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<h1>Current Bibliographies in Medicine 2000-1</h1>
<hr />
<h1><a id="list" name="list">Health Literacy</a></h1>
<hr />
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<td valign="top" width="150" bgcolor="#dddddd"><font
face="Arial, Helvetica"><b>Table of Contents</b><br /></font>
<hr />
<font face="Arial, Helvetica"><br /><a
href="hliteracy.html#5">Series
Note</a><br /><br /><a
href="hliteracy.html#10"><font size="-1">PDF
Version of This CBM</font></a><br /><br /><a
href="hliteracy.html#20">Sample
Citations</a><br /><br /><a
href="hliteracy.html#15">Introduction</a><br /><br /><b>Bibliography</b>:<br /><br /></font>
<p><font face="Arial, Helvetica"><a
href="hliteracy.html#100">I.
Background</a></font></p>
<p><a href="hliteracy.html#110">II.
Strategies in Health Literacy</a></p>
<ol type="A">
<li><a href="hliteracy.html#120"><font
size="-1">Theoretical Constructs</font></a>
<li><a href="hliteracy.html#130"><font
size="-1">Applied Communication Strategies</font></a>
<ol type="1">
<li><a href="hliteracy.html#140"><font
size="-1">Media</font></a>
<li><a href="hliteracy.html#150"><font
size="-1">Negotiation / Policy</font></a> </li></ol></li></ol>
<p><a href="hliteracy.html#160">III.
Tactics</a></p>
<ol type="A">
<li><a href="hliteracy.html#170"><font
size="-1">New Technologic Interventions</font></a>
<li><a href="hliteracy.html#180"><font
size="-1">Educational Programs</font></a>
<li><a href="hliteracy.html#190"><font
size="-1">Readability Indices (Applied)</font></a>
<li><a href="hliteracy.html#200"><font
size="-1">Special Populations</font></a>
<li><a href="hliteracy.html#220"><font
size="-1">Client Communication</font></a>
<li><a href="hliteracy.html#240"><font
size="-1">Disease / Content Specific (e.g., diabetes, tobacco)</font></a>
</li></ol>
<p><a href="hliteracy.html#250">IV.
Ideas</a></p>
<ol type="A">
<li><a href="hliteracy.html#260"><font
size="-1">Theory</font></a>
<li><a href="hliteracy.html#270"><font
size="-1">Measurement Techniques</font></a>
<li><a href="hliteracy.html#280"><font
size="-1">Communicating Risk</font></a>
<li><a href="hliteracy.html#290"><font
size="-1">Cross-Cultural / Cultural Competency</font></a>
<li><a href="hliteracy.html#300"><font
size="-1">International Experiences</font></a> </li></ol>
<p><a href="hliteracy.html#310">V.
Internet Resources</a></p>
<p><a href="hliteracy.html#320">Appendix:
Readability</a></p><br />
<hr />
<p><a href="hliteracy.html#top"><font
size="-1"><i>Return to the top</i></font></a></p></td>
<td valign="top" width="490">
<p>January 1990 through October 1999</p>
<p>479 Citations</p>
<p>Prepared by<br />Catherine R. Selden, M.L.S., National Library of
Medicine<br />Marcia Zorn, M.A., M.L.S., National Library of
Medicine<br />Scott C. Ratzan, M.D., M.P.A., M.A., <i>Journal of Health
Communication</i>, Academy for Educational Development<br />Ruth M. Parker,
M.D., Emory University School of Medicine<br /></p>
<p>2000 February</p>
<p>U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES<br />Public Health
Service<br />National Institutes of Health</p>
<p><a href="http://www.nlm.nih.gov/nlmhome.html">National Library of
Medicine</a><br />Reference Section<br />8600 Rockville Pike<br />Bethesda,
Maryland 20894</p>
<hr />
<p><a name="5"><b>Series Note</b></a></p>
<p>Each bibliography in the Current Bibliographies in Medicine (CBM)
series covers a distinct subject area of biomedicine and is intended to
fulfill a current awareness function. Citations are usually derived from
searching a variety of online databases. <a
href="pubs/factsheets/online_databases.html">NLM
databases</a> utilized include MEDLINE®, AVLINE®, BIOETHICSLINE®,
CANCERLIT®, CATLINE®, HEALTHSTAR<sup><font size="1">tm</font></sup>,
POPLINE<sup><font size="-2">tm</font></sup>, and TOXLINE®. The only
criterion for the inclusion of a particular published work is its
relevance to the topic being presented; the format, ownership, or location
of the material is not considered.</p>
<p>Other publications in the <i>Current Bibliographies in Medicine</i>
series are available at no cost to anyone with Internet access through the
Library's World Wide Web site at <a
href="pubs/resources.html">pubs/resources.html</a>.</p>
<p>Comments and suggestions on this series may be addressed to:</p>
<p>Karen Patrias, Editor<br />Current Bibliographies in
Medicine<br />Reference Section<br />National Library of Medicine<br />Bethesda,
MD 20894<br />Phone: 301-496-6097<br />Fax: 301-402-1384<br />Internet: <a
href="mailto:ref@nlm.nih.gov">ref@nlm.nih.gov</a></p>
<p><b>PubMed<sup><font size="1">TM</font></sup> and Internet Grateful
Med®</b></p>
<p>To make online searching easier and more efficient, the Library offers
two user-friendly interfaces to its databases. Both PubMed and Internet
Grateful Med are available from the World Wide Web. The user with Internet
access need only point a compatible Web browser to the NLM Web site <a
href="http://www.nlm.nih.gov/nlmhome.html">http://www.nlm.nih.gov/nlmhome.html</a>.
No other software at the user end is required. Searching through either
PubMed or Internet Grateful Med is free-of-charge. Further information on
both PubMed and Internet Grateful Med may be found at the NLM Web site
given above.</p>
<p>For those users without access to the World Wide Web, please contact
the Library's Customer Service Desk at 1-888-FINDNLM (301-594-5983
international) or <a
href="http://apps.nlm.nih.gov/mainweb/siebel/nlm/index.cfm">send
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<p><a href="hliteracy.html#top"><font
size="-1"><i>Return to the top</i></font></a></p>
<hr />
<p><b><a name="10">PDF Version of This CBM</a></b></p>
<p>Beginning with the 2000 CBMs, two formats are offered: HyperText Markup
Language (HTML) and Portable Document Format (PDF). PDF documents require
the use of the Adobe® Acrobat® Reader, which can be <a
href="http://www.adobe.com/products/acrobat/readstep.html">downloaded</a>
from Adobe's Web site at no charge.</p>
<p>The PDF version of this CBM can be downloaded directly from <a
href="hliteracy.pdf">hliteracy.pdf</a>.</p>
<p><a href="hliteracy.html#top"><font
size="-1"><i>Return to the top</i></font></a></p>
<hr />
<p><b><a name="20">Sample Citations</a></b></p>
<p>Citations are formatted according to the rules established for <i>Index
Medicus</i>®<b>*</b>. Sample journal and monograph citations appear below.
For journal articles written in a foreign language, the English
translation of the title is placed in brackets; for monographs, the title
is given in the original language. In both cases the language of
publication is shown by a three letter abbreviation appearing at the end
of the citation.</p>
<p><b>Journal Article:</b></p>
<p><i>Example:</i><br />Baker DW, Parker RM, Williams MV, Clark WS, Nurss J.
