Roundtable on Health Literacy

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The National Academies Roundtable on Health Literacy, in collaboration with the HHS Office of Minority Health (OMH), hosted a workshop in April 2023 to explore the use of community health workers and youth ambassadors in promoting health literacy in their communities. Held in observation of National Minority Health Month, workshop discussions highlighted the effectiveness of including youth and young adults in community-based interventions, and lessons learned from implementing similar grant programs under the OMH Advancing Health Literacy to Enhance Equitable Community Responses to COVID-19 and the National Infrastructure for Mitigating the Impact of COVID-19 within Racial and Ethnic Minority Communities. This Proceedings of a Workshop-in Brief summarizes the discussions held during the workshop.

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11 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-70635-1
DOI: https://doi.org/10.17226/27146

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National Academies of Sciences, Engineering, and Medicine. 2023. Engaging Community Health Workers/Youth Ambassadors to Improve Health Literacy: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.

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The National Academies Roundtable on Health Literacy convened the first of three workshops to explore the positive impacts on health equity improved literacy practices in clinical settings can have. To relate and inspire confidence, physicians must communicate plainly and at the literacy level of the patient and recognize the knowledge the patient brings. Equality and equity are not the same, and treating every patient, their conditions, history, and identity, identically can interfere with trust. Diversifying the work force can facilitate better clinical practices that honor all patients. This Proceedings document summarizes workshop discussions.

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8 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-70034-5
DOI: https://doi.org/10.17226/26888

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National Academies of Sciences, Engineering, and Medicine. 2023. The Roles of Trust and Health Literacy in Achieving Health Equity: Clinical Settings: Proceedings of a Workshop-in Brief. Washington, DC: The National Academies Press.

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The National Academies Roundtable on Health Literacy convened the third of three workshops to address the themes of trust and positive health equity outcomes that arise from strategic community-based organization practices. Given the historical and current reasons individuals and communities with marginalized identities have to mistrust public health communications and institutions, health literacy is essential. To bolster mutual trust, hospitals, payers, providers, and public health professionals should have the cultural competence and humility to match the health literacy needed from their patients.This Proceedings document summarizes workshop discussions.

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10 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-70035-3
DOI: https://doi.org/10.17226/26889

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National Academies of Sciences, Engineering, and Medicine. 2023. The Roles of Trust and Health Literacy in Achieving Health Equity: Community Settings: Proceedings of a Workshop-in Brief. Washington, DC: The National Academies Press.

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The National Academies Roundtable on Health Literacy convened the second of three workshops, this one focusing on how health literacy best practices might affect trust in public health institutions at the state, local, tribal, and federal levels. The different contexts of trust include self-trust, trust within interpersonal relationships, trust within an organization, trust outside of an organization, and trust on a societal level, and public health institutions are reliant on trust on all of these levels to operate. This Proceedings document summarizes workshop discussions.

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8 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-70036-1
DOI: https://doi.org/10.17226/26890

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National Academies of Sciences, Engineering, and Medicine. 2023. The Roles of Trust and Health Literacy in Achieving Health Equity: Public Health Institutions: Proceedings of a Workshop-in Brief. Washington, DC: The National Academies Press.

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Clinical research is critical to developing new treatments and therapies for patients. To maximize societal benefit and health equity, it is important that clinical research information be accessible and inclusive, and participants should be representative of the patient population. To explore the role that patient comprehension of clinical research can have in delivering high-quality clinical care and in increasing the diversity of the populations enrolled in clinical research, the National Academies of Sciences, Engineering, and Medicine's Roundtable on Health Literacy held a virtual public workshop on October 28, 2021.

Workshop attendees discussed current and promising resources and approaches for ensuring that the public receives clinical research information in accessible language that promotes health literacy. They also discussed strategies for integrating clinical research information into various care and community settings to improve research awareness and engagement. This Proceedings of a Workshop-in Brief highlights the presentations and discussions of the workshop.

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12 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-29523-8
DOI: https://doi.org/10.17226/26506

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National Academies of Sciences, Engineering, and Medicine. 2022. Adoption of Health Literacy Best Practices to Enhance Clinical Research and Community Participation: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.

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The COVID-19 pandemic has led to a dramatic increase in health services being conducted by telephone or video. While this change may have important benefits to patients, such as increasing access to care, it may also pose challenges for those with low health literacy. To explore these challenges, as well as opportunities for increasing access to care, the National Academies of Sciences, Engineering, and Medicine's Roundtable on Health Literacy held a virtual public workshop on September 23, 2021. The workshop examined the experiences that individuals with low health literacy have with using virtual or telehealth services; best practices for ensuring that individuals with low health literacy are able to obtain, process, understand, and act upon health information and services provided virtually or through telehealth; and health system and provider strategies for ensuring the delivery of health literate virtual health services that benefit patients and practitioners alike. This Proceedings of a Workshop-in Brief highlights the presentations and discussions of the workshop.

