1.2 Health Literacy

Healthy People 2030 is published by the United States Department of Health and Human Services Office of Disease Prevention and Promotion and addresses the most current national public health priorities. Health literacy is a central focus of Healthy People 2030 with an overarching goal of, “Eliminating health disparities, achieving health equity, and attaining health literacy to improve the health and well-being of all.”^[1]

Healthy People 2030 defines personal health literacy as the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.^[2]

Health information can be difficult to understand, and the health care system is complex. Nurses can provide health teaching that is easier to understand for clients by completing the following actions^[3]:

• Use evidence-based strategies, such as answering questions in simple, nonmedical language and providing written materials tailored to the client’s literacy, language, and comprehension levels.
• Realize that while everyone can have trouble understanding complex health information, certain populations are at higher risk for having difficulty understanding. Older adults, those learning the English language, and those who have difficulty with math and reading comprehension are at even greater risk for lack of understanding that can result in poor health outcomes. Health teaching and client understanding can be improved if the nurse teaches with the assumption that everyone is at risk for misunderstanding.
• Use health literacy strategies to encourage health care consumers to take part in decisions about testing, treatment, and procedures. This helps people make health care decisions that fit their values, goals, preferences, and circumstances.
• Take time to listen respectfully and make information easy to understand based on the client’s needs. Check to make sure the information is understood by using the teach-back method, where the client explains or demonstrates what was taught.
• Help people achieve their personal health goals, whether that means engaging in a healthy lifestyle, managing a chronic health condition, or taking precautions to avoid getting sick.

Health Teaching Topics

Health teaching by nurses focuses on primary prevention (i.e., preventing illness and injury), secondary prevention (i.e., early detection of disease), and tertiary prevention (i.e., helping clients reduce the severity of disease and/or altered functioning; also referred to as “rehabilitation”).^[6] Examples of health teaching topics for these categories that are provided by nurses include the following:

• Prevention of illness/injury (primary prevention)
  • Preventing illness with good nutrition, physical activity, stress management, immunizations, lifestyle modifications to reduce risk, parent education about children’s growth and development, family planning, and resources within the community to maintain wellness
  • Teaching about cardiac risk factors
  • Teaching specific protective measures such as the use of seat belts, helmets, car seats, condom use, and sunscreen use
  • Providing preoperative and postoperative teaching to prevent complications and enhance recovery

• Early detection of disease (secondary prevention)
  • Providing information about diagnostic testing, medical diagnoses, treatment, and medication
  • Promoting screening tests such as a mammogram, Papanicolaou (PAP) test, and colonoscopy
  • Promoting preventive health screening (i.e., blood glucose, cholesterol)

• Adaptation to altered health and functioning (tertiary prevention)
  • Promoting self-care skills to manage chronic diseases at home
  • Sharing community resources such as support groups
  • Teaching about assistive devices
  • Teaching strategies to manage current medical problems (for example, diabetic education, colostomy care, and wound care at home)
  • Teaching positive coping strategies (for example, coping with fear and/or anxiety related to terminal cancer, future surgeries, or other invasive medical treatments)
  • Providing grief and bereavement counseling