The relationship of patient reading ability to self-reported health and
use of health services. Am J Public Health 1997 Jun;87(6):1027-30.</p>
<p><i>Order, with separating punctuation:</i><br />Authors. Article Title.
Abbreviated Journal Title Date;Volume(Issue):Pages.</p>
<p><b>Monograph:</b></p>
<p><i>Example:</i><br />AMC Cancer Research Center; Centers for Disease
Control and Prevention (US). Beyond the brochure: alternative approaches
to effective health communication. Denver (CO): The Center; 1994. 74
p.</p>
<p><i>Order, with separating punctuation:</i><br />Authors/Editors. Title.
Edition. Place of Publication: Publisher; Date. Total No. of Pages.</p>
<p><b>*</b> For details of the formats used for references, see the
following publication:<br />Patrias, Karen. <i>National Library of Medicine
recommended formats for bibliographic citation</i>. Bethesda (MD): The
Library; 1991 Apr. Available from: NTIS, Springfield, VA; PB91-182030.</p>
<p><a href="hliteracy.html#top"><font
size="-1"><i>Return to the top</i></font></a></p></td></tr></tbody></table>
<hr />
<p><a name="15"><b><font size="+2">Introduction</font></b></a></p>
<hr />
<p><font size="+1">Health Literacy</font></p>
<p>As we enter the twenty-first century, medical discovery is advancing at a
rate unequaled in any previous time, yet Americans have not kept pace in
adopting ideal health behaviors to live longer, better lives. It took over
twenty-five years with a major long-term initiative by the National Heart, Lung,
and Blood Institute to get many individuals in this country to know their blood
pressure level and seek appropriate treatment. Numerous efforts to eliminate
smoking have achieved only moderate success, and many Americans avoid getting
appropriate medical check-ups for breast, colorectal, and cervical cancer even
though it might help them live longer. Is the problem that people do not know,
do not want to know, or just do not care? Perhaps one answer is that they are
unable to understand and process the health information available to them.</p>
<p>Americans are reportedly more educated today than at any time in our history.
According to the 1993 National Adult Literacy Survey (NALS), the average
educational attainment of US adults is above the twelfth grade level. <sup><a
href="hliteracy.html#01">1</a></sup> However,
educational level does not necessarily translate into a corresponding level of
reading or comprehension. Twenty-two percent of the 13,600 adults surveyed for
the NALS struggle with such tasks as locating the expiration date on a driver's
license or determining the location of a meeting on a form. Another fifty
million Americans have only marginal literacy skills, as they have difficulty
locating an intersection on a street map and identifying and entering background
information on a social security application. Inadequate literacy is especially
common among the elderly, with nearly half scoring in the lowest skill level.
Unfortunately, despite our increasing education, average reading skills of
adults in the United States are between the eighth and ninth grade levels.
<sup><a href="hliteracy.html#02">2</a></sup>
Overall, among the 90 million Americans with limited literacy skills, only 15%
were born outside the country and 5 % reported having a learning
disability<sup><a
href="hliteracy.html#01">1</a></sup>. Literacy
is also content and setting specific. An individual may have adequate
understanding of material with familiar content, but struggle to comprehend
information with unfamiliar vocabulary and concepts.</p>
<p>What is health literacy? The term was first used in a 1974 paper titled
<i>Health education as social policy</i>. <sup><a
href="hliteracy.html#03">3</a></sup> In
discussing health education as a policy issue affecting the health care system,
the educational system, and mass communication, the author calls for minimum
standards for "health literacy" for all school grade levels. This early use of
the term shows there is a link between health literacy and health education.
Failures in health education have certainly contributed to poor health literacy,
but the roots of the health literacy problems in this country are not just in
the history of our system of education. Health literacy problems have grown as
patients are asked to assume more responsibility for self-care in a complex
health care system. Patients' health literacy, then, can be thought of as the
currency needed to negotiate this complex system.</p>
<p>Appropriate health literacy is also essential to health promotion,
particularly as we address issues of primary prevention. A health literate
individual is more apt to know how to answer the question "How do I keep myself
well?" Adequate health literacy maybe of even greater importance in secondary
prevention, as ineffective communication between health providers and patients
can result in medical errors due to misinformation about medications and
self-care instructions.</p>
<p>A 1999 report of the Council of Scientific Affairs of the American Medical
Association <sup><a
href="hliteracy.html#04">4</a></sup> refers to
functional health literacy as "the ability to read and comprehend prescription
bottles, appointment slips, and the other essential health-related materials
required to successfully function as a patient." In the largest study of health
literacy to date,<sup><a
href="hliteracy.html#05">5</a></sup> one third
of English-speaking patients at two public hospitals were unable to read basic
health materials. Forty-two percent of patients could not comprehend directions
for taking medication on an empty stomach, 26% were unable to understand
information on an appointment slip, 43% did not understand the rights and
responsibilities section of a Medicaid application, and 60% did not understand a
standard informed consent document. A recent study of community-dwelling
Medicare managed care patients in four cities <sup><a
href="hliteracy.html#06">6</a></sup> found that
34% of the English speaking and 54% of the Spanish speaking patients had
inadequate or marginal health literacy.</p>
<p>With the proliferation of new media, health information is becoming
voluminous. Unfortunately health information is also more fragmented and
confusing due to its many different formats and its duplication in multiple
locations. Educational multimedia products, electronic communication, advanced
networking technologies, and distance learning are expanding and hold out the
promise for increasing health literacy. Some people can use multimedia to learn
interactively what they might not have learned with traditional print or oral
instruction alone.</p>
<p>This bibliography has been compiled to help define and describe the evidence
base for advancing health literacy programs by examining theories, strategies,
and tactics in the published literature. For purposes of the bibliography and to
further the study of health literacy, we have defined health literacy as " the
degree to which individuals have the capacity to obtain, process, and understand
basic health information and services needed to make appropriate health
decisions." In compiling this bibliography a variety of government-sponsored and
commercially available databases as well as the Internet were searched for
candidate material published within the past ten years. In addition, a number of
health education and health communication journals were manually searched. Using
these sources over 3500 citations were retrieved. Those references in which
health literacy contributed to the definition stated above or evaluated tactics
and/or strategies to further health literacy were selected. The references were
then arranged into four broad subject categories: Background; Strategies in
Health Literacy; Tactics; and Ideas. Following these categories, there is a
section of Internet Resources. This list is not meant to be all inclusive, but
rather is intended to provide representative government and private sites which
will lead the user to additional information. Finally, we have added an Appendix
of citations on Readability. Generally, items in foreign languages, letters to
the editor, editorials, and book chapters were eliminated. In addition,
references focused on communicating with special needs populations, e.g.,
visually/hearing impaired and psychiatric patients, were eliminated. Most
references dealing with the physician-patient relationship and truth telling
were eliminated also.</p>
<p>The attainment of health literacy for our nation's citizens is a task of
great magnitude. At this point we have only limited knowledge about which
learning strategies and tactics are the most viable. We hope that this
bibliography will provide a foundation for future work in health literacy and
challenge others to add their efforts to it.</p>
<p>Scott C. Ratzan, M.D., M.P.A., M.A.<br /><i>Journal of Health
Communication</i><br />Academy for Educational Development</p>
<p>Ruth M. Parker, M.D.<br />Emory University School of Medicine<br /></p><br />
<p>The compilers wish to thank Mary Ryan, Dora Smith, and Karen Patrias of the
National Library of Medicine for their editorial and production assistance.</p>
<p>Any reproductions of this bibliography, in whole or in part, must include all
credits. If you wish to cite this bibliography, the correct format
is:<br />Selden, Catherine; Zorn, Marcia; Ratzan, Scott C.; Parker, Ruth M.,
compilers. Health literacy [bibliography online]. Bethesda (MD): National
Library of Medicine; 2000 Feb [insert cited year month day in brackets]. [insert
no. of screens or lines in brackets]. (Current bibliographies in medicine; no.
