial Literacy ..................................................................................................................... 4 Health Literacy.......................................................................................................................... 6 3.0 METHODOLOGY .............................................................................................................. 9 Scope......................................................................................................................................... 9 Literature Review...................................................................................................................... 9 Peer‐Reviewed Literature..............................................................................................................................10 Gray Literature ..............................................................................................................................................11 Data Abstraction and Analysis.......................................................................................................................11 Limitations to the Literature Review Methodology ......................................................................................11 Key Informant Interviews....................................................................................................... 11 Limitations to the Interview Methodology ...................................................................................................13 4.0 FINDINGS FROM THE LITERATURE........................................................................ 13 Financial Literacy Research Overview................................................................................... 13 Health Literacy Research Overview ....................................................................................... 14 Lessons Learned Relating to the Target Audiences................................................................ 15 Lessons Learned Relating to the Channels of Information..................................................... 20 Lessons Learned Relating to the Source of the Initiative ....................................................... 24 Identification of Challenges and Limitations.......................................................................... 26 5.0 FINDINGS FROM THE INTERVIEWS ........................................................................ 27 Characteristics of Financial and Health Literacy Initiatives................................................... 27 Interview Sources..........................................................................................................................................28 Initiative Goals...............................................................................................................................................28 Target Audiences...........................................................................................................................................29 Channels........................................................................................................................................................31 Content..........................................................................................................................................................34 Collaboration.................................................................................................................................................35 Evaluation......................................................................................................................................................36 i Consumer Education Initiatives in Financial and Health Literacy: Final Report Lessons Learned From the Interviews .................................................................................... 41 Promising Elements from Financial Literacy Initiatives Applicable to Health Literacy..................................41 Promising Elements from Health Literacy Initiatives Applicable to Financial Literacy..................................43 Lessons Learned Applicable to Both Financial and Health Literacy ..............................................................47 Limitations to Findings from the Interviews .......................................................................... 53 6.0 NEXT STEPS ..................................................................................................................... 54 Implications for Future Initiatives .......................................................................................... 54 Opportunities to Synchronize Initiatives across Agencies and Initiatives.............................. 57 REFERENCES............................................................................................................................ 59 Appendices Appendix A: Literature Review Methodology and Sources Appendix B: Interview Protocol and Information Sheet Appendix C: Literature Review Results Appendix D: Description of Consumer Education Initiatives ii Consumer Education Initiatives in Financial and Health Literacy: Executive Summary Executive Summary Consumer education regarding financial and health decision making has been an important issue for many years. In a concerted effort to develop successful consumer education programs, the Office of the Assistant Secretary for Planning and Evaluation (ASPE), Department of Health and Human Services (HHS), commissioned the American Institutes for Research (AIR) to conduct an environmental scan to provide a synthesis of the research, develop lessons learned from financial and health literacy, and identify future next steps. This environmental scan focused on financial and/or health literacy initiatives for low-income or underserved consumers. We define financial literacy as the ability to make informed judgments and manage money effectively (U.S. Government Accounting Office [GAO], 2006). Health literacy is the ability to obtain, process, and understand basic health information to make appropriate health-related decisions (HHS, 2000). Initiative is any effort or program that seeks to educate individuals about financial or health issues and, more importantly, to engage individuals to improve their skills and behaviors relating to finances and health. AIR conducted a review of literature from 2005 through 2010 and conducted interviews with program officials from Federal agencies and private organizations to develop key findings and lessons learned. The lessons learned below are categorized around those related to target audiences, channels of information, and sources for information. Lessons Learned Relating to Target Audiences Better long-term financial and health outcomes are associated with highly targeted and proactive counseling. Both the research and the interviews suggested that highly targeted or individually tailored counseling or interventions increases the likelihood an individual would become aware of the information, find it relevant, use it, and perform a specific and desired behavior. Theoretical frameworks were sometimes used to understand the knowledge, attitudes, and beliefs of consumers and develop information or an initiative specific to the audience. Both the interviews and the literature suggested customizing the information to specific target populations, such as new immigrants, or even tailoring it at the individual level and that the information should be relevant to the situation. Seemingly, conversely, the interviews suggested that materials developed for low-income or low-health literacy audiences may benefit those with higher incomes or health literacy levels, thus developing interventions with low-income and low- health literacy audiences specifically may be the most efficient approach. However, this is not to say that interventions should not be customized to a specific audience, the intervention should be simple to understand,
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