Provider perceptions of limited health literacy in community health centers

Patient Educ Couns. 2007 Dec;69(1-3):114-20. doi: 10.1016/j.pec.2007.08.003. Epub 2007 Sep 21.


Objective: To examine techniques used by community health center (HC) providers to care for patients with limited health literacy (LHL).

Methods: Survey mailed to 803 HC providers in 10 Midwestern states. Response rate was 47.5%. Associations between variables were examined using generalized estimating equations (GEE) models to account for clustering of respondents within HCs.

Results: The average provider estimates of LHL prevalence among English- and Spanish-speaking patients were 41+/-24% (mean+/-S.D.) and 48+/-30%, respectively. Those with training in health literacy were more likely to have patients repeat instructions back to check understanding (OR=2.05 and p=0.04) and were more likely to give out health education materials designed for patients with LHL (OR=2.80 and p=0.0002). Providers differed by type in encouraging patients to bring friends or family members to appointments (p=0.02).

Conclusion: Providers estimate LHL to be highly prevalent in their HCs, and use various techniques to assist patients.

Practice implications: Training in health literacy is associated with increased usage of evidence-based techniques to assist patients with LHL. Providers at all levels would likely benefit from LHL training. Most providers believe providing health education materials designed specifically for patients with LHL would be very helpful.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Community Health Centers* / organization & administration
  • Educational Status
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Services Needs and Demand
  • Helping Behavior
  • Humans
  • Logistic Models
  • Male
  • Mass Screening
  • Medical Staff / education
  • Medical Staff / organization & administration
  • Medical Staff / psychology
  • Middle Aged
  • Midwestern United States
  • Nurse Practitioners / education
  • Nurse Practitioners / organization & administration
  • Nurse Practitioners / psychology
  • Nursing Assessment
  • Nursing Methodology Research
  • Nursing Staff / education
  • Nursing Staff / organization & administration
  • Nursing Staff / psychology
  • Patient Education as Topic / organization & administration*
  • Primary Health Care / organization & administration
  • Professional Role / psychology*
  • Surveys and Questionnaires