Health Literacy is defined in the Institute of Medicine report, Health Literacy: A Prescription to End Confusion,, as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to mak

Selected Books and Journals

Internet Resources

Adult meducation: improving medication adherence in older adults.
American Society on Aging and the American Society of Consultant Pharmacists Foundation.  2012
The American Society on Aging (ASA) and the American Society of Consultant Pharmacists (ASCP) Foundation have collaborated on the development of Adult Meducation: Improving Medication Adherence in Older Adults, a web-based program to educate ASA and ASCP members on important aspects of medication adherence in older adults. Materials on the web site can be copied or downloaded for use in educational or training programs.

Agency For Healthcare Research and Quality (AHRQ): Health Literacy 
The Agency for Healthcare Research and Quality's (AHRQ) mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to work within the U.S. Department of Health and Human Services and with other partners to make sure that the evidence is understood and used.

  • Agency for Healthcare Research and Quality's Health Literacy Universal Precautions Toolkit  
    • This toolkit provides information on designing easy-to-read materials and strategies for addressing health literacy issues.
  • The Patient Education Materials Assessment Tool (PEMAT) and Users Guide: An Instrument To Assess the Understandability and Actionability of Print and Audiovisual Patient Education Materials 
    • The Patient Education Materials Assessment Tool (PEMAT) is a systematic method to evaluate and compare the understandability and actionability of patient education materials. It is designed as a guide to help determine whether patients will be able to understand and act on information. Separate tools are available for use with print and audiovisual materials.
  • Health Literacy Measurement Tools 
    • The AHRQ-supported tools are for the assessment of health literacy in speakers of English and Spanish, the languages most frequently spoken in the United States.
    • Short Assessment of Health Literacy - Spanish and English (SAHL-S&E) 
      The Short Assessment of Health Literacy–Spanish and English (SAHL–S&E) is a new instrument, consisting of comparable tests in English and Spanish, with good reliability and validity in both languages. Persons being examined in English or Spanish are presented with 18 test terms. For each term a key word with a related meaning and a distractor word unrelated in meaning to the test term. This tests the subject's comprehension as well as pronunciation (decoding) of health-related terms. Administration of the test takes only 2-3 minutes and requires minimal training. Administration of these instruments could be facilitated by using laminated 4"-by-5" flash cards, with each card containing a medical test term printed in boldface on the top and the two association words"”i.e., the key and the distracter"”at the bottom.
    • Rapid Estimate of Adult Literacy in Medicine - Short Form (REALM-SF) 
      The Rapid Estimate of Adult Literacy in Medicine"”Short Form (REALM-SF) is a 7-item word recognition test to provide clinicians with a valid quick assessment of patient health literacy. The REALM-SF has been validated and field tested in diverse research setting, and has excellent agreement with the 66-item REALM instrument in terms of grade-level assignments.
    • Short Assessment of Health Literacy for Spanish Adults (SAHLSA-50) 
      The Short Assessment of Health Literacy for Spanish Adults (SAHLSA-50) is a validated health literacy assessment tool containing 50 items designed to assess a Spanish-speaking adult's ability to read and understand common medical terms. Administration of the test takes 3-6 minutes. The SAHLSA was based on the Rapid Estimates of Adult Literacy in Medicine (REALM), known as the most easily administered tool for assessing health literacy in English. However, it is important to note that SAHLSA-50 results are not comparable with REALM results. Users who are interested in comparing the health literacy ability of English and Spanish speakers are advised to adopt SAHL-S&E.

Assessing and Developing Health Materials 
The Harvard T.H. Chan School of Public Health: Health Literacy Studies Web Site. Available at: http:www.hsph.harvard.edu/healthliteracy.

ATOS for Text 
"ATOS for Text is used to calculate the readability level for shorter text passages such as magazine and newspaper articles, test items, and other classroom materials. The resulting ATOS level does not include any adjustment for overall length (word count) and is expressed as ATOS Level."

Beyond the Brochure: Alternative Approaches to Effective Health Communication: A Guidebook
The AMC Cancer Research Center, with collaboration and support of the Centers for Disease Control and Prevention (CDC), Division of Cancer Prevention and Control, 1994
Brochure to assist health educators and health communicators in conceiving and producing educational materials and activities that do not rely solely on the printed word. [80 p.]

