Lessons Learned from Using Health Literacy Strategies in a Pilot Communication Skills Program

Rosina A. Connelly1, *, Teri L. Turner2, Xuan G. Tran3, Angelo P. Giardino2
1 Department of Pediatrics and Adolescent Medicine, University of South Alabama – Mobile, AL, USA
2 Department of Pediatrics, Section of Academic General Pediatrics, Baylor College of Medicine – Houston, TX, USA
3 Health Services Research and Continuing Medical Education, Texas Children's Health Plan – Houston, TX, USA

© 2010 Connelly et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Correspondence: * Address correspondence to this author at the University of South Alabama, Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, 1504 Springhill Avenue, Room 5316, Mobile, AL 36604, USA; Tel: (251) 434-3971; Fax: (251) 434-3980; E-mail:



Limited health literacy results in poorer health outcomes, however, effective communication can facilitate understanding. Communication skills programs could incorporate strategies to address communication gaps caused by poor health literacy.


1) to describe the effects of a pilot educational intervention on providers' knowledge and reported use of health literacy strategies; 2) to describe participants' reasons to participate and their opinions regarding the educational intervention's delivery and content.


We conducted a quasi-experimental study design with a questionnaire before, immediately after, one and three months after the intervention. Semi-structured interviews conducted one year after the intervention explored participants' opinions and experiences with the intervention and strategies.


Of 329 physicians invited, only 13 (3.9%) participated. Participants' mean knowledge score increased from 59.2% to 80% (p<0.001) but was lower at three months (63.3, p<0.005). Reported awareness of health literacy issues increased from 23.1% to 92.3% (p<0.001) and remained high at three months. Using simple language, limiting amount of information and checking for understanding were strategies reportedly still used at three months. Information presented was new for participants and increased their awareness of communication problems. Health literacy strategies were reportedly simple to use.


Our program increased participants' awareness of health literacy issues and self-reported use of health literacy strategies for communication up to three months after the intervention. Future research areas should include replication with a larger sample size, objective measurement of strategies utilized by providers, and measuring patients' opinions about these strategies.

Keywords: Health literacy, communication skills, continuing medical education.