Create Effective Health Literacy Education Programs for Providers

Are you developing a health literacy education program for providers? 

Then this article is for you. It tells how to create an effective workshop, training, or class that teaches providers about health literacy.

We’ll review how to make a health literacy education program succeed.

We’ll also discuss how to structure a provider-facing program on health literacy.

What are some tips for making a health literacy education program succeed?

Let’s start by reviewing how to make a health literacy education program—for any audience—succeed.

Follow these tips:

• Provide accurate information.
• Use effective communication.

Tips for speaking and writing:

o   Use simple, everyday words.

o   Be friendly.

o   Be brief.

o   Give action steps.

o   Use examples and stories.

o   Organize information.

o   Introduce and summarize.

Tips for speaking:

o   Be kind.

o   Treat your listeners with respect.

o   Take it slow.

o   Invite questions.

Tips for writing:

o   Use short sentences and paragraphs.

o   Use lists.

o   Use headings and subheadings.

Tips for using body cues:

o   Be friendly.

o   Be a good listener.

Tips for design:

o   Make text easier to understand.

o   Make text easier to use.

o   Choose images wisely.

o   Use images wisely.

• Use a variety of learning methods.
• Use co-creation.
• Use a tailored approach. 

o   Identify your learners.

o   Identify your learners’ needs.

o   Address your learners’ needs.

• Use a systemic process.

(Note: To learn more about these tips, see Effective Health Literacy Education Programs.)

How should a provider-facing health literacy education program be structured?

We’ve reviewed how to make a health literacy education program succeed. Now let’s discuss how to structure a program that teaches providers key principles of health literacy.

Although there are many options, we’ll focus on a program with four parts:

1. Personal health literacy
2. Organizational health literacy
3. Plain language 
4. Teach-back

We’ll look at each of these parts in turn.

Part 1: Personal health literacy

In Part 1 of the program, teach learners about personal health literacy.

Define personal health literacy

First, tell learners what personal health literacy is. Healthy People 2030 defines it as “the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.”

State that personal health literacy affects health

Next, tell learners that personal health literacy is a social determinant of health (SDOH). SDOHs are factors in the environment that affect people’s health.

Compared to adults with adequate health literacy, adults with limited health literacy have:

• More serious medication errors.
• Higher rates of emergency room visits, hospitalizations, and death.
• Worse preventive care and health outcomes for their children.
  
  

State that limited personal health literacy is common

Also, tell learners how common personal health literacy is. Many of us have trouble finding, understanding, and using health information. According to the Centers for Disease Control and Prevention, “nine out of 10 adults struggle to understand and use health information when it is unfamiliar, complex, or jargon-filled.” According to the Agency for Healthcare Research and Quality, even strong health literacy skills can falter at times of stress — such as a health crisis.

State that limited personal health literacy is hard to spot

Finally, tell learners that limited personal health literacy is hard to spot. Providers can’t always tell when a patient has trouble finding, understanding, and using health information. According to the Agency for Healthcare Research and Quality, it’s hard to identify patients with limited health literacy.

Incorporate patient stories

To engage learners in this topic, incorporate the stories of patients who have been affected by limited health literacy. You can do this either in person or through videos.

Part 2: Organizational Health Literacy

In Part 2 of the program, teach learners about organizational health literacy.

Define organizational health literacy

First, tell learners what organizational health literacy is. Healthy People 2030 defines it as “the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.”

List the benefits of promoting organizational health literacy

Next, tell learners about the benefits of promoting organizational health literacy for patients, as well as for healthcare providers and organizations. Here are some of them:

• Better patient self-management = better health outcomes. Boosting organizational health literacy empowers patients to manage their health. For instance, clear labeling helps patients correctly measure their medicine doses. Better self-management, in turn, improves health outcomes, such as lowering the rate of deaths caused by heart problems.
• Better use of healthcare services = more efficient, less costly healthcare. At the same time, boosting organizational health literacy improves use of healthcare services. That is, it increases use of preventive care (such as getting flu shots), while decreasing avoidable hospitalizations and use of emergency care. This makes healthcare more efficient and less costly.
• Higher patient satisfaction. Boosting organizational health literacy also increases patient satisfaction. That is, it leads to higher scores on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS).
• Higher rewards for healthcare providers and organizations. Value-based programs (such as Medicare) reward healthcare providers and organizations for scoring well on such measures as health outcomes, patient safety, patient experience, efficiency, and cost. Better scores mean higher rewards.
• Fewer legal problems for healthcare providers and organizations. Finally, health literate healthcare providers and organizations are less likely to face legal problems, such as malpractice claims. That’s because they are better communicators.
  