CDC's Gateway to Health Communication: Training, Tools & Templates
Centers for Disease Control & Prevention's online portal for health communication. The Training, Tools & Templates section contains links to health literacy resources, social medial tools, images and interactive media

CDC: Plain Language Materials & Resources
Includes Plain Language for Palliative Care and a poster Plain Language: Communication Your Audience Understands the First Time [checklist]

Centers for Disease Control and Prevention's Plain Language Thesaurus for Health Communications 
The Centers for Disease Control and Prevention's National Center for Health Marketing, 2007
This Plain Language Thesaurus aims to help make health information clear and easy to understand. This thesaurus offers plain language equivalents to medical terms, phrases, and references that we often use. The technical terms found in health information can be confusing

Center for Disease Control and Prevention"s Simply Put: A Guide to Creating Easy-to-Understand Materials 
The Centers for Disease Control and Prevention, 2009
The guidance in Simply Put helps you transform complicated scientific and technical information into communication materials your audiences can relate to and understand. The guide provides practical ways to organize information and use language and visuals. This guide will be useful for creating fact sheets, FAQ's, brochures, booklets, pamphlets, and other materials, including web content.

Centers for Medicare and Medicaid Services: Toolkit for Making Written Materials Clear and Effective 
This eleven part toolkit emphasizes using a reader-centered approach to develop and test patient education material and includes information on developing materials for the internet.

Clear & Simple: Developing Effective Print Materials for Low-Literate Readers 
Updated and expanded “Clear & Simple” for contemporary use by NIH. Clear & Simple outlines a process — five standard steps — for developing health information materials for people with limited-literacy skills. The 2003 National Assessment of Adult Literacy found that about 14 percent of 18,500 adult Americans surveyed could not read, or understand text written in English and could only comprehend basic, simple text.

Communicating Risks and Benefits: An Evidence-Based Users' Guide.
FDA. 2011

Designing Print Materials: A Communications Guide for Breast Cancer Screening 
International Cancer Screening Network, 2007
Includes worksheets, checklists, tables and audience assessment.

Easy to Read
MedlinePlus.  Alphabetical list of easy to read medical information from MedlinePlus

Everyday Words for Public Health Communication 
Centers for Disease Control and Prevention, 2016
Everyday Words for Public Health Communication offers expert recommendations from CDC's Health Literacy Council and other agency communicators on how to reduce jargon and replace problematic terms to improve comprehension. "Everyday Words" provides: substitute terms, real-life examples of difficult public health passages, revised wording, and tips to reinforce meaning and avoid other common pitfalls.

A Guide to Creating and Evaluating Patient Materials: Guidelines for Effective Print Communication 
MaineHealth.org, 2010 
Includes step-by-steps instructions for developing patient education materials, checklists and readability. [16 p.] 

Guide to Providing Effective Communication and Language Assistance Services 
Health and Human Services, Office of Minority Health
The Guide is designed to help you and your organization communicate effectively with patients with diverse communication needs and preferences. Requires one-time free registration to view the guide.

Guidelines for easy-to-read materials 
International Federation of Library Association and Institutions, 2010
IFLA Professional Reports, No.120

Health Communications Playbook
Agency for Toxic Substances and Disease Registry (ATSDR).  2018
Covers key communication materials for consumers and professionals and includes practical resources like: Annotated examples of fact sheets, press releases, and more; Research-based tips and step-by-step instructions»Worksheets to help you get started; Checklists to review when you’re done.

Health Literacy and Patient Safety: help patients understand: manual for clinicians. 2nd ed.
AMA. 2007

The Health Literacy & Plain Language Resource Guide, 2nd ed.
Health Literacy Innovations, 2018
The guide offers health care providers and educators resources to improve health communications with patients with different cultural and linguistic needs. It includes toolkits, suggested communication standards, books, and much more.

Health Literacy Fact Sheets 
Center for Health Care Strategies
Series of fact sheets on various aspects of health literacy.

  • Health Literacy: Policy Implications and Opportunities
  • Improving Oral Communication to Promote Health Literacy
  • Improving Print Communication to Promote Health Literacy
  • Health Literacy and the Role of Culture
  • How Is Health Literacy Identified?
  • What Is Health Literacy?