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11 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-28715-4
DOI: https://doi.org/10.17226/26490

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National Academies of Sciences, Engineering, and Medicine. 2022. Providing Health Literate Virtual Health Services: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.

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The Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine held a virtual public workshop on January 27, 2021 on the role of critical health literacy in addressing the social determinants of health (SDOH), particularly among vulnerable populations. The SDOH are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.

The workshop examined the evolving concept of critical health literacy, which refers to health literacy skills that lead to empowerment of individuals, communities, and organizations to take action around the conditions that create or detract from health. Participants also explored how the concept of critical health literacy differs from the general concept of health literacy; how individuals and organizations use critical health literacy strategies to address the SDOH; and what research and implementation opportunities exist for critical health literacy as a tool to address the SDOH.

This publication summarizes the presentations and discussions from the workshop.

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13 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-68378-5
DOI: https://doi.org/10.17226/26214

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National Academies of Sciences, Engineering, and Medicine. 2021. Exploring the Role of Critical Health Literacy in Addressing the Social Determinants of Health: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.

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On July 29, 2020, the Roundtable on Health Literacy convened a public workshop to explore the challenges resulting from the proliferation of health and medical misinformation and disinformation, particularly as they relate to the COVID-19 pandemic. The workshop explored the role of fact-checking organizations and the technology industry in addressing misinformation and disinformation, the social psychology behind their spread, and health literacy strategies to support this ongoing multidisciplinary work. This publication highlights the presentation and discussion of the workshop.

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8 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-14385-3
DOI: https://doi.org/10.17226/26021

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National Academies of Sciences, Engineering, and Medicine. 2020. Addressing Health Misinformation with Health Literacy Strategies: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.

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Young people develop health literacy skills in a variety of environments, facing critical thinking challenges about their health from school, home and family life, peers and social life, and online. To explore the development of health literacy skills in youth, the Roundtable on Health Literacy convened a workshop on November 19, 2019, in Washington, DC. Presenters at the workshop discussed factors relating to health literacy skills and ways to further develop those skills among youth from early childhood to young adulthood. This publication summarizes the presentation and discussion of the workshop.

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114 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-68132-4
ISBN Ebook: 0-309-68133-2
DOI: https://doi.org/10.17226/25888

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National Academies of Sciences, Engineering, and Medicine. 2020. Developing Health Literacy Skills in Children and Youth: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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Because of the individualized nature of drug and therapeutic treatments, clinical trials require participants who represent the diversity of the patient base. If early trials do not have a broad patient base, it can be difficult to know who may or may not benefit from or respond to a treatment later. In addition to diversity in recruitment, informed consent during participation is also crucial. If participants do not fully understand what they are signing up for, they may become confused, mistrustful, or drop out of a trial altogether, confusing investigators and possibly affecting the generalizability of a study.

To explore the incorporation of health literacy practices into clinical trials, the Roundtable on Health Literacy convened a workshop titled Clinical Trials: Practice and Impact on April 11, 2019, in Washington, DC. The workshop presentations and discussion centered around issues related to the challenges or barriers for diverse populations' participation in clinical trials, best practices for clinical trial sites and researchers incorporating health literacy practices, and effective health literacy strategies for clear communication with participants. This publication summarizes the presentation and discussion of the workshop.

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120 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-49969-0
ISBN Ebook: 0-309-49970-4
DOI: https://doi.org/10.17226/25616

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National Academies of Sciences, Engineering, and Medicine. 2020. Health Literacy in Clinical Research: Practice and Impact: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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Oral health care and medical health care both seek to maintain and enhance human health and well-being. Yet, dentistry and primary care in the United States are largely separated and isolated from each other. Each has its own siloed systems for education, service delivery, financing, and policy oversight. The result has been duplication of effort, a cultural gap between the two professions, and lost opportunities for productive collaboration and better health.

On December 6, 2018, in Washington, DC, the National Academies of Sciences, Engineering, and Medicine held a workshop titled Integrating Oral and General Health Through Health Literacy Practices. This publication summarizes the presentations and discussions from the workshop.