2000-1). 479 citations from January 1990 through October 1999. Available from:
<a
href="pubs/resources.html">pubs/resources.html</a></p>
<hr align="left" width="550" />
<p>References:</p>
<p><a name="01">1.</a> Kirsch I, Jungeblut A, Jenkins L, Kolstad A. Adult literacy
in America: a first look at the results of the National Adult Literacy Survey.
Washington: Department of Education (US), National Center for Education
Statistics; 1993.</p>
<p><a name="02">2.</a> Stedman L, Kaestle C. Literacy and reading performance in
the United States from 1880 to present. In: Kaestle C, editor. Literacy in the
United States: readers and readings since 1880. New Haven (CT): Yale University
Press; 1991. p. 75-128.</p>
<p><a name="03">3.</a> Simonds SK. Health education as social policy. Health Educ
Monogr 1974;2:1-25.</p>
<p><a name="04">4.</a> American Medical Association, Council on Scientific
Affairs, Ad Hoc Committee on Health Literacy. Health literacy: report of the
Council on Scientific Affairs. JAMA 1999 Feb 10;281(6):552-7.</p>
<p><a name="05">5.</a> Williams MV, Parker RM, Baker DW, Parikh NS, Pitkin K,
Coates WC, Nurss JR. Inadequate functional health literacy among patients at two
public hospitals. JAMA 1995 Dec 6; 274(21):1677-82.</p>
<p><a name="06">6.</a> Gazmararian JA, Baker DW, Williams MV, Parker RM, Scott TL,
Green DC, Fehrenbach SN, Ren J, Koplan JP. Health literacy among Medicare
enrollees in a managed care organization. JAMA 1999 Feb 10;281(6):545-51.</p>
<p><a href="hliteracy.html#top"><font
size="-1"><i>Return to the top</i></font></a></p>
<hr />
<h2><a name="100">I. Background</a></h2>
<hr />
<p>AMC Cancer Research Center; Centers for Disease Control and Prevention (US).
Beyond the brochure: alternative approaches to effective health communication.
Denver (CO): The Center; 1994. 74 p. Available from: <a
href="http://www.cdc.gov/cancer/publica.htm">http://www.cdc.gov/cancer/publica.htm</a></p>
<p>American Medical Association, Ad Hoc Committee on Health Literacy for the
Council on Scientific Affairs. Health literacy: report of the Council on
Scientific Affairs. JAMA 1999 Feb 10;281(6):552-7.</p>
<p>Baker DW. Reading between the lines - Deciphering the connections between
literacy and health. J Gen Intern Med 1999 May;14(5):315-7.</p>
<p>Baker DW, Parker RM, Williams MV, Clark WS. Health literacy and the risk of
hospital admission. J Gen Intern Med 1998 Dec;13(12):791-8. Comment in: J Gen
Intern Med 1998 Dec;13(12):850-1.</p>
<p>Baker DW, Parker RM, Williams MV, Clark WS, Nurss J. The relationship of
patient reading ability to self-reported health and use of health services. Am J
Public Health 1997 Jun;87(6):1027-30.</p>
<p>Beitz JM. Education for health promotion and disease prevention: convince
them, don't confuse them. Ostomy Wound Manage 1998 Mar;44(3A Suppl):71S-76S;
discussion 77S.</p>
<p>Breen M. Women, literacy and action: a handbook. Toronto: Ontario Literacy
Coalition; 1991 Feb. 69 p.</p>
<p>Buck ML. Providing patients with written medication information. Ann
Pharmacother 1998 Sep;32(9):962-9.</p>
<p>Cate FH, Blanck PD, Makoul G. Communications in medicine: the Annenberg
Washington program and a decade of making a difference [monograph on the
Internet]. Washington: Northwestern University, The Annenberg Washington Program
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Available from: <a
href="http://www.annenberg.nwu.edu/pubs/commed/">http://www.annenberg.nwu.edu/pubs/commed/</a></p>
<p>Centers for Disease Control and Prevention (US), Center for Chronic Disease
Prevention and Health Promotion. Literacy and health in the United States:
selected annotations. Atlanta: CDC; 1991 Mar. 65 p.</p>
<p>Cresswell PA, Tait EJ, Donaldson LJ. Nomenclature of health care
organisations: the extent of public understanding. J R Soc Health 1996
Jun;116(3):180-2.</p>
<p>Davis TC, Arnold C, Berkel HJ, Nandy I, Jackson RH, Glass J. Knowledge and
attitude on screening mammography among low-literate, low-income women. Cancer
1996 Nov 1;78(9):1912-20.</p>
<p>Davis TC, Crouch MA, Wills G, Miller S, Abdehou DM. The gap between patient
reading comprehension and the readability of patient education materials. J Fam
Pract 1990 Nov;31(5):533-8.</p>
<p>Davis TC, Meldrum H, Tippy PKP, Weiss BD, Williams MV. How poor literacy
leads to poor health care. Patient Care 1996 Oct 15;30(16):94-119.</p>
<p>Division of Adult Education and Literacy Clearinghouse bibliography of
resource materials 1998 [monograph on the Internet]. Washington: Dept. of
Education (US); [modified 1999 Nov 11; cited 2000 Jan 19]. Available from:
http://www.ed.gov/offices/OVAE/bib98.html</p>
<p>Eng TR, Maxfield A, Patrick K, Deering MJ, Ratzan SC, Gustafson DH. Access to
health information and support: a public highway or a private road? JAMA 1998
Oct 21;280(15):1371-5.</p>
<p>Farrow SC, Charny MC, Lewis PA. People's knowledge of health and disease. J
Public Health Med 1990 Feb;12(1):2-8. Comment in: J Public Health Med 1991
Feb;13(1):54.</p>
<p>Fredrickson DD, Washington RL, Pham N, Jackson T, Wiltshire J, Jecha LD.
