Health Literacy Publications
Guiding Frameworks and Models | Articles, Papers and Reports
Guiding Frameworks and Models
AHRQ has contributed to the development of several guiding frameworks and models for how healthcare systems can address health literacy.
Ten Attributes of Health Literate Health Care Organizations
Health literate healthcare organizations make it easier for people to navigate, understand, and use information and services to take care of their health. The discussion paper, "Ten Attributes of Health Literate Health Care Organizations," describes what health systems must do to become health literate.
Learn about AHRQ tools that can help health systems address the 10 attributes of health literate healthcare organizations.
Listen to a podcast with Cindy Brach on the Attributes of Health Literate Organizations.
Health Literate Care Model
Improving health outcomes relies on patients' full engagement in prevention, decision-making, and self-management activities. Health systems that incorporate health literacy strategies into the Care Model (also known as the Chronic Care Model) make it easier for people to understand and act on available health information. The Health Literate Care Model explains how to tackle that integration. For each of the Care Model's elements, an updated "health-literate" version includes relevant tools from the AHRQ Health Literacy Universal Precautions Toolkit and maximizes the potential for system change. The Health Literate Care Model represents a practical systems framework for organizations that aspire to address all patients' health literacy challenges comprehensively, synergistically, and proactively.
Access the article, "A Proposed 'Health Literate Care Model' Would Constitute A Systems Approach To Improving Patients' Engagement In Care."
Visit an interactive graph of the Health Literate Care Model.
Moving Beyond the Cycle of Costly "Crisis Care"
Navigating the healthcare system is not just a challenge for those who have limited health literacy. Patients are regularly confronted with complicated, confusing forms and instructions. As a result, too many people are hospitalized after being given ambiguous instructions about medications or failing to recognize the symptoms of a worsening condition. A Health Affairs article depicts the costly cycle of "crisis care" and describes how health systems can break the cycle by addressing health literacy.
Access the article "New Federal policy initiatives to boost health literacy can help the Nation move beyond the cycle of costly 'crisis care'".
Listen to a podcast with Dr. Howard Koh, former Assistant Secretary for HHS, on Boosting Health Literacy To Move Beyond the Cycle of Costly Crisis Care.
Articles, Papers, and Reports
Peer-Reviewed Articles, Book Chapters, and Reports
AHRQ researchers have published the following articles and book chapters related to health literacy.
- Updating Health Literacy for Healthy People 2030: Defining Its Importance for a New Decade in Public Health (2021), and its associated infographic and podcast.
- Healthy People 2030 Health Literacy Definition Tells Organizations: Make Information and Services Easy to Find, Understand, and Use (2021)
- How the U.S. Agency for Healthcare Research and Quality Promotes Health Literate Health Care (2020)
- More Effort Is Needed To Ensure Patients Understand Doctors’ Instructions (2019 fact sheet [PDF, 753 KB])
- More Adults Report Always Being Asked To Teach Back Providers' Instructions (2019 infographic)
- A Model Partnership to Develop a Health Literate Care Curriculum: Preparing the Next Generation of Physicians to Deliver Excellent Outcomes and Patient Experiences (2019)
- Organizational Health Literacy: Quality Improvement Measures with Expert Consensus (2019)
- Health Literacy in the Inpatient Setting: Implications for Patient Care and Patient Safety
- Opportunities to Improve Informed Consent with AHRQ Training Modules (2018)
- Challenges Optimizing the After Visit Summary (2018)
- The Journey to Become a Health Literate Organization: A Snapshot of Health System Improvement (2017)
- Improving the Effectiveness of Medication Review: Guidance from the Health Literacy Universal Precautions Toolkit (2017)
- Health Literacy Universal Precautions Are Still a Distant Dream: Analysis of U.S. Data on Health Literate Practices (2017)
- Demonstration of the Health Literacy Universal Precautions Toolkit: Lessons for Quality Improvement (2016)
- How Hospitals Reengineer Their Discharge Processes to Reduce Readmissions (2016)
- Using the Health Literacy Universal Precautions Toolkit to Improve the Quality of Patient Materials (2016)
- Even in an Emergency, Doctors Must Make Informed Consent an Informed Choice (2016)
- Poor Oral Health Literacy: Why Nobody Understands You (2015)
- Identifying and Preventing Medical Errors in Patients With Limited English Proficiency: Key Findings and Tools for the Field (winner of the Journal for Healthcare Quality Impact Article of the Year award) (2014)
- A Daughter's Frustration With The Dearth Of Patient- And Family-Centered Care (2014)
- Physicians' Roles in Creating Health Literate Organizations: A Call to Action (2014)
- A Proposed 'Health Literate Care Model' Would Constitute a Systems Approach to Improving Patients' Engagement in Care (2013) (Also visit the interactive graphic of the Health Literate Care Model.)
- Toward a Systems Approach To Health Literacy Research (2013)
- Ten Attributes of Health Literate Health Care Organizations (2012)
- New Federal Policy Initiatives to Boost Health Literacy Can Help The Nation Move Beyond the Cycle of Costly 'Crisis Care' (2012)
- Improving Patient Safety Systems for Patients With Limited English Proficiency: A Guide for Hospitals (2012)
- Integrating Literacy, Culture, and Language to Improve Health Care Quality for Diverse Populations (2007)
You can also find AHRQ-funded studies on health literacy by searching AHRQ Research Studies.
Blogs
- Organizations Have an Opportunity to Enhance Health Literacy.
- Making Progress on Healthy People 2030 Health Literacy Objectives.
- Achieving Value in Health Care Through Health Literacy.
- Making Informed Consent An Informed Choice.
- Action Planning: Breaking Down Health Goals into Manageable Steps.
- The Imperative for Learning Health Systems to Address Health Literacy.
America's Health Literacy: Why We Need Accessible Health Information
This brief, America's Health Literacy: Why We Need Accessible Health Information (PDF), co-authored by researchers from AHRQ and the Office of Disease Prevention and Health Promotion, summarizes key findings and presents some policy implications of health literacy data from the National Assessment of Adult Literacy.
Health Literacy Interventions and Outcomes: A Systematic Review
The 2011 report, Health Literacy Interventions and Outcomes: A Systematic Review (PDF), is an update of a 2004 systematic review of research on healthcare service use and health outcomes related to differences in health literacy level and interventions designed to improve these outcomes for individuals with low health literacy.
Advances in Patient Safety
This AHRQ-published volume of government-sponsored patient safety research includes the following articles related to health literacy.
- Language, Literacy, and Communication Regarding Medication in an Anticoagulation Clinic: Are Pictures Better Than Words? (PDF)
- Preventing Medication Errors in Ambulatory Care: The Importance of Establishing Regimen Concordance (PDF)
- Speaking Plainly: Communicating the Patient's Role in Health Care Safety (PDF)