Health Literacy Online A Guide for Simplifying the User Experience, 2nd ed. U.S.
Department of Health and Human Services, Office of Disease Prevention and Health Promotion. 
This research-based guide discusses why and how to design health websites and other digital health information tools for all users, including the millions of Americans who don’t have strong reading or health literacy skills—as well as those who don’t have a lot of time to find, process, and use complex health information.

The Health Literacy Style Manual 
Southern Institute on Children and Families, 2005
Prepared for Covering Kids & Families [98 p.]

Health Literacy Tool Shed 
The Health Literacy Tool Shed is an online database of health literacy measures. The site contains information about measures, including their psychometric properties, based on a review of the peer-reviewed literature.

Minnesota Health Literacy Partnership 
The mission of the Minnesota Health Literacy Partnership is to improve the health of all Minnesotans through clear health communication. Resources include:

  • Minnesota Health Literacy Partnership: An Overview 
    PowerPoint presentation, which includes slides as well as speaker notes, is designed to help educate individuals and organizations about the Minnesota Health Literacy Partnership. It can be used on its own or as part of Health Literacy 101.
  • Training Materials 
    HeLP MN Seniors
    Health Literacy 101: Focusing on Clear Health Communications
    Teach Back Program
    Health numeracy toolkit

Patient Education 
From U-Write.com. Handy tips section that covers illustrations, readability, design layout, effectiveness and costs of in-house production.

PlainLanguage.gov 
Plain Writing Act of 2010; plain writing guidelines, examples and health literacy.

Readability Test 
This free online software tool calculate various readability measurements like Coleman Liau index, Flesh Kincaid Grade Level, ARI (Automated Readability Index), SMOG. Document readability is the indication of number of years of education that a person needs to be able to understand the text easily on the first reading. Comprehension tests and skills training. Tool is made primary for English texts but might work also for some other languages. It displays also complicated sentences (with many words and syllables) as suggestion what you might do to improve its readability." From Online-Utility.org

Ten Attributes of Health Literate Health Care Organizations 
Cindy Brach, Debra Keller, Lyla M. Hernandez, Cynthia Baur, Ruth Parker, Benard Dreyer, Paul Schyve, Andrew J. Lemerise, Dean Schillinger. (27 p.) June 19, 2012

A wide range of organizations have recognized that having health literate health care organizations benefits not only the 77 million Americans who have limited health literacy, but also the majority of Americans who have difficulty understanding and using currently available health information and health services. This paper presents 10 attributes that exemplify a health literate health care organization. Each attribute includes a brief elaboration of the meaning of and basis for the attribute, followed by a set of implementation strategies that can be used to achieve the attribute.

Translating Materials for Non-English Speaking Audiences 
Center for Medicare Education, 2000
Issue brief vol.1 no. 3

University of Michigan Libraries Plain Language Medical Dictionary  

WordsCount 
The WordsCount Service is a free service created by Alain Trottier to help language workers, and anyone looking for a better way to communicate. Includes the Readability calculator, SMOG calculator and the CLEAR calculator.

Videos

Health Literacy: A prescription to End Confusion, Academy for Educational Development for the Institute of Medicine. (Video, 11:02).

Health Literacy: A Prescription to End Confusion NASEM Health & Medicine Division (Video, 3:27)

Health Literacy and Cultural Competency. (Video, 3:20)
PFontJr.  2016

Health Literacy Basics for Health Professionals, Vancouver Coastal Health, the BC College of Family Physicians and the BC Ministry of Health (Video, 6:10)

Health Literacy Video, American College of Physicians Foundation. (Video, 6:26)
This video gives an illustration of the problem of low health literacy, combining interviews with actual patients, commentary from practicing physicians, and health communication statistics. Can be viewed from the website.

Health Literacy for Student Healthcare Professionals: A Tool for Better Health Outcomes (Video, 5:08)
This video was created by 5 student Occupational Therapists at University of Manitoba to be used as an advocacy tool in order to provide student healthcare professionals information that would assist in ensuring better outcomes for clients. 2014.

Health Literacy: Learning is the best medicine  (Video, 9:19)
Literacy can be a major determinant of health. Health literacy is the ability to access, understand, evaluate and communicate information as a way to promote, maintain and improve health in a variety of settings across the life course. 2010.