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122 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-49348-X
ISBN Ebook: 0-309-49349-8
DOI: https://doi.org/10.17226/25468

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National Academies of Sciences, Engineering, and Medicine. 2019. Integrating Oral and General Health Through Health Literacy Practices: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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The field of health literacy has evolved from early efforts that focused on individuals to its current recognition that health literacy is a multidimensional team and system function. Health literacy includes system demands and complexities as well as individual skills and abilities. While communicating in a health-literate manner is truly important for everyone, it can be especially important for those with mental or behavioral health issues and for the systems and teams that interact with them and treat these individuals.

The purpose of the workshop, which was held on July 11, 2018, in Washington, DC, was to explore issues associated with effective communication with individuals with mental or behavioral health issues and to identify ways in which health literacy approaches can facilitate communication. In particular, the workshop aimed to gain a better understanding of how behavioral health and mental health concerns can adversely affect communications between providers and patients and their families. This publication summarizes the presentations and discussions from the workshop.

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96 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-48530-4
ISBN Ebook: 0-309-48531-2
DOI: https://doi.org/10.17226/25278

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National Academies of Sciences, Engineering, and Medicine. 2019. The Intersection of Behavioral Health, Mental Health, and Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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Adults age 65 and older make up the fastest-growing segment of the U.S. population. At the same time, the complexity of health care delivery continues to grow, creating challenges that are magnified for older adults, given that age is one of the highest correlates of low health literacy. This creates a shared obligation between health care and the health care team to use the principles, tools, and practices of health literacy so that patients and families of older adults can more easily navigate discussions related to chronic disease, polypharmacy, long-term care, palliative care, insurance complexities, the social determinants of health, and other factors that create challenges for older adults, particularly among underserved populations nationwide.

To gain a better understanding of the health communication challenges among older adults and their professional and family caregivers and how those challenges affect the care older adults receive, the National Academies of Sciences, Engineering, and Medicine's Roundtable on Health Literacy convened a 1-day public workshop featuring presentations and discussions that examined the effect of low health literacy on the health of older adults. This publication summarizes the presentations and discussions from the workshop.

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102 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-47946-0
ISBN Ebook: 0-309-47947-9
DOI: https://doi.org/10.17226/25188

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National Academies of Sciences, Engineering, and Medicine. 2018. Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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The field of health literacy has evolved from one focused on individuals to one that recognizes that health literacy is multidimensional. While communicating in a health literate manner is important for everyone, it is particularly important when communicating with those with limited health literacy who also experience more serious medication errors, higher rates of hospitalization and use of the emergency room, poor health outcomes, and increased mortality. Over the past decade, research has shown that health literacy interventions can significantly impact various areas including health care costs, outcomes, and health disparities.

To understand the extent to which health literacy has been shown to be effective at contributing to the Quadruple Aim of improving the health of communities, providing better care, providing affordable care, and improving the experience of the health care team, the National Academies of Sciences, Engineering, and Medicine convened a public workshop on building the case for health literacy. This publication summarizes the presentations and discussions from the workshop, and highlights important lessons about the role of health literacy in meeting the Quadruple Aim, case studies of organizations that have adopted health literacy, and discussions among the different stakeholders involved in making the case for health literacy.

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170 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-47429-9
ISBN Ebook: 0-309-47430-2
DOI: https://doi.org/10.17226/25068

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National Academies of Sciences, Engineering, and Medicine. 2018. Building the Case for Health Literacy: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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In its landmark report, Health Literacy: A Prescription to End Confusion, the Institute of Medicine noted that there are 90 million adults in the United States with limited health literacy who cannot fully benefit from what the health and health care systems have to offer. Since the release of that report, health literacy has become a vibrant research field that has developed and disseminated a wide range of tools and practices that have helped organizations, ranging in size from large health care systems to individual health care providers and pharmacists, to engage in health literate discussions with and provide health literate materials for patients and family members. Improving the health literacy of organizations can be an important component of addressing the social determinants of health and achieving the triple aim of improving the patient experience, improving the health of populations, and reducing the cost of care. However, the focus on organizations does not address the larger issue of how to improve health literacy across the U.S. population.

To get a better understanding of the state of community-based health literacy interventions, the Roundtable on Health Literacy hosted a workshop on July 19, 2017 on community-based health literacy interventions. It featured examples of community-based health literacy programs, discussions on how to evaluate such programs, and the actions the field can take to embrace this larger view of health literacy. This publication summarizes the presentations and discussions from the workshop.

