Improving Health Equity Through Health Literacy Education.

Health literacy is the ability to understand and use health information. More than one-third of adults living in the United States have limited health literacy, which is associated with adverse health outcomes. Physicians need education about how to communicate effectively across the range of health literacy levels, but residency programs often fail to provide it. We aimed to develop and evaluate a curriculum to establish evidence-based recommendations for training family medicine resident physicians to communicate effectively across the range of health literacy levels. We developed and implemented a 6-month curriculum about health literacy and best practices for communication and collected three pre-/post-measures: patient surveys, videos of residents' patient encounters, and resident self-surveys of knowledge, attitudes, and use of communication techniques. Training of 39 residents included conferences, videotape reviews, written feedback, targeted supervision, and environmental cues. All knowledge/attitude questions on the resident survey improved significantly, as did the use of 4 of 6 communication techniques. Video observation also showed significant improvement in the residents' use of three techniques and a decrease in jargon use and an increase in "plain language" explanations of terms. Multimodal interventions improved residents' knowledge and attitudes about health literacy and use of health literacy precautions. [