Reading grade levels and health behaviors of parents at child clinics. Kans Med
1995 Fall;96(3):127-9.</p>
<p>Gazmararian JA, Baker DW, Williams MV, Parker RM, Scott TL, Green DC,
Fehrenbach SN, Ren J, Koplan JP. Health literacy among Medicare enrollees in a
managed care organization. JAMA 1999 Feb 10;281(6):545-51.</p>
<p>Giorgianni ST. Responding to the challenge of health literacy. Pfizer J
[journal on the Internet]. c 1998,1999 [modified 1999 Dec 13; cited 2000 Feb 4];
document 5. Available from: <a
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<p>Hanson C. Computer applications in health enhancement [monograph on the
Internet]. Billings (MT): Montana State University; 1998 Oct 15 [cited 2000 Jan
19]. 16 slides. Available from:
http://www.msubillings.edu/fac/hanson/mahperd/sld001.htm PowerPoint
Presentation.</p>
<p>Health communication and literacy: an annotated bibliography [monograph on
the Internet]. Montreal: Center for Literacy; [modified 1999 Jun 25; cited 2000
Jan 19]. Available from: <a
href="http://www.nald.ca/province/que/litcent/publication_products/hclbibli/cover.htm">http://www.nald.ca/province/que/litcent/Publication_Products/Hclbibli/cover.htm</a></p>
<p>Irvine C. Health and literacy compendium: an annotated bibliography of print
and Web-based health materials for use with limited-literacy adults [monograph
on the Internet]. Boston: World Education, Health and Literacy Initiative; 1999
[modified 1999 Jun 11; cited 2000 Jan 19]. Available from: <a
href="http://easternlincs.worlded.org/health/comp/index.html">http://easternlincs.worlded.org/health/comp/index.html</a></p>
<p>Jackson RH, Davis TC, Bairnsfather LE, George RB, Crouch MA, Gault H. Patient
reading ability: an overlooked problem in health care. South Med J 1991
Oct;84(10):1172-5.</p>
<p>Jolly BT, Scott JL, Feied CF, Sanford SM. Functional illiteracy among
emergency department patients: a preliminary study. Ann Emerg Med 1993
Mar;22(3):573-8.</p>
<p>Kalichman SC, Ramachandran B, Catz S. Adherence to combination antiretroviral
therapies in HIV patients of low health literacy. J Gen Intern Med 1999
May;14(5):267-73. Comment in: J Gen Intern Med 1999 May;14(5):315-7.</p>
<p>Kanonowicz L. National project to publicize link between literacy, health.
CMAJ 1993 Apr 1;148(7):1201-2. Comment in: CMAJ 1993 Nov 15;149(10):1379,
1382.</p>
<p>Kirsch IS, Jungeblut A, Jenkins L, Kolstad A. Adult literacy in America: a
first look at the results of the National Adult Literacy Survey. Washington:
Dept. of Education (US); 1993. Available from: ERIC Document Reproduction
Service, Springfield, VA; No. ED358375.</p>
<p>Lasater L, Mehler PS. The illiterate patient: screening and management. Hosp
Pract (Off Ed) 1998 Apr 15;33(4):163-5, 169-70.</p>
<p>Lee PP. Why literacy matters. Links between reading ability and health. Arch
Ophthalmol 1999 Jan;117(1):100-3.</p>
<p>Ley P. The use and improvement of written communication in mental health care
and promotion. Psychol Health Med 1998 Feb;3(1):19-53.</p>
<p>Logan PD, Schwab RA, Salomone JA 3rd, Watson WA. Patient understanding of
emergency department discharge instructions. South Med J 1996
Aug;89(8):770-4.</p>
<p>Marwick C. Patients' lack of literacy may contribute to billions of dollars
in higher hospital costs [news]. JAMA 1997 Sep 24;278(12):971-2.</p>
<p>Mayberry JF, Mayberry MK. Effective instructions for patients. J R Coll
Physicians Lond 1996 May-Jun;30(3):205-8.</p>
<p>Mayeaux EJ Jr, Murphy PW, Arnold C, Davis TC, Jackson RH, Sentell T.
Improving patient education for patients with low literacy skills. Am Fam
Physician 1996 Jan;53(1):205-11.</p>
<p>Mazta SR, Ahelluwalia SK. Literacy campaign and health education go hand in
hand [letter]. World Health Forum 1995;16(2):184-5.</p>
<p>Miles S, Davis T. Patients who can't read. Implications for the health care
system [editorial]. JAMA 1995 Dec 6;274(21):1719-20. Comment on: JAMA 1995 Dec
6;274(21):1677-82.</p>
<p>Morley G. Functional health literacy: a primer. Princeton (NJ): Center for
Health Care Strategies; 1997 Dec. 9 p.</p>
<p>Murphy PW, Davis TC, Mayeaux EJ, Sentell T, Arnold C, Rebouche C. Teaching
nutrition education in adult learning centers: linking literacy, health care,
and the community. J Community Health Nurs 1996;13(3):149-58.</p>
<p>National Work Group on Cancer and Literacy. Interview report. Bethesda (MD):
National Cancer Institute; 1993 Nov. 32 p.</p>
<p>National Work Group on Literacy and Health. Communicating with patients who
have limited literacy skills. J Fam Pract 1998 Feb;46(2):168-76.</p>
<p>Perrin B. How does literacy affect the health of Canadians? A profile paper
[monograph on the Internet]. Ottawa: Minister of Public Works and Government
Serivces Canada; 1998 [modified 1999 Oct 20; cited 2000 Jan 19]. Available from:
<a
href="http://www.hc-sc.gc.ca/hppb/healthpromotiondevelopment/pube/literacy-health/literacy.htm">http://www.hc-sc.gc.ca/hppb/healthpromotiondevelopment/pube/literacy-health/literacy.htm</a></p>
<p>Root J, Stableford S. Easy-to-read consumer communications: a missing link in
Medicaid managed care. J Health Polit Policy Law 1999 Feb;24(1):1-26.</p>
<p>Roter DL, Rudd RE, Comings J. Patient literacy. A barrier to quality of care
[editorial]. J Gen Intern Med 1998 Dec;13(12):850-1. Comment on: J Gen Intern
Med 1998 Dec;13(12):791-8.</p>
<p>Sharf BF. Reading the vital signs: research in health care communication.
Commun Monogr 1993 Mar;60(1):35-41.</p>
<p>Sissel PA, Hohn MD. Literacy and health communities: potential partners in
practice. New Dir Adult Contin Educ 1996;70:59-71.</p>
<p>Spandorfer JM, Karras DJ, Hughes LA, Caputo C. Comprehension of discharge
instructions by patients in an urban emergency department. Ann Emerg Med 1995
Jan;25(1):71-4.</p>
<p>Wallerstein N. Health and safety education for workers with low-literacy or
limited-English skills. Am J Ind Med 1992;22(5):751-65.</p>
<p>Weiss BD. Identifying and communicating with patients who have poor literacy
skills [editorial]. Fam Med 1993 Jun;25(6):369-70.</p>
<p>Weiss BD, Hart G, Pust RE. The relationship between literacy and health. J
Health Care Poor Underserved 1991 Spring;1(4):351-63.</p>
<p>Williams MV, Parker RM, Baker DW, Parikh NS, Pitkin K, Coates WC, Nurss JR.
Inadequate functional health literacy among patients at two public hospitals.
JAMA 1995 Dec 6;274(21):1677-82. Comment in: JAMA 1995 Dec 6;274(21):1719-20;
JAMA 1996 Mar 20;275(11):840.</p>
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<hr />
<h2><a name="110">II. Strategies in Health Literacy</a></h2>
<h3><a name="120">II. A. Theoretical Constructs</a></h3>
<hr />
<p>Clear &amp; simple: developing effective print materials for low-literate
readers. Bethesda (MD): National Cancer Institute; 1994 Dec. 65 p. Available
from: <a
href="http://rex.nci.nih.gov/NCI_Pub_Interface/Clear_and_Simple/HOME.HTM">http://rex.nci.nih.gov/NCI_Pub_Interface/Clear_and_Simple/HOME.HTM</a></p>
<p>Doak CC, Doak LG, Friedell GH, Meade CD. Improving comprehension for cancer
patients with low literacy skills: strategies for clinicians. CA Cancer J Clin
1998 May-Jun;48(3):151-62.</p>
<p>Doak CC, Doak LG, Root JH. Teaching patients with low literacy skills.
