New Approaches for Overcoming Literacy Barriers

Did you know that one in two Americans can’t read above a 5th grade level, yet most health care materials are written above the 10th grade level?1 According to the U.S. Department of Health and Human Services, health literacy is the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.

Often it’s believed that health literacy only relates to individuals with a lower income. However, that’s not the case. Health literacy impacts everyone, regardless of race, income, cultural background, age or level of intelligence. It’s recommended by experts that people should assume that all people may have difficulty understanding their health care.

By using plain language to describe a patient’s condition and treatment, care for all patients can be improved. Communication skills, knowledge of medical topics, social and cultural practices, complexity of health care systems, and emotional impact of the situation affect patients’ care. Limited health literacy is associated with medication errors, increased health costs, and inadequate knowledge and care for chronic health conditions.

What is our community doing to remove the barriers?

In an effort to educate patients, medical practices, employers, and insurers on how to remove the barriers, Healthy York County Coalition and HealthyAdamsCounty formed health literacy task forces. In both counties, professionals meet each month to plan and implement efforts to improve health literacy practices.

In addition, through Aligning Forces for Quality – South Central PA and Highmark Blue Shield, the Health Literacy Learning Collaborative is offered to six primary care or specialty practices in Adams and York counties. As part of the responsibilities, the medical practices work with staff from the University of North Carolina and local task force members to implement three tools from the Health Literacy Universal Precautions Toolkit. The toolkit offers practices a way to structure their services and patient interactions, so any of their patients can understand the health information given, and ultimately, allow patients to make informed decisions about their care.

One of the tools implemented by each practice is the Teach-Back Method, which provides an opportunity for patients to repeat back to the doctor what they’ve heard in their own words. The patient continues to explain what’s been said by the doctor until it’s 100% clear for the patient. Another tool the practices are using is the Brown Bag Medication Review. Patients are asked to bring all of their medications in a brown bag to their appointment. The doctor and patient review what’s in the bag, discuss how to take the medication, and talk about why he or she should be taking it.

The practices are also required to assess the methods used, attend meetings to review the tactics being used, share outcomes and challenges with other practices, as well as other items.

The Health Literacy Learning Collaborative is one of the many things being done to improve health literacy in Adams & York counties, and health care providers are encouraged to join the collaborative.  It’s an opportunity to get the entire practice involved because it’s not only the doctors and patients who communicate information, but the entire staff. Doctors, nurses and other members of the health care team need to be aware that culture, educational level and language impact patients’ abilities to follow instructions, or grasp what is being said. From the doctor’s appointment to handouts, each piece of communication needs to be explained in a way that every person can understand.

To become involved with the Health Literacy Learning Collaborative, contact Robin Rohrbaugh at or (717) 851-2333, or Kathy Gaskin at (717) 337-4137.



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