Health Literacy Skit (Video, 7:27)
SCSU Nursing class. 2013.

Plain language: Say It Simply (Video, 4:28)
Minnesota Department of Human Services.  2016

Cultural and Cross-Cultural Resources

Culture and health literacy: tools for cross-cultural communication and language access ...
Centers for Disease and Control and Protection. 

Culture, Health and Literacy: a guide to health education materials for adults with limited English literacy skills
Julie McKinney and Sabrina Kurtz-Rossi.
Developed by World Education in collaboration with the National Institute for Literacy with a generous grant from Metropolitan Life Foundation 

Cultural Awareness Checklist
Infographic from Quaity Interactions

Ethnomed 
EthnoMed contains information about cultural beliefs, medical issues and other related issues pertinent to the health care of recent immigrants to the US. Has links to patient education materials in a wide variety of languages

Health Information Translations 
Provides plain language health education resources for health care professionals and others working in communities with limited English proficient populations. The website is a collaboration of health education specialists from the four health systems in Central Ohio.

Health Translations: Translated Information about Health & Wellbeing.
Victorian Department of Health & Human Services. Australia. Health Translations is an online library which enables health practitioners and those working with culturally and linguistically diverse communities to easily find free translated health information. Health Translations provides direct links to free reliable translated health resources produced in Australia.

HealthReach: Health Information In Many Languages 
HealthReach is a national collaborative partnership that has created a resource of quality multilingual, multicultural public health information for those working with or providing care to individuals with limited English proficiency.

Resources include:

  • Health education materials in various languages and formats (brochures, fact sheets, videos)
  • Provider tools (including best practices, cultural information, and effective use of interpreters)
  • Special collections on Emergency and Disaster, Women's Health and Mental Health

    The HealthReach offers easy access to quality health information to individuals for whom English is not their primary language. It is also an important resource for health professional as well as public health administrators. HealthReach grew out of the Refugee Health Information Network (RHIN) when it became apparent that the information resources in the database are useful to all those who have limited English proficiency, not just refugees and asylees.

Multi-cultural Resources for Health Information
National Library of Medicine: Specialized Information Services (SIS)
Includes cultural competency; dictionaries/glossies; health resources in multiple languages; interpreting in healthcare; limited English proficiency; law/policy/standards; health literacy

New South Wales (NSW) Multicultural Health Communication Service
NSW Department of Health 
Search for resources by either topic or language. Also includes a multicultural phrasebook.

S*P*I*R*A*L: Selected Patient Information Resources in Asian Languages
Joint initiative of the South Cove Community Health Center and Tufts University Hirsh Health Sciences Library.
Materials available in Chinese, Cambodian, Hmong, Korean, Laotian, Thai and Vietnamese.

What's In a Word? A guide to understanding interpreting and translation in healthcare
National Health Law Program, 2010
This guide will demystify the two terms and, in the process, help you understand why the work of the interpreter and translator is indeed distinct, why not all bilingual individuals can be assumed to have the skills to interpret or translate, and why the same bilingual individual cannot always do both

Journal Articles

PubMed Search for Patient Education AND Health Literacy 
PubMed search using the MeSH subject headings Patient Education AND Health Literacy, limited to English and humans. The search is done in real-time, so results will change as the database is updated.

PubMed Search for Patient Education and Cultural Diversity 
PubMed search using the MeSH subject headings Patient Education AND Cultural Diversity, limited to English and humans. The search is done in real-time, so results will change as the database is updated.

PubMed Search for Patient Education and Teaching Materials 
PubMed search using the MeSH subject headings Patient Education AND Teaching Materials, limited to English and humans. The search is done in real-time, so results will change as the database is updated.

PubMed Search for Health Literacy AND Teaching Materials 
PubMed search using the MeSH subject headings Health Literacy AND Teaching Materials, limited to English and humans. The search is done in real-time, so results will change as the databases is updated.

Illustrations and Other Media

"Free" Clipart: These are image collections that are free for educational use. Please carefully read the copyright notices and disclaimers before use - some sites have detailed instructions and conditions on use of the images.