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244 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-46667-9
ISBN Ebook: 0-309-46668-7
DOI: https://doi.org/10.17226/24917

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National Academies of Sciences, Engineering, and Medicine. 2018. Community-Based Health Literacy Interventions: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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Health literacy, cultural competence, and language access services are distinct but inextricably linked concepts for delivering equitable care to all members of the increasingly diverse population of the United States. These concepts are linked, but they developed via different paths, and each has its own unique focus with regard to enabling every individual to obtain the ability to process and understand basic health information and services needed to make appropriate health care decisions. Fragmentation of these disciplines has impeded implementation of relevant measures for quality improvement and accountability.

To foster an integrated approach to health literacy, cultural competency, and language access services, the Roundtable on Health Literacy initiated a project with three components: a commissioned paper to propose a framework for integrating measurements of health literacy, cultural competency, and language access; a workshop to review and discuss the framework; and a second commissioned paper that will provide a roadmap for integrating health literacy, cultural competency, and language access services as well as a revised measurement framework. Held on May 4, 2017, the workshop explored the quality performance measures for integration of health literacy, cultural competence, and language access services. This publication summarizes the presentations and discussions from the workshop.

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162 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-46672-5
ISBN Ebook: 0-309-46673-3
DOI: https://doi.org/10.17226/24918

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National Academies of Sciences, Engineering, and Medicine. 2018. A Proposed Framework for Integration of Quality Performance Measures for Health Literacy, Cultural Competence, and Language Access Services: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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The increasingly diverse ethnic composition of the United States population has created a profound and ongoing demographic shift, and public health and health care organizations face many challenges as they move to address and adapt to this change. To better understand how the public health and health care communities can meet the challenges of serving an increasingly diverse population, the Roundtable on Health Literacy conducted a public workshop on facilitating health communication with immigrant, refugee, and migrant populations through the use of health literate approaches. The goal of the workshop was to identify approaches that will enable organizations that serve these ethnically and culturally diverse populations in a manner that allows all members of these communities to obtain, process, and understand basic health information and the services needed to make appropriate health and personal decisions. This publication summarizes the presentations and discussions from the workshop.

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104 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-46340-8
ISBN Ebook: 0-309-46341-6
DOI: https://doi.org/10.17226/24845

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National Academies of Sciences, Engineering, and Medicine. 2017. Facilitating Health Communication with Immigrant, Refugee, and Migrant Populations Through the Use of Health Literacy and Community Engagement Strategies: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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Research conducted over the past two decades has shown that poor patient understanding of medication instructions is an important contributor to the more than 1 million medication errors and adverse drug events that lead to office and emergency room visits, hospitalizations, and even death. Patients who have limited literacy skills, who have multiple comorbidities, and who are elderly face the greatest risk, and limited literacy skills are significantly associated with inadequate understanding and use of prescription instructions and precautions. The Agency for Healthcare Research and Quality notes that only 12 percent of U.S. adults have proficient health literacy that allows them to interpret a prescription label correctly.

Given the importance of health literacy to the proper use of medications, and the apparent lack of progress in improving medication adherence, the Roundtable on Health Literacy formed an ad hoc committee to plan and conduct a 1-day public workshop that featured invited presentations and discussion of the role and challenges regarding clarity of communication on medication. Participants focused on using health literacy principles to address clarity of materials, decision aids, and other supportive tools and technologies regarding risks, benefits, alternatives, and health plan coverage. This publication summarizes the presentations and discussions from the workshop.

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124 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-46185-5
ISBN Ebook: 0-309-46186-3
DOI: https://doi.org/10.17226/24814

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National Academies of Sciences, Engineering, and Medicine. 2017. Communicating Clearly About Medicines: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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In March 2017, the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine convened a workshop focused on health communication with people from immigrant, refugee, and migrant worker populations. The workshop was organized to explore the application of health literacy insights to the issues and challenges associated with addressing the health of immigrants, refugees, and migrant workers. Participants explored issues of access and services for these populations as well as outreach and action. This publication summarizes the presentations and discussions from the workshop.

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7 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-46017-4
DOI: https://doi.org/10.17226/24796

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National Academies of Sciences, Engineering, and Medicine. 2017. Health Communication with Immigrants, Refugees, and Migrant Workers: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.

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On November 17, 2016, the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine convened a workshop on communicating clearly about medicines. The workshop focused on the clarity of written information given to patients and consumers as printed or digital materials. Participants explored the design of health-literate written materials and examples that illustrated implementation of research into the development of these materials. This publication summarizes the presentations and discussions from the workshop.

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7 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-45970-2
DOI: https://doi.org/10.17226/24785

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National Academies of Sciences, Engineering, and Medicine. 2017. Communicating Clearly About Medicines: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.

