Locating Easy-to-Read Patient Materials
Top Tips
Health literacy refers to the set of skills needed to read, understand and act on basic health care information. Patients’ literacy skills can affect their ability to follow prescriptions, keep appointments, give informed consent or complete required forms. This can impact their health status and contribute to rising health care costs. According to the National Institute for Literacy, an estimated 90 million Americans have literacy skills that make navigating the health care system difficult. Below are some tips, adapted in part from the Maine Area Health Center (www.une.edu/com/othrdept/ahec/ahec_home_menu.html), for making patient materials easier to read.
- Talk to patients and families to assess materials you currently use. Ask them to help develop or test new materials.
- Limit technical language and jargon. Use a conversational style, friendly tone and explain unfamiliar terms.
- Keep words and sentences short. Use bullets for lists.
- Use illustrations to re-emphasize the text. Be sure they fit the intended audience.
- Ensure that material is culturally and age appropriate.
- Include lots of white space so the page does not look cluttered.
- Select a serif font (a typeface that has a short line or curl that stems from the ends of the letter) of at least 12-14 point size. Serif fonts are generally easier to read in print materials because the eye is better able to follow the lines from one letter to the next.
Online Tools and Resources
Ethnomed
www.ethnomed.org/
This site contains information about cultural beliefs, medical issues and other topics related to the health care of recent immigrants to the US, many of whom are refugees fleeing war-torn parts of the world. It includes patient information in languages such as Spanish, Khmer, Russian, Somali, Chinese and Vietnamese (some bilingual English). Additionally, you can find cultural profiles that provide overviews of traditional health care beliefs and practices as well as references for further reading for a range of ethnic groups and information on cross-cultural health topics and immigration issues.
Family Doctor.org
www.familydoctor.org/
The American Academy of Pediatrics hosts this user-friendly site. It includes interactive health information for children, teens and parents; Spanish language fact sheets on a variety of health conditions; drug and drug safety information including a searchable database with both patient and physician information; easy-to-read question and answer pages on common health topics; and a searchable health dictionary.
Health and Literacy Compendium
www.worlded.org/us/health/docs/comp/index.html
This site includes more than 80 citations to print and Web materials available in North America that covers topics such as: the links between health status and literacy status; how to assess and develop easy-to-read health education materials; how to teach health with literacy in mind, and how to teach literacy using health content; health education curricula and materials for adults with limited literacy skills; bibliographies and databases for easy-to-read or multilingual health materials; and articles about the connections between health and literacy.
Health and Literacy Special Collection
www.worlded.org/us/health/lincs/
Funded by the National Institute for Literacy, this site includes health curricula for literacy or English as a Second Language (ESL) classes, resources to provide basic health information in simple language, information about the link between literacy and health status, and links to organizations dedicated to health and literacy education. You may also subscribe to the Health Literacy listserv at www.nifl.gov/nifl-health/.
Health Literacy Toolbox
www.prenataled.com/healthlit/hlt2k/script/index.asp
Visit this site for articles and information related to health literacy, including the impact of low health literacy, laws and regulations, successful programs and resources for low-literacy health materials.
Journal of the American Medical Association Patient Page
www.ama-assn.org/public/journals/patient/
This site includes fact sheets on health topics in English and Spanish that can be freely copied for patient education.
Low Literacy Patient Handouts
http://itsa.ucsf.edu/~hclinic/handouts.dir/lowlit.dir/lowlit.html
A collection of 17 handouts prepared for the UCSF Homeless Clinic in 1995 by a medical student. The handouts are written in simple, clear language with a number of line drawings in order to convey their messages to persons who may not read English very well. Some handouts have blank, write in spaces for specific or personalized information (e.g. The How to Deal With Lice handout has a blank space in it where someone can fill in the locations of nearby Laundromats).
Medline Plus
www.nlm.nih.gov/medlineplus/
A major source for patient information and education, this site includes interactive, easy-to-understand slide presentations with audio, available in English and Spanish. You may also access a medical encyclopedia with pictures, medical dictionaries, provider directories and links to other health resources.
Patient Education Materials/Recursos en Español
www.med.utah.edu/pated/handouts/indexspan.cfm
This collection of Spanish materials is a collaborative effort between the Spencer S. Eccles Health Sciences Library and the University of Utah Health Sciences Center, funded by the National Library of Medicine. It includes resources on a variety of topics such as cancer, women’s health, pediatrics, infectious diseases, nutrition, prevention, skin care, orthopedics and poison control, as well as Frequently Asked Questions (FAQ) and links to multilingual health information.
Patient Education Menu
http://lib-sh.lsumc.edu/fammed/pted/pted.html
Sponsored by Louisiana State University Health Sciences Center, the Patient Education Menu posts materials, many of which are designed for low-literacy audiences.
Patient Education Resources for Clinicians
www.ohsu.edu/library/patiented/
As part of Oregon Health and Science University’s Consumer Health Library, this section includes links to low-literacy patient education materials in English and Spanish, as well as a few links to other Non-English language sites of interest.
Spanish Patient Education Websites
www.ach.uams.edu/frlibrary/spanish_patient_education_website.html
Posted as part of Arkansas Children's Hospital Family Resource Library, this page contains links to approximately 30 websites that post Spanish language patient education materials.
Stanford Patient Education Research Center
www.stanford.edu/group/perc/index.html
This site offers selected books and audiotapes in English and Spanish.
UCSF Vietnamese Community Health Promotion Project
www.suckhoelavang.org/main.html
Includes downloadable Vietnamese language health education materials on topics such as breast and cervical cancer, quitting smoking, hepatitis B and Vietnamese recipes.
Suggested Reading
Center for Health Care Strategies and National Academy on an Aging Society. Low Health Literacy Skills Increase Annual Health Care Expenditures by $73 Billion. Fact sheet can be downloaded at: www.agingsociety.org/healthlit.htm
Doak, Cecilia, Doak, Leonard and Root, Jane. (1995). Teaching Patients with Low Literacy Skills. Philadelphia, PA: Lippincott, Williams & Wilkins. This guide shows how to develop various types of patient teaching materials, assess the suitability of materials, help patients understand health teaching, motivate patients to comply with health care instructions, use visuals to communicate, teach with technology, reduce material development costs, and more. To order, call (800) 777-2295 or visit the web at: http://lww.com/store/products?0-397-55161-4.
González, Virginia, González Judith T., Freeman, Victor and Howard-Pitney, Beth. (1991). Health Promotion in Diverse Cultural Communities. Palo Alto, CA: Stanford University, Stanford Center for Research in Disease Prevention (http://prevention.stanford.edu/). This book presents practical guidelines for working more successfully in and with diverse cultural communities, without perpetuating cultural stereotypes. It suggests some ways to learn about the cultural specifics of a community, with the understanding that each community's cultural identity and background is quite diverse and dynamic.
Pfizer. Low Health Literacy Harms Patient Health, Increases Health Care Costs. From the Views Making News website at: www.viewsmakingnews.com/policy/literacy.shtml (also links to a check list for Producing Easy-to-Read Materials).
© Public Health Institute, Center for Civic Partnerships 1999
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