  • Wellcome Images 
    Wellcome Images is one of the world's richest and most unique collections, with themes ranging from medical and social history to contemporary healthcare and biomedical science. All low resiolution images on this site are freely available for download for personal, academic teaching or study use, under one of two Creative Commons licenses. For further details please see our Terms of Use. Hi-res historical images are also available to download from this site free of charge, for any usage, under a Creative Commons Attribution Only – CC-BY license. Requires creation of account.
  • USP Pictograms 
    USP Pictograms are standardized graphic images that help convey medication instructions, precautions, and/or warnings to patients and consumers. Pictograms are particularly helpful in passing on important information to patients with a lower level reading ability and patients for whom English is a second language. USP offers 81 pictograms in .gif or .eps format. You can download the entire pictogram library after accepting our license agreement.
  •  Healthcare Symbols
  • Public Health Image Library 
    Public Health Image Library (PHIL) is an extensive collection of still images, image sets, and multimedia files related to public health.
  • Nursing Graphics 
    The Student Nurse Forum
  • NIH Photo Galleries 
  • Medical Clipart and Graphics 
    Classroomclipart.com/Medical. Clipart available free of charge for educational purposes. Be sure to read the copyright agreement before using.
  • HEAL: Health Education Assets Library 
    The Health Education Assets Library (HEAL) is a digital library that provides freely accessible digital teaching materials. Requires free registration.
  • Food Clipart, Illustrations - Graphics
    Classroomclipart.com. Clipart available free of charge for educational purposes. A variety of Food related clipart such as Fruits, Vegetables, Seafood, Fast Food, Dairy Clipart, Ice cream, desserts and more.Also view related Food Clipart categories.  Be sure to read the copyright agreement before using.
  • Public Domain Vectors
    Publicdomainvectors.org, offers copyright-free vector images in popular .eps, .svg, .ai and .cdr formats.To the extent possible under law, uploaders on this site have waived all copyright to their vector images. You are free to edit, distribute and use the images for unlimited commercial purposes without asking permission. Although absolutely not required, they appreciate every link back or mention of their website.  Use to the search box for medical, healthcare, food, nutrition, nursing, etc. images.
  • SMART: Servier Medical Art
    3000 free medical images to illustrate publications and powerpoint presentations.  Provided by Les Laboratories Servier, with Creative Commons attribution 3.0 unported license requirement.

     

    Fee-Based Clipart: Commercial images available on a fee-based service. This is not an endorsement of these companies, just a representation of some of the larger one available via the web. Please check copyright notices and disclaimers before use.

    • Medical Imagery: Medical Arts & Graphics 
      Medical Imagery provides an on-line catalog of images that can be used as stock art.
    • ClipArt.com 
      Largest subscription based royality-free graphics website. Thousands of illustrations.
    • Can Stock Photo 
    • Nucleus Medical Art 
      A full-service creative studio specializing in developing and licensing medical illustrations, medical animations, interactive media and other communications tools for the healthcare market. The company maintains a proprietary database of more than 15,000 highly detailed, expert reviewed medical illustrations and animations.

Copyright and Other Publishing Resources

Copyright Information and Education (U of M Libraries)
The site of the University of Minnesota Libraries' Copyright Information and Education Initiative, which supports an informed and educated University community on matters of copyright and its application in teaching, research, and scholarship. Includes tools such as the Fair Use Analysis Tool and the Copyright Decision Map.

Copyright & Fair Use 
Prepared by Stanford University Libraries this is a very useful site.

Copyright Crash Course 
The Copyright Crash Course Online Tutorial will help you learn about how ownership of copyrighted materials works, what is fair use and when and how to get permission to use someone else's materials.

Copyright Permissions Office, U of M  
This office, secures permission for copyrighted materials use for instructional or other academic purposes by U of M faculty and staff. Photocopying guidelines are also provided.

Copyright Website 
This site endeavors to provide real world, practical and relevant copyright information of interest to infonauts, netsurfers, webspinners, content providers, musicians, appropriationists, activists, infringers, outlaws, and law abiding citizens. (Website text.)

U.S. Copyright Office: The Library of Congress 
An essential site for copyright information for both those who what to obtain copyright and those who want to use copyrighted materials. The Copyright Basics section and the FAQ are especially helpful.

Printing Services - University of Minnesota 
Wide variety of printing options, along with copy service and graphic design

Last Updated: Sep 11, 2020 10:25 AM