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Since the passage of the Patient Protection and Affordable Care Act (ACA), health care reform has created major changes in the U.S. health care system. The ACA has brought millions of people into the system who had no previous access, and many of these newly enrolled individuals have had limited experience navigating the complex and complicated U.S. health system.

In July 2016 the National Academies of Sciences, Engineering, and Medicine convened a public workshop to examine health insurance through the lens of health literacy, focusing on literacy related barriers to information and coverage as well as on possible solutions. Participants discussed the role of health literacy in accessing health care and remaining in treatment; delivery and financing system reforms that affect organizational health literacy; and quality and equity considerations. This publication summarizes the presentations and discussions from the workshop.

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128 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-45473-5
ISBN Ebook: 0-309-45474-3
DOI: https://doi.org/10.17226/24664

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National Academies of Sciences, Engineering, and Medicine. 2017. Health Insurance and Insights from Health Literacy: Helping Consumers Understand: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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On July 21, 2016, the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine convened a workshop on health literacy and health insurance literacy in the context of health reform in the United States. Since 2010, the year the Patient Protection and Affordable Care Act (ACA) became law, the roundtable has convened two workshops related to this topic as well as commissioned two papers, and several members have prepared individually written perspectives. The roundtable's attention to the topic of health insurance is appropriate because health reform has created major changes in the health care system in this country. It has brought millions of people into the system that previously did not have access. In addition, many of these individuals have limited experience with health care and health insurance and are from populations that traditionally have high rates of low health literacy. The workshop focused on the challenges and opportunities in helping consumers obtain, understand, and use health insurance.

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6 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-45236-8
DOI: https://doi.org/10.17226/24613

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National Academies of Sciences, Engineering, and Medicine. 2016. Health Insurance and Insights from Health Literacy: Helping Consumers Understand: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.

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On January 20, 2015, President Obama announced the Precision Medicine Initiative (PMI) in his State of the Union address. The PMI, by developing new approaches for detecting, measuring, and analyzing a wide range of biomedical information including molecular, genomic, cellular, clinical, behavioral, physiological, and environmental parameters, is intended to enable a new era of medicine in which researchers, providers, and patients work together to develop individualized care. Part of this effort included the creation of a national, large-scale research participant group, or cohort. The PMI Cohort Program is aimed at extending precision medicine to many diseases, including both rare and common diseases such as diabetes, heart disease, Alzheimer's disease, obesity, and mental illnesses such as depression, bipolar disorder, and schizophrenia, by building a national research cohort of 1 million or more U.S. participants.

An important challenge to assembling the PMI Cohort will be to reach individuals who are socioeconomically disadvantaged. Individuals who are socioeconomically disadvantaged have lower health literacy; often belong to racial, ethnic, and minority communities; and are often less likely to participate in research studies and biorepositories. To explore possible strategies and messaging designs, the Roundtable on Health Literacy formed an ad hoc committee charged with planning and conducting a 1-day public workshop on the intersection of health literacy and precision medicine. The workshop participants discussed a variety of topics including an overview of precision medicine and its potential, the relevance of health literacy to the success of precision medicine efforts, and perspectives and understanding of different groups, such as health care providers, consumers, and insurers. This publication summarizes the presentations and discussions from the workshop.

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124 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-44732-1
ISBN Ebook: 0-309-44733-X
DOI: https://doi.org/10.17226/23592

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National Academies of Sciences, Engineering, and Medicine. 2016. Relevance of Health Literacy to Precision Medicine: Proceedings of a Workshop. Washington, DC: The National Academies Press.

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On March 2, 2016, the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine convened a workshop to examine the relevance of health literacy to precision medicine, a growing field that takes into account individuals' differences in genes, environments, and lifestyles. The workshop explored the intersection of health literacy and precision medicine through a number of topics, but its impetus was the Precision Medicine Initiative (PMI). The PMI is a multiyear effort announced in 2015 and launched in 2016, led by the White House and including agencies across the federal government, to advance the practice of precision medicine. The information and viewpoints summarized in this Workshop in Brief reflect the knowledge and opinions of the workshop participants.

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Interactive Report Overview

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4 pages · 8.5 x 11 ·
ISBN Ebook: 0-309-44405-5
DOI: https://doi.org/10.17226/23538

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National Academies of Sciences, Engineering, and Medicine. 2016. Relevance of Health Literacy to Precision Medicine: Workshop in Brief. Washington, DC: The National Academies Press.

