20 tools address literacy needs

Toolkit offers range of resources

Some of the "tools" in the Health Literacy Universal Precautions Toolkit may not be the typical forms or handouts that many toolkits provide, but they are effective, says Laura Noonan, MD, director of the Center for Advancing Pediatric Excellence at Carolinas Healthcare System in Charlotte, NC.

For example, one of the tools is a list of recommendations to improve one-on-one communication with patients. In addition to the description of tips, such as greeting patients with a smile and speaking at a moderate pace, the tool includes links to other teaching methods that should be incorporated into one-on-one teaching.

The toolkit addresses four areas:

1. Improve spoken communication.

2. Improve written communication.

3. Improve self-management and empowerment.

4. Improve supportive systems.

One area that surprises many people is the section on supportive systems, says Darren DeWalt, MD, associate professor of medicine at University of North Carolina School of Medicine in Chapel Hill and lead author of the toolkit. "We found that even when you make sure the patient understands the importance of taking medication, if the patient can't afford the medication or has no transportation to go to a pharmacy, the medication won't be taken," he explains. For this reason, a number of tools to identify community resources to address barriers beyond literacy are included in the kit, he says.

A few of the tools included in the kit are:

the teach-back method

telephone considerations

brown bag medication review

how to address language differences

culture and other considerations

design easy-to-read material

welcome patients: helpful attitudes, signs, and more

encourage questions

improve medication adherence and accuracy

get patient feedback

link patients to non-medical support.