Development and Implementation of a Health Literacy Program in a Community Primary Care Clinic in Houston, Texas

Literacy is the way in which our society is able to express ideas and have them understood by others. Without literacy, and particularly health literacy, individuals cannot become full participants in managing their own health and wellness. In the United States, 37% of the population has basic or below basic health literacy1. A person is more likely to have basic or below basic health literacy if they did not graduate from high school, did not speak English at home before starting school, are Black or Hispanic, are older than 65, or have multiple disabilities1. The HOPE Clinic has an ethnically diverse and unique population that has many of these risks for having low health literacy. The descriptive statistics obtained for this project indicated that 45% of the population requires translation assistance. The clinic has a well trained staff that is fluent in the majority of the languages encountered in the clinic; the most common are Spanish, Chinese, and Vietnamese. However, there are minimal written resources available for the patients to take away from the clinic encounter. Hypertension was found to a medical issue for 11% of the patient population. Evidence based information about the diagnosis, treatment, and morbidity associated with hypertension were provided in the form of educational material that were created following plain language guidelines, without the requirement of specialized computing software. The educational material was developed in English then translated into Spanish, Chinese, and Vietnamese to reflect the most commonly spoken languages in the clinic that also most frequently requested language translation assistance. The material was pre-screened by a small number of the patients to ensure that the material was culturally and linguistically appropriate as well as beneficial to patients. Additionally, a presentation was made to the health care providers to provide information about how to continue to develop and use plain language material. Health literacy cannot be improved through one modality alone; however the combination of health care provider education, written educational material, and audiovisual information can together make an impact. If the hypertension educational material produced in this project is able to improve the health literacy of the individuals, this could be expanded to other health related issues in print or audiovisual formats in the future.