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The Institute of Medicine Roundtable on Health Literacy convened a 1-day public workshop to explore the relationship between palliative care and health literacy, and the importance of health literate communication in providing high-quality delivery of palliative care. Health Literacy and Palliative Care summarizes the discussions that occurred throughout the workshop and highlights the key lessons presented, practical strategies, and the needs and opportunities for improving health literacy in the United States.

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136 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-38036-7
ISBN Ebook: 0-309-38037-5
DOI: https://doi.org/10.17226/21839

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National Academies of Sciences, Engineering, and Medicine. 2016. Health Literacy and Palliative Care: Workshop Summary. Washington, DC: The National Academies Press.

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The proliferation of consumer-facing technology and personal health information technology has grown steadily over the past decade, and has certainly exploded over the past several years. Many people have embraced smartphones and wearable health-monitoring devices to track their fitness and personal health information. Providers have made it easier for patients and caregivers to access health records and communicate through online patient portals. However, the large volume of health-related information that these devices can generate and input into a health record can also lead to an increased amount of confusion on the part of users and caregivers.

The Institute of Medicine convened a workshop to explore health literate practices in health information technology and then provide and consider the ramifications of this rapidly growing field on the health literacy of users. Health Literacy and Consumer-Facing Technology summarizes the discussions and presentations from this workshop, highlighting the lessons presented, practical strategies, and the needs and opportunities for improving health literacy in consumer-facing technology.

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122 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-37690-4
ISBN Ebook: 0-309-37691-2
DOI: https://doi.org/10.17226/21781

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National Academies of Sciences, Engineering, and Medicine. 2015. Health Literacy and Consumer-Facing Technology: Workshop Summary. Washington, DC: The National Academies Press.

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In 2004, the Institute of Medicine released Health Literacy: A Prescription to End Confusion, a report on the then-underappreciated challenge of enabling patients to comprehend their condition and treatment, to make the best decisions for their care, and to take the right medications at the right time in the intended dose. That report documented the problems, origins, and consequences of the fact that tens of millions of U.S. adults are unable to read complex texts, including many health-related materials, and it proposed possible solutions to those problems.

To commemorate the anniversary of the release of the 2004 health literacy report, the Institute of Medicine's Roundtable on Health Literacy convened a 1-day public workshop to assess the progress made in the field of health literacy over the past decade, the current state of the field, and the future of health literacy at the local, national, and international levels. Health Literacy: Past, Present, and Future summarizes the presentation and discussion of the workshop.

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130 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-37154-6
ISBN Ebook: 0-309-37155-4
DOI: https://doi.org/10.17226/21714

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National Academies of Sciences, Engineering, and Medicine. 2015. Health Literacy: Past, Present, and Future: Workshop Summary. Washington, DC: The National Academies Press.

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Informed consent - the process of communication between a patient or research subject and a physician or researcher that results in the explicit agreement to undergo a specific medical intervention - is an ethical concept based on the principle that all patients and research subjects should understand and agree to the potential consequences of the clinical care they receive. Regulations that govern the attainment of informed consent for treatment and research are crucial to ensuring that medical care and research are conducted in an ethical manner and with the utmost respect for individual preferences and dignity. These regulations, however, often require - or are perceived to require - that informed consent documents and related materials contain language that is beyond the comprehension level of most patients and study participants.

To explore what actions can be taken to help close the gap between what is required in the informed consent process and communicating it in a health-literate and meaningful manner to individuals, the Institute of Medicine's Roundtable on Health Literacy convened a one-day public workshop featuring presentations and discussions that examine the implications of health literacy for informed consent for both research involving human subjects and treatment of patients. Topics covered in this workshop included an overview of the ethical imperative to gain informed consent from patients and research participants, a review of the current state and best practices for informed consent in research and treatment, the connection between poor informed consent processes and minority underrepresentation in research, new approaches to informed consent that reflect principles of health literacy, and the future of informed consent in the treatment and research settings. Informed Consent and Health Literacy is the summary of the presentations and discussion of the workshop.

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192 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-31727-4
ISBN Ebook: 0-309-31728-2
DOI: https://doi.org/10.17226/19019

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Institute of Medicine. 2015. Informed Consent and Health Literacy: Workshop Summary. Washington, DC: The National Academies Press.

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The Roundtable on Health Literacy brings together leaders from academia, industry, government, foundations, and associations and representatives of patient and consumer interests who work to improve health literacy. To achieve its mission, the roundtable discusses challenges facing health literacy practice and research and identifies approaches to promote health literacy through mechanisms and partnerships in both the public and private sectors.

