Attributes of a Health Literate Organization
The white paper, Ten Attributes of Health Literate Health Care Organizationspdf iconexternal icon, describes what health care organizations can do to “make it easier for people to navigate, understand, and use information and services.” Participants in the Institute of Medicine (now the National Academies) Roundtable on Health Literacyexternal icon wrote the paper to inspire health care organizations to address health literacy issues.
If you or your organization provides direct patient care, please refer to the original white paper as well as the following:
- The 2021 articleexternal icon by Brach and Harris, “Healthy People 2030 Health Literacy Definition Tells Organizations: Make Information and Services Easy to Find, Understand, and Use” (Journal of General Internal Medicine)
- The Agency for Healthcare Research and Qualityexternal icon’s health literacy resources
CDC’s Office of the Associate Director for Communication has interpreted the attributes and offers a modified version to apply to organizations doing public health work. Each of the following attributes briefly describes strategies that organizations can adopt and augment.
Has leadership that makes health literacy integral to its mission, structure, and operations
The organization makes advancing health literacy a high priority and part of the organizational values, culture, and day-to-day operations. Committed, continuous, knowledgeable leadership is key to effectively implement and sustain health literacy improvement activities.
Integrates health literacy into strategic and operational planning, quality improvement, goals, and measures
The organization makes sure that health literacy is explicitly integrated into all relevant activities and that health literacy informs strategic and operational planning, execution, and evaluation. The organization assesses success with groups at higher risk of poor health outcomes as part of its overall organizational performance measures.
Prepares the workforce to address health literacy issues and monitors progress
The organization recognizes and meets staff health literacy training needs. The training contributes to a culture in which everyone values and promotes effective communication. The organization measures the training’s impact on advancing health literacy and other goals.
Provides easy access to information and services and uses clear signage or instructions to help people find their way in facilities and online
The organization makes it easy for people to find information on websites and via communication channels and to find where they’re going in facilities, such as federal, state, and county public health and social service agencies. Help finding the way in facilities can mean providing clear signs, directions, forms, and helpful staff who provide information in plain language.
Best practices in web design and social media help the organization make its electronic materials, messages, and systems, such as customer portals or online databases, easy for people to find, understand, and use.
If the organization provides telephone-based information or services, such as a toll-free contact center or publication fulfillment center, staff use plain language when talking with the public.
Addresses health literacy in high-risk situations, such as emergency preparedness, crisis and emergency response, and clinical emergencies or transitions
The organization puts processes in place to make sure that people receive clear and useful communication when they’re most vulnerable or under emotional or physical stress. Plans for emergencies, crises, and stressful transitions anticipate the audience’s health literacy issues and the information and services people will need to respond to high-risk situations.
Communicates clearly available health services and costs
The organization uses clear communication techniques to explain a person’s choices among health services and, if relevant, the costs. If a person must complete forms to receive information or services, the forms are in plain language with design techniques that make the forms easy to understand and complete.
Attributes about Audience and Group Participation and Feedback in Health Communication and Information Activities
Includes members of groups served in the design, implementation, and evaluation of health information and services
The organization invites members of the groups it serves to be part of the processes that result in health information and services. It pays special attention to including people with limited literacy and numeracy skills when planning programs and preparing materials.
Meets the needs of audiences with a range of health literacy skills while avoiding stigmatization
The organization makes information clear and culturally and linguistically appropriate for all audiences. Staff avoid demeaning, criticizing, or calling negative attention to people with limited literacy and numeracy skills. The organization tests communication materials with intended audiences to verify comprehension and information usefulness. It selects formats and communication channels with the greatest reach for the intended audience.
Uses health literacy strategies in oral communication
The organization uses clear communication techniques in spoken communication, such as conversations, interviews, oral presentations, and podcasts and videos. It reinforces spoken information and communication with other formats that help people remember the information and learn how to find more information when they need it. The organization encourages audience feedback in oral communications to verify comprehension and information usefulness.
Designs and distributes print, audiovisual, and social media content that is easy to understand and use to make informed health decisions
The organization asks the intended users of the information to contribute to all steps of the content development process. The staff uses multiple channels to distribute the information so that people can use their preferred channels and hear or see the information multiple times to help with learning and recall. The materials have a clear message and provide actions the audience can take to protect and promote their health. The materials use words, numbers, and concepts familiar to the intended audience.
Public health organizations and their partners, as well as clinical care groups, may find the following resources to be helpful. There’s still a need to help organizations address health literacy issues for the people they serve.
- HLE 2 The Health Literacy Environment of Hospitals and Health Centers: An Updated Assessment Tool for Identifying Facilitating Factors and Barriers to Information, Care, and Servicespdf iconexternal icon (Harvard School of Public Health, 2019)
- Building Health Literate Organizations: A Guidebook to Achieving Organizational Changeexternal icon(Unity Point Health, 2014)
- AHRQ Health Literacy Universal Precautions Toolkitexternal icon(Agency for Healthcare Research and Quality, 2010)
- The Health Literacy Environment Activity Packet: First Impressions & Walking Interviewpdf iconexternal icon (Harvard School of Public Health, 2010)
- Pharmacy Health Literacy Assessment Toolexternal icon(Agency for Healthcare Research and Quality, 2007)
- The Health Literacy Environment of Hospitals and Health Centers – Partners for Action: Making Your Healthcare Facility Literacy-Friendlypdf iconexternal icon(Harvard School of Public Health, 2006)
See our Find Training page for training opportunities in health literacy, plain language, and culture and communication
- CDC Clear Communication Index (Centers for Disease Control and Prevention, 2014)
- Federal Plain Language Guidelinesexternal icon (The Plain Language Action and Information Network, 2011)
- Simply Put: A guide for creating easy-to-understand materialspdf icon (CDC 2009)
See Develop Materials for additional guidance and resources for preparing materials to address health literacy.
- AHRQ Health Literacy Universal Precautions Toolkitexternal icon(Agency for Healthcare Research and Quality 2010)
- Questions Are the Answerexternal icon(Agency for Healthcare Research & Quality 2009)
- National Culturally and Linguistically Appropriate Services (CLAS) Standardsexternal icon (U.S. Department of Health and Human Services Office of Minority Health) can help organizations address the cultural and language differences between the people who provide information and services and the people they serve.
See the resources below for information about accessible and usable health information, including websites.
- NIH National Library of Medicine Evidence-based Practice and Health Technology Assessment Links to Resourcesexternal icon(National Institutes of Health National Library of Medicine 2011)
- Accessible Health Information Technology (IT) for Populations with Limited Literacy: A Guide for Developers and Purchasers of Health IT pdf iconexternal icon(Agency for Healthcare Research and Quality National Resource Center for Health IT 2007)
- Improving the User Experienceexternal icon (U.S. General Services Administration, Technology Transformation Services)
See the resources below for information on how to improve the readability of consent forms and other print materials for participants in health care research.
- AHRQ Informed Consent and Authorization Toolkit for Minimal Risk Research (Agency for Healthcare Research & Quality 2009)external icon
- Program for Readability in Science & Medicine (PRISM) pdf iconexternal icon(Group Health Research Institute)
See Evaluate Skills & Programs for assessment tools to identify health literacy issues in your organization.
- Crisis & Emergency Risk Communication (CERC) (Centers for Disease Control and Prevention 2018)
- Crisis and Emergency Risk Messaging in Mass Media News Stories: Is the Public Getting the Information They Need to Protect Their Health?external icon (Health Communication 2016)