Health Literacy

Define health literacy.

The ability to obtain, process, and understand basic health information to make appropriate health decisions.

Define personal health literacy.

The degree to which individuals can find, understand, and use health information and services for health decisions.

Define organizational health literacy.

The degree to which organizations equitably enable individuals to find, understand, and use health information and services.

What does Weiss (2009) emphasize about patient rights?

Patients have the right to understand health information in simple, clear language. “Providers have a duty to provide information in simple, clear and plain language…”

Why is health literacy important for OT?

OTs must ensure patients understand their role in rehab and can follow home programs.

List the four skills included in health literacy.

Reading, verbal comprehension, numeracy, analyzing information.

Why are health literacy skills considered dynamic?

They change with age, health, education, culture, and prior experience.

What percentage of Americans cannot read basic text according to NAAL?

14%.

List the four NAAL literacy levels.

Proficient, Intermediate, Basic, Below Basic.

What does “Proficient” literacy mean in NAAL?

Ability to understand complex text and numeric information.

What does “Intermediate” literacy mean in NAAL?

Can read medication labels and determine correct dosages.

What does “Basic” literacy mean in NAAL?

Can read simple pamphlets and newspapers.

What does “Below Basic” literacy mean in NAAL?

Can read only short, simple instructions.

What trend did PIAAC show from 2017–2023?

U.S. adult literacy and numeracy scores decreased.

List populations at higher risk for low health literacy.

Older adults, low income, low education, English-language learners, people in poverty.

Why can’t clinicians identify low health literacy by appearance?

Because literacy level is not visually observable.

List three consequences of low health literacy.

Poorer health outcomes, less preventive care, higher healthcare costs.

What is the OT’s responsibility regarding patient comprehension?

Match communication to the patient’s level of understanding.

Why is written material important in OT?

Patients rely on written home programs to manage their conditions.

What is a red flag for low health literacy related to reading?

“I forgot my glasses” when asked to read a handout.

What is a red flag related to medication management?

Identifying pills by color/shape instead of label information.

What is a red flag related to appointments?

Missing appointments or arriving on the wrong day.

What is a red flag related to diagnosis understanding?

Inability to explain their diagnosis or reason for surgery.

What is a red flag related to home programs?

Inability to demonstrate exercises or apply splints correctly.

What is the REALM assessment?

A word-recognition health literacy test (66 words; 2–5 minutes).

What is the TOFHLA?

A test of functional health literacy using prose and numeracy tasks.

What is the Chew screening question used for?

Identifying inadequate health literacy through self-report.

What is the Newest Vital Sign (NVS)?

A 3-minute screening using a nutrition label to assess literacy and numeracy.

What NVS score indicates high likelihood of limited literacy?

0–1 correct.

What NVS score indicates possible limited literacy?

2–3 correct.

What NVS score indicates adequate literacy?

4–6 correct.

What is the SAHL?

A word-recognition test pairing words with related meanings (18 items).

List two newer health literacy assessments.

BRIEF (BHLS) and Short Form Health Literacy Questionnaire (12 items).

Why might patients struggle to communicate?

Fear, embarrassment, illness, or confusion about diagnosis.

What should clinicians do if a patient is too ill to participate?

Reassure them and return later; ensure they can contact you.

Why should clinicians encourage questions?

To reduce fear and improve understanding.

Why should clinicians avoid medical jargon?

Plain language improves comprehension.

Why limit talking points to three?

Patients retain information better when it is chunked.

Why use pictures or drawings?

Visuals improve understanding and recall.

What is the purpose of the teach-back technique?

To confirm patient understanding by having them restate information.

List three key elements of teach-back.

Caring tone, eye contact, plain language.

Why avoid yes/no questions in teach-back?

They do not confirm true understanding.

What should clinicians do if teach-back is incorrect?

Re-explain and re-check understanding.

What should be documented about teach-back?

The patient’s response and comprehension.

Why is readability important for written materials?

Most patient materials are written above the average reading level.

What readability tool is available in Microsoft Word?

Flesch-Kincaid readability statistics.

What reading level should patient materials target?

6th grade or below.

What font size and type are recommended for readability?

14-point serif font (e.g., Times New Roman).

Why include white space in written materials?

Improves readability and reduces cognitive load.

Why use headings and short paragraphs?

They help patients navigate information easily.

Why include reputable resources in written materials?

To guide patients to accurate information.

What is digital health literacy?

Ability to find, evaluate, and use online health information.

List three criteria for evaluating online content.

Content, currency, accuracy.

What does “content” refer to in website evaluation?

Author credibility and organizational affiliation.

What does “currency” refer to in website evaluation?

How recently the site was updated.

What does “accuracy” refer to in website evaluation?

Presence of references, editing, and factual information.

What does “fact-based” mean in evaluating websites?

Information is straightforward and free of advertising.

What is the purpose of the AHRQ Health Literacy Universal Precautions Toolkit?

To help practices simplify care and improve patient understanding.

List the first five attributes of a health-literate organization.

Leadership prioritizes HL; conduct assessments; train staff; seek patient input; use universal precautions.

List the last five attributes of a health-literate organization.

Use clear communication; design accessible systems; create easy-to-read materials; address medication management; explain costs clearly.