health educators through programs such as the Integrated Health Network’s 2004 Health Education and Literacy Program, which used 8 “health coaches” to serve over 200,000 uninsured and underinsured residents in St. Louis, Missouri. The program empowered patients to take control of their health and communicate more confidently with healthcare providers [1]. Results of the positive impact of these coaches showed significant increases from 57% to 81% in patients’ acquiring of a primary care provider and 1% to 27% of patients able to discuss their health management plans effectively [1]. Thus, legislation that specifically supports and funds the development of accessible information and educators through government collaboration across multiple sectors would be the first step in addressing the historical lack of health literacy governmental action and accountability in the United States. A major step in improving health literacy is improving and emphasizing communication skills in healthcare providers. The National Plan to Improve Health Literacy states that focusing on the patient-provider relationship provides key intervention methods that

A major step in improving health literacy is improving and emphasizing communication skills in healthcare providers have been proven to be successful in multiple settings. For example, a study done by Schillinger et al. showed that the teach-back method, or “interactive communication loop,” was significantly associated with better glycemic control in patients with diabetes mellitus and low functional health literacy [12]. This method of communication aims to decrease the 22

THE TRIPLE HELIX Spring 2016

gap in patient knowledge by asking the patient to “teach back” the information accurately to the provider in order to confirm their level of understanding. Through this method, providers are able to gauge the patient’s level of understanding as well as assess the effectiveness of their own communication skills. In addition, this method facilitates an environment of open and comfortable communication and rapport between patient and provider. Patients can gain a better understanding of health information and decisions regarding treatments, procedures, and medical devices. In addition, The Agency for Health Care Research and Quality (AHRQ) has written several sets of questions that they recommend patients should pose to their providers that promote the use of plain language and patient self-advocacy [12]. This program, titled Questions Are the Answers, prepares patients and providers for their visits and provides structure for their communication in order to build a better understanding of the circumstances of the patient for both the patient and provider. This resource suggests questions that patients “should know” to ask, questions to ask before, during, and after the appointment, and tools to help patients build their own list of questions through an interactive online quiz [13]. This program thus empowers the patient to take an active role in their healthcare and increases their self-advocacy. It is imperative for healthcare providers to advocate and encourage the use of this resource in both their healthcare facilities and patient consultations. Furthermore, support of educational and training programs for and by healthcare providers would greatly improve the overall quality and awareness of health literacy. These programs should aim to educate healthcare providers in understanding the social aspects of patients’ circumstances that affect their level of health literacy understanding, and would be most effective if incorporated into undergraduate and medical school curricula. Thus, heightened awareness and © 2016, The Triple Helix, Inc. All rights reserved.