With a doctorate degree in social policy and master’s degrees in social work, public health, and learning sciences, it’s no surprise that Michael S. Wolf, PhD, MPH, MA, associate professor of medicine and associate division chief, research in the Feinberg School of Medicine Division of General Internal Medicine, and associate professor of learning sciences in the Northwestern University School of Education and Policy, focuses his research efforts in areas such as health literacy, adult learning, health promotion, and medication safety.
Wolf, also member of the Robert H. Lurie Comprehensive Cancer Center, serves as director of the medical school’s Health Literacy and Learning Program, is on the editorial board of Patient Education and Counseling, and is a reviewer of numerous professional journals, including American Journal of Public Health, Journal of the American Medical Association, and Social Science and Medicine. Wolf is also an active contributor to national organizations such as the Food and Drug Administration, Joint Commission, and Agency for Healthcare Research and Quality.
He will be soon continue his work from the University of Liverpool, as he was recently awarded a prestigious J. William Fulbright Foreign Scholarship that grants him the opportunity to move abroad and collaborate with investigators from academic and public health institutions across the United Kingdom.
What are your research interests?
Our program studies learning in the context of healthcare, which requires a focus on individual abilities and health system demands. We conduct cognitive epidemiological research investigating the skills one must possess to promote, protect, and manage health. This line of inquiry is at the heart of the emerging field of “health literacy” research, defined as an individual’s capacity to obtain, process, and understand health information and make informed decisions.
Likewise, several of our funded projects attempt to simplify the user-interface of healthcare. Working with colleagues from Cornell, Emory, Harvard, and Louisiana State, I lead a clinical trial testing a universal medication schedule to standardize how prescription drug label instructions are written. We believe that clearer, explicit guidance on how to use medicine can improve a patient’s ability to consolidate and self-administer complex drug regimens.
Similarly, we have leveraged the electronic health record to impart clinic protocols that engage patients in providing more complete medication lists, standardizing prescribing practices of physicians, and generating plain language print information for patients newly prescribed medicines that explain its safe use.
In yet another clinical trial, we are testing how best to implement a low-literacy, diabetes self-management strategy in safety net clinics.
What research projects are you currently pursuing?
The health literacy field has mostly addressed the health implications of poor reading and numeracy skills. Along with my colleague Stacy Cooper Bailey, our program is now extending our work to address language barriers as well. We just received a research grant from the Agency for Healthcare Research and Quality (AHRQ) to address better drug labeling for Spanish-speaking, diabetic patients. The California Endowment also funded our program to translate a standard set of prescription instructions and precautions for pharmacy practice in Russian, Chinese, Korean, Vietnamese, and Spanish.
The most challenging research project I lead to date is referred to as LitCog, funded by the National Institute on Aging. We are recruiting 1,100 older adults from Northwestern and community-based practices and administering a comprehensive cognitive battery, while also having them perform numerous common health tasks (e.g., dose out multiple drug regimens, read health forms, recall information from a medical encounter, learn from a health education video, navigate a web site, etc.). Improving our understanding of what the actual health literacy barriers are will better inform future interventions aimed at restructuring health tasks, as well as better identify those who may be at greater risk for poor self-management.
We recently requested further NIH support to track participants for the next five years as a cohort study, so we may examine how health literacy skills decline over time and explore ways to maintain self care skills.
What is the ultimate goal of your research?
I want to help patients and families understand their role and responsibilities in managing their health, while simultaneously reducing the unnecessary confusion within the healthcare system.
Our program reflects an applied research agenda with the potential to make direct impacts on personal health and healthcare in the foreseeable future. Whether our target is community health centers, pharmacies, schools, or primary care practices at Northwestern, the focus has always been on improving the accessibility of healthcare services to those most vulnerable and underserved.
What brought you to Northwestern?
I originally came here for the Institute for Healthcare Studies post-doctoral fellowship, where I was fortunate to meet wonderful faculty that helped to shape my current career. However, what kept me at Northwestern was a stroke of good fortune (that is, for me). One of my personal heroes early in my career happens to be my current division chief, David Baker. As I was prepping myself to be on the job market at the end of my fellowship, a colleague of mine at Emory introduced me to Dr. Baker via email, who at the time was senior faculty at Case Western in Cleveland. I drove out to meet him and to be considered for a faculty position there. I didn’t know he was coming to Northwestern when I interviewed, but once he contacted me with the news, I happily stayed and have never looked back.
What are some of the challenges you face?
In this line of research, there are challenges in every direction. Many of the past successes in health education and behavior interventions have demonstrated only short-term gains. Ironically, what is often most exciting about several of our active projects is what we are learning from the difficulties experienced during implementation. The objective is to best understand the root causes of failure, then identify the most sustainable manner to modify healthcare and promote patient compliance.