  
  

State that effective communication in healthcare is a universal precaution

Finally, explain that effective communication in healthcare is a health literacy universal precaution. Since limited personal health literacy is common and hard to spot, providers should strive to communicate as well as possible every time, with every patient.

Parts 3 and 4 of the program outline key practices for effective communication in healthcare.

Part 3: Plain language

In Part 3 of the program, teach learners about plain language.

Define plain language

First, tell learners what plain language is. The Plain Language Action and Information Network defines it as “communication your audience can understand the first time they read or hear it.”

Tell how to use plain language

Next, tell learners how to use plain language:

• Use simple, everyday words.
• Avoid using unusual words, medical jargon, acronyms, and abbreviations. For instance, instead of saying “hyperglycemia,” you might say “high blood sugar.”
• If you must use a challenging word, tell patients what it means. 
• Use examples and stories to explain tough concepts. 
• If you use written materials, make sure these materials use plain language. 
  
  

Put plain language into action

Finally, give learners a chance to practice using plain language. Here are two possible activities.

Small-group work. Break learners into small groups. Give each group a list of words, phrases, and concepts that might confuse patients. Ask each group to brainstorm ways to explain them using plain language. Then bring the groups back together and discuss these ideas.

Large-group work. Write a list of words, phrases, and concepts that might confuse patients on a whiteboard. Then work with the whole group to brainstorm ways to explain them using plain language.

Part 4: Teach-back

In Part 4 of the program, teach learners about teach-back.

Define teach-back

First, tell learners what teach-back is. Teach-back:

• Is a communication approach used near the end of a health visit to go over key health information, like how to use an inhaler.
• Helps you make sure you communicated clearly.
• Is a test of you — not your patient.
  
  

Tell how to use teach-back

Next, tell learners how to use teach-back:

1. Explain the health information clearly. 
2. Check for understanding. Ask the patient to tell or show you what you said. For instance, you might say: “Using an inhaler has a few steps. I want to make sure I explained them clearly. Can you tell or show me what you’ll do first?” 
3. Explain the health information more clearly, if needed. 
   
   

Put teach-back into action

Finally, give learners a chance to practice using teach-back. Here are two possible activities.

Video. Watch and discuss the video “Teach-back in a Cardiology Practice.” The North Carolina Program on Health Literacy made this video to show how to use teach-back.

Role plays. Break learners into pairs. Ask each pair to choose a patient care situation, or assign them a situation. Then ask each pair to practice using teach-back. One person should play the patient, while the other plays the provider. Then ask them to switch roles.

Summary

We just went over how to create an effective provider-facing education program about health literacy. Here’s a quick recap.

How to make the program succeed

• Provide accurate information.
• Use effective communication.
• Use a variety of learning methods.
• Use co-creation.
• Use a tailored approach. 
• Use a systemic process.
  
  

How to structure the program

We discussed how to structure an education program that teaches providers key principles of health literacy.

Part 1: Personal health literacy

• Define personal health literacy.
• State that personal health literacy affects health.
• State that limited personal health literacy is common.
• State that limited personal health literacy is hard to spot.
• Incorporate patient stories.
  
  

Part 2: Organizational health literacy

• Define organizational health literacy.
• List the benefits of promoting organizational health literacy.
• State that effective communication in healthcare is a universal precaution.
  
  

Part 3: Plain language

• Define plain language.
• Tell how to use plain language.
• Put plain language into action.
  
  

Part 4: Teach-back

• Define teach-back.
• Tell how to use teach-back.
• Put teach-back into action.

We extend our sincere gratitude to Sophia Wong, for her invaluable peer review and expert feedback, which significantly contributed to the enhancement of this article.

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