Making Progress on Healthy People 2030 Health Literacy Objectives

“Research clearly shows that when patients communicate effectively with their healthcare team, clinical care and outcomes improve,” AHRQ Acting Director David Meyers recently noted. Everyone—no matter how educated—appreciates and can benefit from clear communication. Yet the complexity of health information and our healthcare system challenges people from all walks of life, impeding their ability to prevent and manage disease.

Improving health literacy is a goal in the United States and around the world. The World Health Organization emphasizes the crucial role of health literacy to achieve its 2030 Agenda for Sustainable Development. In the United States, health literacy is a foundational principle and overarching goal of Healthy People 2030, which established three core objectives for improving organizational health literacy.

This month—Health Literacy Month—is an excellent time to reflect on how we can make progress on the Nation’s health literacy objectives to improve health and well-being over the next decade. AHRQ is encouraging healthcare organizations to adopt health literacy strategies that will move three objectives forward and has developed resources that will help them.

Health Literacy Objective 1: Increase the proportion of adults whose healthcare provider checked their understanding

People often leave their provider’s office without understanding what they’ve been told or with unanswered questions. Healthcare providers can help the U.S. reach its goal for the first objective by using the teach-back or show-me methods of confirming understanding. Asking people to “teach-back” in their own words, or to show via a demonstration (e.g., how they’ll take their medicine) is the only reliable way to ascertain that you have been communicating effectively. Healthcare delivery organizations can promote teach-back by training staff in the method and re-enforcing and evaluating its implementation.

Health Literacy Objective 2: Decrease the proportion of adults who report poor communication with their healthcare provider

Organizations can help the country advance this objective with both training and system changes. Teaching providers to listen, be respectful, and use easy-to-understand language is an important first step.  Training alone, however, is not sufficient to institutionalize behavior change. Organizations need to supplement training with system-level supports, such as tracking training completion, providing booster training, using team members effectively, scheduling sufficient time for good communication, providing simple educational materials, and holding providers accountable for clear communication.

Health Literacy Objective 3: Increase the proportion of adults whose healthcare providers involved them in decisions as much as they wanted

The third health literacy objective fosters providers and patients making healthcare decisions together. Addressing health literacy is a prerequisite to achieving shared decision making since people need to be able to access, understand, and use health information before they can participate in decisions. Furthermore, while some people may prefer their providers to make medical decisions for them, people may be more likely to want to participate in decisions when they understand all the options, their benefits, harms, and risks.

AHRQ Resources

AHRQ has many resources to help organizations become more health literate. These include the following:

• The AHRQ Health Literacy Universal Precautions Toolkit—short, action-oriented tools to ensure that systems are in place to promote better understanding by all patients.
• The SHARE Approach Workshop Curriculum—training  healthcare professionals on how to engage patients in their healthcare decision making.
• The Toolkit for Engaging Patients to Improve Diagnostic Safety—encouraging patients and families to tell their stories and providers to listen.
• The Question Builder—lets people create a list of questions that they can take to medical appointments.

This month HHS and AHRQ announced that the Question Builder App is now also available as a Spanish language App. Called a “game changer” by Health and Human Services Secretary Xavier Becerra, the App can improve healthcare decision making for Spanish-speaking patients.

All organizations that produce health information or deliver healthcare services can improve communication by adopting health literacy strategies. Check out AHRQ’s health literacy improvement tools and training, and help the U.S. reach its Healthy People 2030 health literacy objectives.

Cindy Brach is a senior healthcare researcher in AHRQ’s Center for Evidence and Practice Improvement. She leads the AHRQ Health Literacy Workgroup and co-chairs the HHS Health Literacy Workgroup.

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