Philadelphia: JB Lippincott Co.; 1996.</p>
<p>Freimuth VS, Edgar T, Fitzpatrick MA. The role of communication in health
promotion. Commun Res 1993;20:509-16.</p>
<p>Freimuth VS, Mettger W. Is there a hard-to-reach audience? Public Health Rep
1990 May-Jun;105(3):232-8.</p>
<p>Gollop CJ. Health information-seeking behavior and older African American
women. Bull Med Libr Assoc 1997 Apr;85(2):141-6.</p>
<p>Hawe P, McKenzie N, Scurry R. Randomised controlled trial of the use of a
modified postal reminder card on the uptake of measles vaccination. Arch Dis
Child 1998 Aug;79(2):136-40.</p>
<p>Hohn MD. Empowerment health education in adult literacy: a guide for public
health and adult literacy practitioners, policy makers and funders [monograph on
the Internet]. Washington: National Institute for Literacy; 1998 [cited 2000 Jan
19]. Available from: <a
href="http://www.nifl.gov/hohn/HOHN.HTM">http://www.nifl.gov/hohn/HOHN.HTM</a></p>
<p>National health education standards [monograph on the Internet]. Atlanta:
American Cancer Society; [modified 1999 Jun 24; cited 2000 Jan 19]. Available
from: <a
href="http://www.cancer.org/cshe/cshe.html">http://www.cancer.org/cshe/cshe.html</a></p>
<p>Rogers EM. The field of health communication today: an up-to-date report. J
Health Commun 1996;1:15-23.</p>
<p>Rudd RE, Comings JP. Learner developed materials: an empowering product.
Health Educ Q 1994 Fall;21(3):313-27.</p>
<p>Theory at a glance: a guide for health promotion practice [monograph on the
Internet]. Bethesda (MD): National Cancer Institute; [modified 1997 Oct 16;
cited 2000 Jan 19]. Available from: <a
href="http://rex.nci.nih.gov/NCI_Pub_Interface/Theory_at_glance/HOME.html">http://rex.nci.nih.gov/NCI_Pub_Interface/Theory_at_glance/HOME.html</a></p>
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<hr />
<h3><a name="130">II B. Applied Communication Strategies</a></h3>
<h3><a name="140">II. B. 1. Media</a></h3>
<hr />
<p>Agre P, McKee K, Gargon N, Kurtz RC. Patient satisfaction with an informed
consent process. Cancer Pract 1997 May-Jun;5(3):162-7.</p>
<p>Anderson C, Todd J. Use of leaflets and posters. Pharm J 1994 Aug
20;253:254-6.</p>
<p>Davis TC, Berkel HJ, Arnold CL, Nandy I, Jackson RH, Murphy PW. Intervention
to increase mammography utilization in a public hospital. J Gen Intern Med 1998
Apr;13(4):230-3. Comment in: J Gen Intern Med 1998 Nov;13(11):786.</p>
<p>Davis TC, Bocchini JA Jr, Fredrickson D, Arnold C, Mayeaux EJ, Murphy PW,
Jackson RH, Hanna N, Paterson M. Parent comprehension of polio vaccine
information pamphlets. Pediatrics 1996 Jun;97(6 Pt 1):804-10.</p>
<p>Davis TC, Fredrickson DD, Arnold C, Murphy PW, Herbst M, Bocchini JA. A polio
immunization pamphlet with increased appeal and simplified language does not
improve comprehension to an acceptable level. Patient Educ Counsel
1998;33:25-37.</p>
<p>el-Shazly MK, Farghaly NF, Abou Khatwa SA, Ibrahim AG. Comparative study of
mothers' knowledge of children immunization before and after mass media. J Egypt
Public Health Assoc 1991;66(5-6):609-24.</p>
<p>Lerman C, Hanjani P, Caputo C, Miller S, Delmoor E, Nolte S, Engstrom P.
Telephone counseling improves adherence to colposcopy among lower-income
minority women. J Clin Oncol 1992 Feb;10(2):330-3.</p>
<p>Maynard AM. Preparing readable patient education handouts. J Nurses Staff Dev
1999 Jan-Feb;15(1):11-8.</p>
<p>Plimpton S, Root J. Materials and strategies that work in low literacy health
communication. Public Health Rep 1994 Jan-Feb;109(1):86-92.</p>
<p>Ratzan SC, Payne JG, Massett HA. Effective health message design. Am Behav
Sci 1994 Nov;38(2):294-309.</p>
<p>Sitthi-amorn C, Ngamvithayapongse J. The role of media and communication in
improving the use of drugs and other technologies. Int J Technol Assess Health
Care 1998 Winter;14(1):71-80.</p>
<p>Struempler BJ, Marshall AC. Gem no. 293. Using low-literacy newsletters to
provide nutrition education for limited-resource individuals. J Nutr Educ 1999
Jan-Feb;31(1):60C-61C .</p>
<p>Tracey P. Limited literacy: challenge to patient education. Pharm Exec 1998
Mar;18:88-90, 92.</p>
<p>Wallack L. Media advocacy: a strategy for empowering people and communities.
J Public Health Policy 1994 Winter;15(4):420-36.</p>
<p>Wingand RT. Health information dissemination in the information age: Media,
messages and roles. Communications 1994;19(2-3):209-22.</p>
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<hr />
<h3><a name="150">II. B. 2. Negotiation/Policy</a></h3>
<hr />
<p>Batalden PB, Cronenwett LR, Brown LL, Moffatt C, Serrell NP. Collaboration in
improving care for patients: how can we find out what we haven't been able to
figure out yet? Jt Comm J Qual Improv 1998 Oct;24(10):609-18.</p>
<p>Blenkinsopp A, Bashford J, Dickinson D. Partnership with patients: health
professionals need to identify how much information patients want. BMJ 1998 Aug
8;317:413-4.</p>
<p>Braddock CH 3rd, Fihn SD, Levinson W, Jonsen AR, Pearlman RA. How doctors and
patients discuss routine clinical decisions. Informed decision making in the
outpatient setting. J Gen Intern Med 1997 Jun;12(6):339-45. Comment in: J Gen
Intern Med 1997 Jun;12(6):397-8.</p>
<p>Bradley EH, Rizzo JA. Public information and private search: evaluating the
Patient Self-Determination Act. J Health Polit Policy Law 1999
Apr;24(2):239-73.</p>
<p>Brownson K. Literacy: a problem that managers must handle. Hosp Mater Manage
Q 1998 Aug;20(1):37-47.</p>
<p>Buetow S. Four strategies for negotiated care. J R Soc Med 1998
Apr;91(4):199-201. Comment in: J R Soc Med 1998 Aug;91(8):454.</p>
<p>Degner LF, Sloan JA. Decision making during serious illness: what role do
patients really want to play? J Clin Epidemiol 1992 Sep;45(9):941-50.</p>
<p>Fisch M, Unverzagt F, Hanna M, Bledsoe P, Menke C, Cornetta K. Information
preferences, reading ability, and emotional changes in outpatients during the
process of obtaining informed consent for autologous bone-marrow
transplantation. J Cancer Educ 1998 Summer;13(2):71-5.</p>
<p>Geissler B. Literacy-health partnerships that work. Adult Learn 1994
Jul-Aug;5(6):21-2, 26.</p>
<p>Needlman R, Fried LE, Morley DS, Taylor S, Zuckerman B. Clinic-based
intervention to promote literacy. A pilot study. Am J Dis Child 1991
Aug;145(8):881-4.</p>
<p>Smith-Nonini S. "Popular" health and the state: dialectics of the peace
process in El Salvador. Soc Sci Med 1997 Mar;44(5):635-45.</p>
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<hr />
<h2><a name="160">III. Tactics</a></h2>
<h3><a name="170">III. A. New Technologic Interventions</a></h3>
<hr />
<p>Ah-Fat FG, Sharma MC, Damato BE. Taping outpatient consultations: a survey of
attitudes and responses of adult patients with ocular malignancy. Eye 1998;12(Pt
5):789-91.</p>
<p>Bader SA, Braude RM. "Patient informatics": creating new partnerships in
medical decision making. Acad Med 1998 Apr;73(4):408-11.</p>
<p>Brown SJ, Lieberman DA, Germeny BA, Fan YC, Wilson DM, Pasta DJ. Educational
video game for juvenile diabetes: results of a controlled trial. Med Inform
(Lond) 1997 Jan-Mar;22(1):77-89.</p>
<p>Eng TR, Gustafson DH, editors. Wired for health and well-being: the emergence
of interactive health communication [monograph on the Internet]. Washington:
Dept. of Health and Human Services (US), Office of Disease Prevention and Health
Promotion, Science Panel on Interactive Health Communication; 1999 Apr [modified
1999 Dec 13; cited 2000 Jan]. Available from:
http://www.scipich.org/pubs/finalreport.htm</p>
<p>Evans JH, Collier J, Crook I, Garrud P, Harris P, MacKinlay DR, Redsell SA.
