Assessing the Health Literacy Environment

Assessing your environment is a key step in understanding and assessing the literacy barriers that exist and how to approach intervention.  Below are resources that will assist you.


Environment Navigation PacketCoverThe Health Literacy Environment of Hospitals and Health Centers – Partners for Action: Making Your Healthcare Facility Literacy-Friendly by R. Rudd, J. Anderson, 2006. This guide and the review tools found within it offer an approach for analyzing literacy-related barriers to healthcare access and navigation. We designed this guide to assist chief executive officers, presidents, program directors, administrators, and healthcare workers at hospitals or health centers to consider the health literacy environment of their facilities and to analyze ways to better serve their patients.



ActivityPacketCover (activitypacketcover.jpg)The Health Literacy Environment Activity Packet: First Impressions and A Walking Interview. by R. Rudd, 2010.
This packet focuses on four activities designed to help staff members consider the health literacy environment of their workplace.  First impressions focus on the phone, the web and the walk to the facility.  The walking interview is a navigation exercise.




AHRQCover (ahrqcover.jpg)AHRQ Health Literacy Universal Precautions Toolkit. by D. DeWalt, L. Callahan, V. Hawk, K. Broucksou, A. Hink, R. Rudd, C; 2010.

This toolkit provides step-by-step guidance for examining health literacy in clinical practice settings.  It provides tools for assessing practice and improving interactions with patitenst at all literacy levels.






Navigating Hospitals: Literacy Barriers. by R. Rudd, Literacy Harvest; 2005.

This report is a result of a small exploratory examination of hospital navigation issues in order to garner insight into the literacy environment of hospitals.  Walking interviews were conducted around the public areas of ten municipal hospitals.





Literacy Demands in Health Care Settings: The Patient Perspective by R. Rudd, D. Renzulli, A. Pereira, L. Daltroy.  Understanding Health Literacy: Implications for Medicine and Public Health; 2005

This report examines the literacy demands present in health care settings through a discussion of the patient’s perspective on physical navigation, documents and open entry forms, written directions, patients rights, and patient-provider communication. It discusses the implications of these demands and the needed actions.




Reducing Health Literacy Barriers: How do Medical Doctors Speak to Patients. by O. Gröne, M. Santiñà, M. Borrell, M. Brianso,D. Corominas, M. Febré, M. Fernández, M. González, M. Rubio, R. Sunyer, C. Valls, C. Iniesta; 2010.

This provides a brief summary of a study conducted in the Health Promoting Hospitals Catalonian network.  Researchers assessed the perception of patients about oral and written communication for one clinical process in 9 hospitals.


Assessing the Health Literacy Environment of a Comprehensive Cancer Center. by S. Raivitch, L. Fleisher, R. Gallo, C. Weaver, L. Hammell, R. Rudd; 2010.

This provides a brief summary of a study conducted at the Fox Chase Cancer Center.  Researchers assessed the health literacy environment using an interdisciplinary approach that included activities such as awareness building, educational seminars for staff, plain language evaluation and development services.


Health Literacy Environment of Hospitals, Health and Social Service Agencies.  by R. Rudd, O. Groene, W. Lawrence, L. Fleisher; 2010.

This provides a brief summary of a study conducted in four cities.  Using an environment assessment tool developed by Rudd, researchers conducted walking interviews in hospitals, assessed a sample of available materials and examined aspects of the oral exchange.