Q&A: Addressing health literacy

Q: How do I identify patients with health literacy problems, and what can I do to best assist them?

A: There are some red flags to look out for when identifying patients with health literacy problems. Patients who struggle with health literacy may demonstrate one or more of the following: 

• Do not know the names of their medications or why they are prescribed
• Are passive in clinical settings and rarely ask questions
• Have difficulty completing medical forms
• Experience problems navigating and completing diagnostic tests, procedures, medication refills, and/or consultation processes

When working to improve health literacy, consider the following interventions: 

• Improve communication by the use of plain language and active listening. Repeat the patient’s questions and concerns back to them to ensure you understood the patient.
• Use of plain language. For example, instead of saying “your weight is stable,” rephrase to “your weight is 225 pounds; that is 30 pounds above your expected weight for your height.”
• Use of concrete and specific phrases. For example, “to prepare for your test in the morning, do not eat anything after midnight tonight. You may drink a half glass of water only at 6 a.m. with your blood pressure medicine.”
• Use multiple forms of communication: written, oral, visual. For example, “I have written your new doctor’s name, phone number, and address on this sheet. I have also attached driving directions and a picture of the medical office building.”
• Confirmation of patient’s comprehension (teach back). For example, “I have given you all the information about your new doctor, your appointment, and his office location. Can you please repeat this back to me so I am certain I was clear in my communication with you?”
• Elicit patient questions (sit). Pull up a chair even if you only have five minutes. The patient feels much better if you take the time to sit and look the patient in the eye. This establishes a relationship rather than a passing off of information.
   

For more information, see Case Management Guide to Population Health: Management Across the Continuum of Care.

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