Health Literacy Systems Approach: Empowering Healthcare Practitioners Through Education




Wagner, Teresa
Carbajal-Diaz, Anissa
Linnear, Kim
Carlson, Erin


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Problem: Research indicates that limited health literacy can lead to adverse health outcomes due to patients’ inability to follow instructions regarding medications, labels and health messages especially in preventative care (Koh et al., 2012). Hypothesis: The Affordable Care Act (ACA) has mandated improved patient understanding of medical diagnoses through effective communication by providers. The purpose of this study was to determine if health literacy trainings can improve healthcare practitioners understanding and use of health literate communications. Materials and Methods: Context: Trainings were conducted at four healthcare organizations between December 18, 2013 and June 20, 2014. Site selection utilized a purposive convenience sample through community partner networking. Intervention/Instrument: Trainings engaged participants utilizing a variety of mediums to build capacity towards health-literate practices using the Health Literacy Universal Precautions Toolkit (HLUPT). Study Design: Knowledge levels of training participants were measured by a pre-test, post-test, and a follow-up survey consisting of closed-ended scaled items and open-ended items. Statistical Analysis: Univariate analyses offered descriptive statistics and bivariate analyses assessed mean score changes between pre- and post-tests both in SAS 12.1 using Wilcoxon Signed-Rank test (p = .001). NVivo software analysis of qualitative data assessed open-ended survey questions through coding and emergence of themes, sub-themes and frequency of response. Outcome Measures: Eighty-eight providers and staff members were trained at four healthcare entities. Eighty-eight pre- and post-test surveys and 29 follow-up surveys were collected with 37 pending. Results: Health literacy knowledge increased in 100% of participants and 75% increased knowledge in over half of the survey questions. Follow-up survey respondents demonstrated 100% retention of knowledge. Conclusions: The intervention showed that healthcare providers improved health literacy knowledge after a short, evidence-based training. The knowledge is retained at three months post-training. Future Implications: Despite knowledge increases, patient-centered care depends on improved health information and services. Longitudinal follow-up is needed on whether knowledge becomes integrated into clinical systems and improves compliance, patient outcomes and ultimately population health.