Using multimedia for patient information--a program about nocturnal enuresis. Br
J Urol 1998 May;81 Suppl 3:120-2.</p>
<p>Ferguson T. Health online and the empowered medical consumer. Jt Comm J Qual
Improv 1997 May;23(5):251-7.</p>
<p>Green MJ, Fost N. An interactive computer program for educating and
counseling patients about genetic susceptibility to breast cancer. J Cancer Educ
1997 Winter;12(4):204-8.</p>
<p>Houts PS, Bachrach R, Witmer JT, Tringali CA, Bucher JA, Localio RA. Using
pictographs to enhance recall of spoken medical instructions. Patient Educ Couns
1998 Oct;35(2):83-8.</p>
<p>Kenny T, Wilson RG, Purves IN, Clark J Sr, Newton LD, Newton DP, Moseley DV.
A PIL for every ill? Patient information leaflets (PILs): a review of past,
present and future use. Fam Pract 1998 Oct;15(5):471-9.</p>
<p>Krishna S, Balas EA, Spencer DC, Griffin JZ, Boren SA. Clinical trials of
interactive computerized patient education: implications for family practice. J
Fam Pract 1997 Jul;45(1):25-33.</p>
<p>Mandl KD, Katz SB, Kohane IS. Social equity and access to the World Wide Web
and E-mail: implications for design and implementation of medical applications.
Proc AMIA Symp 1998:215-9.</p>
<p>McLean DD. Use of computer-based technology in health physical education,
recreation, and dance. In: ERIC digests [database on the Internet]. Washington:
Dept. of Education (US), ERIC Clearinghouse on Teaching and Teacher Education;
1996 Feb [cited 2000 Jan 15]. [3.5 p.]. Available from: <a
href="http://www.ed.gov/databases/ERIC_Digests/ed390874.html">http://www.ed.gov/databases/ERIC_Digests/ed390874.html</a>
Also available from ERIC, Washington, DC; ED390874.</p>
<p>Morowitz HJ. Scientific literacy. Hosp Pract (Off Ed) 1995 Nov
15;30(11):17-8.</p>
<p>Murphy KR. Computer-based patient education. Otolaryngol Clin North Am 1998
Apr;31(2):309-17.</p>
<p>Patyk M, Gaynor S, Kelly J, Ott V. Touch-screen computerized education for
patients with brain injuries. Rehabil Nurs 1998 Mar-Apr;23(2):84-7.</p>
<p>Sechrest RC, Henry DJ. Computer-based patient education: observations on
effective communication in the clinical setting. J Biocommun
1996;23(1):8-12.</p>
<p>Skinner H, Morrison M, Bercovitz K, Haans D, Jennings MJ, Magdenko L, Polzer
J, Smith L, Weir N. Using the Internet to engage youth in health promotion.
Promot Educ 1997 Dec;4(4):23-5.</p>
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<hr />
<h3><a name="180">III. B. Educational Programs</a></h3>
<hr />
<p>Adult Literacy and Basic Skills Unit. Making it happen: improving basic
skills within the Health Service. London: The Unit; 1994 Mar.</p>
<p>Almquist NL, Bisson S, Wynia A. Bringing an early pediatric literacy program
to the clinic setting. J Pediatr Health Care 1998 Sep-Oct;12(5):276-9.</p>
<p>Association for the Advancement of Health Education. National Health
Education Standards: achieving health literacy. Washington: The Association;
1995. 90 p. Available from: ERIC Document Reproduction Service, Springfield, VA;
No. ED386418.</p>
<p>Austin PE, Matlack R 2nd, Dunn KA, Kesler C, Brown CK. Discharge
instructions: do illustrations help our patients understand them? Ann Emerg Med
1995 Mar;25(3):317-20.</p>
<p>Berger D, Inkelas M, Myhre S, Mishler A. Developing health education
materials for inner-city low literacy parents. Public Health Rep 1994
Mar-Apr;109(2):168-72.</p>
<p>Business Council for Effective Literacy. Basic skills and the health care
industry. New York: The Council; 1993 May. 13 p. (BCEL brief).</p>
<p>California Healthy Kids Resource Center [homepage on the Internet]. Hayward
(CA): The Center; c1998-2000 [cited 2000 Jan 20]. Available from: <a
href="http://www.hkresources.org/">http://www.hkresources.org/</a> Funded by the
California State Department of Education.</p>
<p>California State Dept. of Education. Health framework for California public
schools kindergarten through grade twelve. Sacramento (CA): California Dept. of
Education, Bureau of Publications; 1994. 245 p.</p>
<p>Carman PS, Van Horn B, Grumm M. Rosalie's neighborhood. A health literacy
series for parents with young children. Washington: National Institute for
Literacy Clearinghouse; 1997. 230 p.</p>
<p>Cedraschi C, Reust P, Lorenzi-Cioldi F, Vischer TL. The gap between back pain
patients' prior knowledge and scientific knowledge and its evolution after a
back school teaching programme: a quantitative evaluation. Patient Educ Couns
1996 Apr;27(3):235-46.</p>
<p>Child safety: a healthy start. Teacher's guide. Albany (NY): New York State
Education Dept.; 1996. 87 p.</p>
<p>Community Outreach Education Program [homepage on the Internet]. Research
Triangle Park (NC): National Institute of Environmental Health Sciences;
[updated 1999 Jun 25; cited 2000 Jan 19]. Available from: <a
href="http://www.niehs.nih.gov/centers/coep/coepcver.htm">http://www.niehs.nih.gov/centers/coep/coepcver.htm</a></p>
<p>Corrarino JE, Walsh PJ, Anselmo D. A program to educate woman who test
positive for the hepatitis B virus during the perinatal period. MCN Am J Matern
Child Nurs 1999 May-Jun;24(3):151-5.</p>
<p>Curran-Everett D. Hearts, lungs, and children: a physiologist returns to
kindergarten. Am J Physiol 1995 Dec;269(6 Pt 3):S32-6.</p>
<p>Davidhizar R, Bechtel G, Dowd SB. Patient education: a mandate for health
care in the 21st century... part 1. J Nucl Med Technol 1998 Dec;26(4):235-41,
243-4.</p>
<p>de Oliveira MA, Bruno VF, Ballini LS, BritoJardim JR, Fernandes AL.