To explore the aspects of health literacy that impact the ability of patients to understand and follow discharge instructions and to learn from examples of how discharge instructions can be written to improve patient understanding of-and hence compliance with-discharge instructions, the Roundtable on Health Literacy held a public workshop. The workshop featured presentations and discussions that examined the implications of health literacy for discharge instructions for both ambulatory and inpatient facilities. Facilitating Patient Understanding of Discharge Instructions summarizes the presentations and discussions of the workshop. This report gives an overview of the impact of discharge instructions on outcomes, and discusses the specifics of inpatient discharge summaries and outpatient after-visit summaries. The report also contains case studies illustrating different approaches to improving discharge instructions.

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76 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-30738-4
ISBN Ebook: 0-309-30739-2
DOI: https://doi.org/10.17226/18834

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Institute of Medicine. 2014. Facilitating Patient Understanding of Discharge Instructions: Workshop Summary. Washington, DC: The National Academies Press.

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Health literacy is the degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions. Nearly half of all American adults - 90 million people - have inadequate health literacy to navigate the health care system. Implications of Health Literacy for Public Health is the summary of a workshop convened by the Institute of Medicine Roundtable on Health Literacy in November 2013 that focused on the implications of health literacy for the mission and essential services of public health. The workshop featured the presentation of a commissioned paper on health literacy activities under way in public health organizations. Other presentations examined the implications of health literacy for the mission and essential services of public health, for example, community health and safety, disease prevention, disaster management, or health communication. This report includes the commissioned paper and summaries of the workshop presentations.

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176 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-30365-6
ISBN Ebook: 0-309-30366-4
DOI: https://doi.org/10.17226/18756

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Institute of Medicine. 2014. Implications of Health Literacy for Public Health: Workshop Summary. Washington, DC: The National Academies Press.

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Although health literacy is commonly defined as an individual trait, it does not depend on the skills of individuals alone. Health literacy is the product of the interaction between individuals' capacities and the health literacy-related demands and complexities of the health care system. Specifically, the ability to understand, evaluate, and use numbers is important to making informed health care choices.

Health Literacy and Numeracy is the summary of a workshop convened by The Institute of Medicine Roundtable on Health Literacy in July 2013 to discuss topics related to numeracy, including the effects of ill health on cognitive capacity, issues with communication of health information to the public, and communicating numeric information for decision making. This report includes a paper commissioned by the Roundtable, "Numeracy and the Affordable Care Act: Opportunities and Challenges," that discusses research findings about people's numeracy skill levels; the kinds of numeracy skills that are needed to select a health plan, choose treatments, and understand medication instructions; and how providers should communicate with those with low numeracy skills. The paper was featured in the workshop and served as the basis of discussion.

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Commissioned Paper

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164 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-29980-2
ISBN Ebook: 0-309-29981-0
DOI: https://doi.org/10.17226/18660

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Institute of Medicine. 2014. Health Literacy and Numeracy: Workshop Summary. Washington, DC: The National Academies Press.

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Organizational Change to Improve Health Literacy is the summary of a workshop convened in April 2013 by the Institute of Medicine Board on Population Health and Public Health Practice Roundtable on Health Literacy. As a follow up to the 2012 discussion paper Ten Attributes of a Health Literate Health Care Organization, participants met to examine what is known about implementation of the attributes of a health literate health care organization and to create a network of health literacy implementers who can share information about health literacy innovations and problem solving. This report discusses implementation approaches and shares tools that could be used in implementing specific literacy strategies.

Although health literacy is commonly defined as an individual trait, there is a growing appreciation that health literacy does not depend on the skills of individuals alone. Health literacy is the product of the interaction between individuals' capacities and the health literacy-related demands and complexities of the health care system. System changes are needed to better align health care demands with the public's skills and abilities. Organizational Change to Improve Health Literacy focuses on changes that could be made to achieve this goal.

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124 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-28805-3
ISBN Ebook: 0-309-28806-1
DOI: https://doi.org/10.17226/18378

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Institute of Medicine. 2013. Organizational Change to Improve Health Literacy: Workshop Summary. Washington, DC: The National Academies Press.

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The roots of health literacy can be traced back to the national literacy movement in India under Gandhi and to aid groups working in Africa to promote education and health. The term health literacy was first used in 1974 and described as "health education meeting minimal standards for all school grade levels". From that first use the definition of health literacy evolved during the next 30 years with official definitions promulgated by government agencies and large programs. Despite differences among these definitions, they all hold in common the idea that health literacy involves the need for people to understand information that helps them maintain good health.

