CTSI forum explores impacts of language, messaging, AI on health literacy

How can researchers modify their everyday language to better reach different audiences? Do recruitment approaches need to change based on geography? How do stories impact understanding? Does format and messaging matter? And does artificial intelligence (AI) have a role in health literacy?

These questions were among those discussed during the featured panel discussion at the UB Clinical and Translational Science Institute’s (CTSI) Annual Forum held on March 15 at the Clinical and Translational Research Center on the Buffalo Niagara Medical Campus.

Here is a brief recap of the discussion.

Kelly Wofford, director of the Health Equity Office, Erie County Department of Health, began the discussion with a presentation titled “Health Literacy as a Social Determinant of Health.” Wofford touched on her own experiences navigating the health care system while also describing the process of creating Health Equity Office newsletters in multiple languages.

“When it comes to medicine and using plain language, and using words that make sense, I want to figure out how you make that transition from [what we use] every day to [what we use for] research and medicine,” she said. Wofford stressed that researchers should aim to eliminate misunderstandings even in professional settings.

“We get caught up in who we are and what we do,” she explained. “Are we using the most common denominator language when it comes to outreach, when it comes to education?”

Next was Veronica Meadows-Ray, research team member and participant, National Witness Project, Buffalo, with “Communicating With Researchers and Research Participants.” Meadows-Ray explained that the responses she received regarding the participation of African American women in research varied depending on location. For example, she found greater interest in direct participation in the southern United States.

“You want to be successful in other places? You have got to get your research introduced by the right people. I am talking churches, sororities, fraternities … You need to have the right person to [vouch for] your research.”

Meadows-Ray also touched on the value of encouraging young people to pursue careers in medicine: “These kids are good readers, good students in math, [but] they do not even know they could be doctors and researchers.”

“Storytelling and Health Communication” was the title of a presentation from Melanie Green, professor and chair of the Department of Communication, College of Arts and Sciences. Green stressed that one of the great challenges for researchers is getting people to pay attention in a “crowded media environment.” Stories, she explained, are a way to draw in audiences.

“In our research, we have used things like comic books and live theater,” Green said. “Stories can help us overcome a variety of different health communication challenges that we might have.”

Green shared examples that showed the importance of “formative research” — in other words, testing stories with people from the audience you are trying to reach. “Don’t make guesses,” she stated. “Don’t assume that your research team knows what’s best.”

Liise K. Kayler, program director, Kidney and Pancreas Transplantation, chief of the Division of Transplant Surgery and research professor of surgery, Jacobs School of Medicine and Biomedical Sciences, was next with “Video-based Education and Mobile Communication.” Five years ago, Kayler decided to try animated videos as an educational intervention to improve the rate of kidney transplantation.

“I thought, ‘I’m the expert on this topic. I should easily be able to make short videos about these subjects.’ But I quickly realized that my expertise was a handicap, and that if I was going to be successful, I would have to try to understand what is going on in my patients’ minds and use their words to speak to them.”

After creating 26 short videos — all featuring input from patients, donors and caregivers — Kayler has many lessons to share, including the importance of choosing the right narrator, how to keep the tone positive and that there is “no amount of imagery that is going to overcome a bad script.”

The final presenter, Jinjun Xiong, SUNY Empire Innovation Professor of Computer Science and Engineering, School of Engineering and Applied Sciences, tackled AI with a provocative presentation titled “Does AI Have a Role in Health Literacy?”

Xiong demonstrated an example that posed “define health literacy” to a ChatGPT and how modifying the questions posed to ChatGPT can impact the reading level of its responses. In addition, Xiong showed how AI can create 3D models that can take a static image and literally “put it in the hands of the patient.”

One of the challenges with ChatGPT, Xiong said, is an inconsistency in responses. "AI can do some very powerful things,” he said. “[But] how do you make sure your answers are consistent? When you communicate with a patient, you do not want the doctor to tell one thing today and the next day to come back and tell you a different story.” This means “you cannot blindly use it; maybe use it with some caution.”

The 2023 forum also featured a “State of the CTSI” talk from CTSI Director Timothy F. Murphy, SUNY Distinguished Professor; a presentation from Erica Rosemond, acting deputy (division) director, branch chief and acting section chief, Initiatives & Consortium-Wide Activities Section, Division of Clinical Innovation, National Center for Advancing Translational Sciences (NCATS), National Institutes of Health; and presentations of the 2023 Buffalo Translational Consortium Clinical Research Achievement Awards.