Building Health Literacy Skills: A Practical Guide

To engage patients effectively, approach every interaction with warmth, respect, and genuine care. Use open body language, sit at eye level, and listen actively without interrupting. Encourage questions with inviting phrases to create a safe, supportive environment where patients feel valued and heard. This fosters trust, improves understanding, and strengthens the patient-provider relationship.

Patients may hold back questions due to fear of seeming uninformed or out of respect for cultural norms. To encourage open communication, healthcare providers should use welcoming, open-ended prompts like “What questions do you have?” throughout the visit—not just at the end. This creates a safe space where asking questions is expected and valued. All staff, from check-in to check-out, should reinforce this message, helping patients feel supported in speaking up across all healthcare settings.

Balancing open and closed questions during a medical interview helps providers gather accurate information while giving patients space to express themselves. Open-ended questions should come first, encouraging patients to describe their symptoms in their own words. More focused and then closed questions can follow to clarify details and confirm facts, keeping the conversation clear, efficient, and patient-centered.

A Brown Bag Medicine Review asks patients to bring all their medications to a visit for a hands-on check. By reviewing actual containers and how each is used, providers can spot errors, ensure correct use, and improve safety. This approach offers a clearer picture than relying on records alone.

Using plain language in healthcare means speaking clearly and simply so patients and families can understand information and actively participate in their care. It involves avoiding jargon, knowing your audience, and using everyday words like “start” instead of “activate” or “sugar” instead of “glucose.” This approach improves understanding, trust, and health outcomes.

To communicate effectively, make instructions clear, direct, and personal by using active voice and focusing on what patients should do, not what they shouldn’t. Keep messages concise with short sentences and only a few key points to avoid overwhelming patients. Finally, organize information by leading with the most important actions, breaking complex details into manageable parts, and addressing one topic at a time for better understanding.

Use medical terms when they help patients understand their condition, but always explain them clearly to avoid confusion. Check if the patient knows the term first, then provide simple explanations if needed. Tailor your approach based on the patient’s interest and health literacy to keep information accessible and empowering without overwhelming them.

Speak slowly and clearly, using specific numbers instead of vague terms like "some" or "many" when describing side effects or outcomes. For example, say "10% of people experienced nausea" rather than "some people feel nauseous." This approach improves clarity, reduces misunderstanding, and helps patients make better-informed health decisions by providing precise and objective information.

The teach-back method ensures patients truly understand their health information by asking them to explain key points in their own words. It helps providers confirm clear communication and clarify misunderstandings by rephrasing as needed. This approach improves patient safety, supports better self-care, reduces errors, and boosts confidence in managing health.

Before using teach-back, it’s important to assess the patient’s baseline understanding with questions like, “Can you tell me why you’re here today?” Teach-back follows a five-step process: clearly explain information in simple language; ask the patient to repeat it in their own words; clarify any misunderstandings; check understanding again; and confirm full comprehension. This method ensures clear communication, builds confidence, and supports safer, more effective care.

Use simple language and clear explanations, avoiding confusing jargon. Present one idea at a time, use examples, and demonstrate medication use. Visual aids help patients understand and remember information better, especially those with literacy or language challenges.

The second step, checking understanding, involves asking patients to explain instructions in their own words to confirm clarity and correct misunderstandings. Instead of asking “Do you understand?” use open-ended questions focused on how they’ll apply the information. Framing this as a way to ensure clear communication—not a test—helps build trust and empowers patients to manage their health confidently.

The third step is to identify and clarify misunderstandings by pinpointing exactly what the patient didn’t understand rather than simply repeating information. Use different approaches—like visual aids, models, or step-by-step demonstrations—tailored to the patient’s learning style. This flexible, patient-centered method helps ensure they feel supported, informed, and confident in managing their care.

The fourth step is to recheck and reclarify by repeating the process of asking patients to explain information back and addressing any remaining misunderstandings. This cycle may need to be done several times, tailored to each patient’s needs, ensuring they truly understand without feeling tested. This patient-centered approach builds trust and promotes clearer, more effective communication for better health outcomes.

The fifth and final step is to close the loop by having the patient repeat all the information back in their own words once misunderstandings are cleared. This reinforces their understanding, helps them remember instructions, and confirms that both provider and patient are aligned. Since retention can fade over time, it’s important to revisit and reinforce key points in future visits, ensuring lasting comprehension and support.

“Chunk and Check” is a communication strategy that breaks information into small, manageable parts and checks understanding after each one. By teaching 2–3 key points at a time and using teach-back to confirm comprehension, it prevents overload and helps build clear understanding step-by-step. This method ensures patients grasp essential information before moving on, focusing on what they truly need to know.

From the patient’s perspective, health literacy means having the knowledge, confidence, and skills to understand health information and make informed care decisions. To engage actively in their healthcare, patients should prepare questions ahead of appointments, bring support persons, request interpreters if needed, and ask for clear explanations. Sharing complete medical information openly and honestly helps ensure safe, personalized care and better health outcomes.

A health literate organization ensures health information is clear and accessible, empowering patients to make informed decisions and engage in their care. The next chapters outline ten practical steps leaders and staff can take to achieve this goal.

All staff, including administrative personnel, should be trained in plain language to ensure clear, jargon-free communication with patients. This promotes understanding, reduces anxiety, and empowers patients by encouraging them to explain information in their own words.

Always offer professional interpreters and translated materials proactively to patients with limited English or hearing ability, making language access a standard part of care. This ensures clear communication, respects patient dignity, and builds trust across diverse communities.

Patient materials should use plain language, clear organization, and readable fonts, ideally at a 5th to 6th grade reading level, to ensure accessibility for all literacy levels. Incorporating visuals and highlighting key points helps patients understand and follow instructions confidently.

Use the Teach-Back method routinely by asking patients to explain information in their own words, ensuring understanding and allowing for immediate clarification. This respectful approach improves comprehension, patient safety, and health outcomes.

Create healthcare environments that are clear and user-friendly with simple signage, universal symbols, and easy-to-follow directions. Testing with patients ensures these spaces reduce stress and support smooth navigation through care.

Involve patients—especially those with low literacy or diverse backgrounds—in designing materials to ensure clarity, relevance, and accessibility while building trust.

Provide patients with clear, upfront explanations of costs and next steps using plain language to reduce confusion, build trust, and guide their care.

Encourage patient questions with patience and respect, creating a safe space for open dialogue and using tools like Ask Me 3® to boost understanding and engagement.

Regularly review and update patient materials with input from staff and patients to keep them clear, accurate, and aligned with current best practices.

Measuring health literacy through patient surveys provides insights to improve communication, staff training, and materials, ensuring ongoing progress toward clearer, safer, and patient-centered care.