Although the United States produces a majority of the research on health literacy, Europe has strong multinational programs as well as research efforts, and health literacy experts in developing countries have created successful programs implemented on a community level. Given these distinct strengths of efforts worldwide, there are many opportunities for collaboration. International collaboration can harness the United States' research power, Europe's multilingual and multinational experience, and developing nations' community-based programs to create robust programs and research that reach people—not based on language or nationality but on need and value.

A workshop on international health literacy efforts that feature presentations and discussion about health literacy interventions from various countries as well as other topics related to international health literacy was held as the basis for this report. Health Literacy: Improving Health, Health Systems, and Health Policy Around the World summarizes the findings and discussions at the workshop.

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234 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-28484-8
ISBN Ebook: 0-309-28485-6
DOI: https://doi.org/10.17226/18325

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Institute of Medicine. 2013. Health Literacy: Improving Health, Health Systems, and Health Policy Around the World: Workshop Summary. Washington, DC: The National Academies Press.

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The Institute of Medicine (IOM) Roundtable on Health Literacy focuses on bringing together leaders from the federal government, foundations, health plans, associations, and private companies to address challenges facing health literacy practice and research and to identify approaches to promote health literacy in both the public and private sectors. The roundtable serves to educate the public, press, and policy makers regarding the issues of health literacy, sponsoring workshops to discuss approaches to resolve health literacy challenges. It also builds partnerships to move the field of health literacy forward by translating research findings into practical strategies for implementation. The Roundtable held a workshop March 29, 2012, to explore the field of oral health literacy.

The workshop was organized by an independent planning committee in accordance with the procedures of the National Academy of Sciences. The planning group was composed of Sharon Barrett, Benard P. Dreyer, Alice M. Horowitz, Clarence Pearson, and Rima Rudd. The role of the workshop planning committee was limited to planning the workshop. Unlike a consensus committee report, a workshop summary may not contain conclusions and recommendations, except as expressed by and attributed to individual presenters and participants. Therefore, the summary has been prepared by the workshop rapporteur as a factual summary of what occurred at the workshop.

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142 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-26289-5
ISBN Ebook: 0-309-26290-9
DOI: https://doi.org/10.17226/13484

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Institute of Medicine. 2013. Oral Health Literacy: Workshop Summary. Washington, DC: The National Academies Press.

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Approximately 80 million adults in the United States have low health literacy - an individual's ability to obtain, process, and understand basic health information. Low health literacy creates difficulties in communicating with clinicians, poses barriers in managing chronic illness, lessens the likelihood of receiving preventive care, heightens the possibility of experiencing serious medication errors, increased risk of hospitalization, and results in poorer quality of life.

It is important for health care organizations to develop strategies that can improve their health literacy, yet organizations often find it difficult to determine exactly what it means to be health literate. How Can Health Care Organizations Become More Health Literate?: Workshop defines a health literate health care organization as "an organization that makes it easier for people to navigate, understand, and use information and services to take care of their health." In November 2011, the IOM Roundtable on Health Literacy held a workshop to discuss the growing recognition that health literacy depends not only on individual skills and abilities but also on the demands and complexities of the health care system. How Can Health Care Organizations Become More Health Literate?: Workshop summarizes the workshop.

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122 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-25681-X
ISBN Ebook: 0-309-25682-8
DOI: https://doi.org/10.17226/13402

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Institute of Medicine. 2012. How Can Health Care Organizations Become More Health Literate?: Workshop Summary. Washington, DC: The National Academies Press.

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To receive the greatest value for health care, it is important to focus on issues of quality and disparity, and the ability of individuals to make appropriate decisions based on basic health knowledge and services. The Forum on the Science of Health Care Quality Improvement and Implementation, the Roundtable on Health Disparities, and the Roundtable on Health Literacy jointly convened the workshop "Toward Health Equity and Patient-Centeredness: Integrating Health Literacy, Disparities Reduction, and Quality Improvement" to address these concerns. During this workshop, speakers and participants explored how equity in care delivered and a focus on patients could be improved.

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102 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-12749-1
ISBN Ebook: 0-309-12750-5
DOI: https://doi.org/10.17226/12502

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Institute of Medicine. 2009. Toward Health Equity and Patient-Centeredness: Integrating Health Literacy, Disparities Reduction, and Quality Improvement: Workshop Summary. Washington, DC: The National Academies Press.

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Roundtable on Health Literacy

Engaging Community Health Workers/Youth Ambassadors to Improve Health Literacy: Proceedings of a Workshop—in Brief

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