Letter to the Editor by Cheryl Allen on Health Literacy: Challenges and Strategies

Promoting Health Literacy: Strategies for Healthcare Providers

May 3, 2013

Response by Cheryl Allen on Health Literacy: Challenges and Strategies, by Nichole Egbert, PhD and Kevin M. Nanna, MSN, RN, BC-NE (September 30, 2009)

Dear Editor:

I recently came across an article in your journal that raised the idea of health literacy as a social issue (Egbert & Nanna, 2009). I cannot seem let go of the thought that if we approach the problem of low health literacy as a community need, then innovative solutions become available.

There are many challenges that seem wise to remember when trying to improve health literacy in our patient population—particular skills may be lacking on the part of the patient or healthcare provider; healthcare personnel making assumptions about what a patient understands; language barriers; time constraints; and the easy availability of incorrect information on the internet. All of these concerns can be obstacles that may lead to negative outcomes for patients. An easy trap for providers to fall into is believing that a patient is being difficult when the real issue is that he or she never understood what we tried to teach them in the first place (Cornett, 2009; Brown & Bussell, 2011).

At first glance, trying to view health literacy as a social need seems overwhelming, but I encourage you to use a different viewpoint. Of course, there is no arguing the importance of providing individualized patient education, but during patient care we also provide generic health information that has value for the community where the patient lives. Throughout my nursing career, I have learned that a) patients talk with family/friends about their health issues and b) they want to feel useful. By recognizing these two observations as educational vehicles, we open the door for patients to actively participate in helping to improve their community. A personal example that comes to mind concerns getting patients to understand the importance of yearly influenza (flu) vaccinations. “Have you had your flu shot” is a straight forward question many of us ask. If my patient says yes, I applaud this and ask if their family members have also gotten their flu shots. Then, I thank them for doing their part to help protect their community. If the answer is no, I spend a few minutes exploring why not. Either way, I have added only a few minutes to the admission process - but what I have really accomplished is to help my patient to think about the impact he or she can have in the community.

Delivering healthcare today requires us to be as resourceful as possible. It can be hard to see beyond immediate concerns especially when we are expected to deliver care with fewer resources. By shifting our perspective, the avenue for improving the health of individual patients is now widened to include their communities. Being a patient is just one role a person may fill at any given time—but the role of community member is shared by all—and being able to positively impact others is important. By visualizing our patients as partners that can help improve their communities, we demonstrate that we value them as an individual person and also the community they represent.


Cheryl A. Allen BSN RN-BC

Brown, M. T., & Bussell, J. K. (2011). Medication adherence: WHO cares? Mayo Clinic Proceedings, 86(4), 304-314.

Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of Issues in Nursing, 14(3). Retrieved from www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No3Sept09/Assessing-Health-Literacy-.html

Egbert, N., & Nanna, K. (2009). Health literacy: Challenges and strategies. OJIN: The Online Journal of Issues in Nursing, 14 (3). Retrieved from: www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No3Sept09/Health-Literacy-Challenges.html