Evaluation of an educational program for asthma control in adults. J Asthma
1997;34(5):395-403.</p>
<p>Delp C, Jones J. Communicating information to patients: the use of cartoon
illustrations to improve comprehension of instructions. Acad Emerg Med 1996
Mar;3(3):264-70. Comment in: Acad Emerg Med 1996 Mar;3(3):200-1.</p>
<p>Educational programs that work: the catalog of the National Diffusion Network
[monograph on the Internet]. Washington: Dept. of Education (US); 1995 [cited
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<p>Fain JA. Assessing nutrition education in clients with weak literacy skills.
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<p>Fouad MN, Kiefe CI, Bartolucci AA, Burst NM, Ulene V, Harvey MR. A
hypertension control program tailored to unskilled and minority workers. Ethn
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<p>Garden AL, Merry AF, Holland RL, Petrie KJ. Anaesthesia information--what
patients want to know. Anaesth Intensive Care 1996 Oct;24(5):594-8.</p>
<p>Harlander C, Ruccione K. Fotoplatica: an innovative teaching method for
families with low literacy and high stress. J Pediatr Oncol Nurs 1993
Jul;10(3):112-4.</p>
<p>Harper P, Van Riper S. Implantable cardioverter defibrillator: a patient
education model for the illiterate patient. Crit Care Nurse 1993
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<p>Hartman TJ, McCarthy PR, Park RJ, Schuster E, Kushi LH. Focus group responses
of potential participants in a nutrition education program for individuals with
limited literacy skills. J Am Diet Assoc 1994 Jul;94(7):744-8.</p>
<p>Hartman TJ, McCarthy PR, Park RJ, Schuster E, Kushi LH. Results of a
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<p>Health literacy for all students: the Rhode Island health education framework
[monograph on the Internet]. Narragansett (RI): Rhode Island Dept. of Elementary
and Secondary Education; [modified 1998 Jun 24; cited 2000 Jan 20]. Available
from: <a
href="http://www.ri.net/RIDE/health/Framework.html">http://www.ri.net/RIDE/health/Framework.html</a></p>
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<p>Hollis NE, Canterbury MA. Health care consumer education: alternative
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UPDATED WITH LINK BELOW ON SEPTEMBER 21, 2005
-->
<p>Massachusetts comprehensive health curriculum framework [monograph on the
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<p>National Institute for Literacy. Literacy for health: improving health in the
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Springfield, VA; No. ED404436.</p>
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<p>Norton M, Horne T. The wholeness of the individual: linking literacy and
health through participatory education. Alberta J Educ Res 1998
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<p>Revell L. Understanding, identifying, and teaching the low-literacy patient.
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<p>Roberts-Gray C, Solomon T, Gottlieb N, Kelsey E. Heart Partners: a strategy
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<p>Rudd RE, Zacharia C, Daube K. Integrating health and literacy: adult
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from: <a
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<p>Weiss BD, Reed RL, Kligman EW. Literacy skills and communication methods of
low-income older persons. Patient Educ Couns 1995 May;25(2):109-19.</p>
<p>Winkleby MA, Howard-Pitney B, Albright CA, Bruce B, Kraemer HC, Fortmann SP.
Predicting achievement of a low-fat diet: a nutrition intervention for adults
with low literacy skills. Prev Med 1997 Nov-Dec;26(6):874-82.</p>
<p>Zweifler J, Gonzalez AM. Teaching residents to care for culturally diverse
populations. Acad Med 1998 Oct;73(10):1056-61.</p>
<p><a href="hliteracy.html#top"><font
size="-1"><i>Return to the top</i></font></a></p>
<hr />
<h3><a name="190">III. C. Readability Indices (Applied)</a></h3>
<hr />
<p>Bartek PA . Increasing subject comprehension of the informed consent form.
Drug Inf J 1995;29(1):91-8.</p>
<p>Bjorn E, Rossel P, Holm S. Can the written information to research subjects
be improved?--an empirical study. J Med Ethics 1999 Jun;25(3):263-7.</p>
<p>Busselman KM, Holcomb CA. Reading skill and comprehension of the dietary
guidelines by WIC participants. J Am Diet Assoc 1994 Jun;94(6):622-5.</p>
<p>Butow P, Brindle E, McConnell D, Boakes R, Tattersall M. Information booklets
about cancer: factors influencing patient satisfaction and utilization. Patient
Educ Couns 1998 Feb;33(2):129-41.</p>
<p>Cardinal BJ, Seidler TL. Readability and comprehensibility of the "exercise
lite" brochure. Percept Mot Skills 1995 Apr;80(2):399-402.</p>
<p>Cooley ME, Moriarty H, Berger MS, Selm-Orr D, Coyle B, Short T. Patient
literacy and the readability of written cancer educational materials. Oncol Nurs
Forum 1995 Oct;22(9):1345-51. Comment in: Oncol Nurs Forum 1996
Apr;23(3):421.</p>
<p>Davis TC, Holcombe RF, Berkel HJ, Pramanik S, Divers SG. Informed consent for
clinical trials: a comparative study of standard versus simplified forms. J Natl
Cancer Inst 1998 May 6;90(9):668-74. Comment in: J Natl Cancer Inst 1998 May
6;90(9):644-5.</p>
<p>Davis TC, Mayeaux EJ, Fredrickson D, Bocchini JA Jr, Jackson RH, Murphy PW.
Reading ability of parents compared with reading level of pediatric patient
education materials. Pediatrics 1994 Mar;93(3):460-8.</p>
<p>Directory of plain language health information [monograph on the Internet].
Ottawa: Canadian Public Health Association, National Literacy and Health
Program; 1999 [modified 2000 Jan 13; cited 2000 Jan 20]. Available from: <a
href="http://www.pls.cpha.ca/">http://www.pls.cpha.ca/</a></p>
<p>Dixon E, Park R. Do patients understand written health information? Nurs
Outlook 1990 Nov-Dec;38(6):278-81.</p>
<p>Dowe MC, Lawrence PA, Carlson J, Keyserling TC. Patients' use of
health-teaching materials at three readability levels. Appl Nurs Res 1997
May;10(2):86-93.</p>
<p>Ebrahimzadeh H, Davalos R, Lee PP. Literacy levels of ophthalmic patient
education materials. Surv Ophthalmol 1997 Sep-Oct;42(2):152-6.</p>
<p>Estey A, Musseau A, Keehn L. Comprehension levels of patients reading health
information. Patient Educ Couns 1991;18(2):165-9.</p>
<p>Estey A, Musseau A, Keehn L. Patient's understanding of health information: a
multihospital comparison. Patient Educ Couns 1994 Aug;24(1):73-8.</p>
<p>Farley D . Making it easier to read prescriptions. FDA Consum 1995
Jul-Aug;29:25-7.</p>
<p>Fisher E. Low literacy levels in adults: implications for patient education.
J Contin Educ Nurs 1999 Mar-Apr;30(2):56-61.</p>
<p>French KS, Larrabee JH. Relationships among educational material readability,
client literacy, perceived beneficence, and perceived quality. J Nurs Care Qual
1999 Aug;13(6):68-82.</p>
<p>Graber MA, Roller CM, Kaeble B. Readability levels of patient education
material on the World Wide Web. J Fam Pract 1999 Jan;48(1):58-61.</p>
<p>Hochhauser M. Informed consent and patient's rights documents: A right, a
rite, or a rewrite? Ethics Behav 1999;9(1):1-20.</p>
<p>Jolly BT, Scott JL, Sanford SM. Simplification of emergency department
discharge instructions improves patient comprehension. Ann Emerg Med 1995
Oct;26(4):443-6.</p>
<p>Jubelirer SJ, Linton JC, Magnetti SM. Reading versus comprehension:
implications for patient education and consent in an outpatient oncology clinic.
J Cancer Educ 1994;9(1):26-9.</p>
<p>Meade CD, Howser DM. Consent forms: how to determine and improve their
readability. Oncol Nurs Forum 1992 Nov-Dec;19(10):1523-8.</p>
<p>Michielutte R, Bahnson J, Dignan MB, Schroeder EM. The use of illustrations
and narrative text style to improve readability of a health education brochure.
J Cancer Educ 1992;7(3):251-60.</p>
<p>Overland JE, Hoskins PL, McGill MJ, Yue DK. Low literacy: a problem in
diabetes education. Diabet Med 1993 Nov;10(9):847-50.</p>
<p>Philipson SJ, Doyle MA, Gabram SG, Nightingale C, Philipson EH. Informed
consent for research: a study to evaluate readability and processability to
effect change. J Investig Med 1995 Oct;43(5):459-67.</p>
<p>Reid JC, Ringenberg QS, Kardash CM, Robinson RD, Scholes R, Kunz C. Why are
some pamphlets hard for patients to read? Mo Med 1994 Sep;91(9):589-92.</p>
<p>TenHave TR, Van Horn B, Kumanyika S, Askov E, Matthews Y, Adams-Campbell LL.
Literacy assessment in a cardiovascular nutrition education setting. Patient
Educ Couns 1997 Jun;31(2):139-50.</p>
<p><a href="hliteracy.html#top"><font
size="-1"><i>Return to the top</i></font></a></p>
<hr />
<h3><a name="200">III. D. Special Populations</a></h3>
<hr />
<p>Baker FM, Johnson JT, Velli SA, Wiley C. Congruence between education and
reading levels of older persons. Psychiatr Serv 1996 Feb;47(2):194-6.</p>
<p>Bushnell FK. Self-care teaching for congestive heart failure patients. J
Gerontol Nurs 1992 Oct;18(10):27-32.</p>
<p>Calabro K, Taylor WC, Kapadia A. Pregnancy, alcohol use and the effectiveness
of written health education materials. Patient Educ Couns 1996
Dec;29(3):301-9.</p>
<p>Carlsson ME, Strang PM. How patients with gynecological cancer experience the
information process. J Psychosom Obstet Gynaecol 1998 Dec;19(4):192-201.</p>
<p>Christensen RC, Grace GD. The prevalence of low literacy in an indigent
psychiatric population. Psychiatr Serv 1999 Feb;50(2):262-3.</p>
<p>Christensen TP, Ascione FJ, Bagozzi RP. Understanding how elderly patients
process drug information: a test of a theory of information processing. Pharm
Res 1997 Nov;14(11):1589-96.</p>
<p>Communicating with older people. Nurs Stand 1997 Jan 8;11(16):48-54; quiz
55-6.</p>
<p>Davis TC, Jackson RH, George RB, Long SW, Talley D, Murphy PW, Mayeaux EJ,
Truong T. Reading ability in patients in substance misuse treatment centers. Int
J Addict 1993 May;28(6):571-82.</p>
<p>DiFlorio I. Mothers' comprehension of terminology associated with the care of
a newborn baby. Pediatr Nurs 1991 Mar-Apr;17(2):193-6.</p>
<p>Forcinio H . Packaging solutions that help patient compliance. Pharm Technol
1993 Mar;17:44, 46, 48, 50.</p>
<p>Gazmararian JA, Parker RM, Baker DW. Reading skills and family planning
knowledge and practices in a low-income managed-care population. Obstet Gynecol
1999 Feb;93(2):239-44.</p>
<p>Guidry JJ, Fagan P, Walker V. Cultural sensitivity and readability of breast
and prostate printed cancer education materials targeting African Americans. J
Natl Med Assoc 1998 Mar;90(3):165-9.</p>
<p>Hayes KS. Randomized trial of geragogy-based medication instruction in the
emergency department. Nurs Res 1998 Jul-Aug;47(4):211-8.</p>
<p>Hosey GM, Freeman WL, Stracqualursi F, Gohdes D. Designing and evaluating
diabetes education material for American Indians. Diabetes Educ 1990
Sep-Oct;16(5):407-14.</p>
<p>Hussey LC. Overcoming the clinical barriers of low literacy and medication
noncompliance among the elderly. J Gerontol Nurs 1991 Mar;17(3):27-9.</p>
<p>Jackson RH, Davis TC, Murphy P, Bairnsfather LE, George RB. Reading
deficiencies in older patients. Am J Med Sci 1994 Aug;308(2):79-82.</p>
<p>Johnson ME, Fisher DG, Davis DC, Cagle HH. Reading abilities of drug users in
Anchorage, Alaska. J Drug Educ 1995;25(1):73-80.</p>
<p>Kistin N, Benton D, Rao S, Sullivan M. Breast-feeding rates among black urban
low-income women: effect of prenatal education. Pediatrics 1990
Nov;86(5):741-6.</p>
<p>Low-literacy patient education handouts [monograph on the Internet]. San
Francisco: University of California, San Francisco, UCSF Homeless Clinic; 1995
[modified 1998 Nov 11; cited 2000 Jan 20]. Available from: <a
href="http://itsa.ucsf.edu/~hclinic/handouts.dir/lowlit.dir/lowlit.html">http://itsa.ucsf.edu/~hclinic/handouts.dir/lowlit.dir/lowlit.html</a></p>
<p>Magyari T. Designing public education brochures to reach low literate and
minority persons. Birth Defects Orig Artic Ser 1990;26(2):217-21.</p>
<p>Magyari T. The role of the genetic counselor in a unique preconception
substance-use education program for low-literate minority women. Birth Defects
Orig Artic Ser 1990;26(3):179-84.</p>
<p>McElveen KA. Communicating with children: could you use some help? MCN Am J
Matern Child Nurs 1997 Mar-Apr;22(2):108-11.</p>
<p>McGuire LC. Remembering what the doctor said: organization and adults' memory
for medical information. Exp Aging Res 1996 Oct-Dec;22(4):403-28.</p>
<p>Moon RY, Cheng TL, Patel KM, Baumhaft K, Scheidt PC. Parental literacy level
and understanding of medical information. Pediatrics 1998 Aug;102(2):e25.
Available from: <a
href="http://www.pediatrics.org/cgi/content/full/102/2/e25">http://www.pediatrics.org/cgi/content/full/102/2/e25</a></p>
<p>Morra ME. Future trends in patient education. Semin Oncol Nurs 1991
May;7(2):143-5.</p>
<p>Morrow DG, Hier CM, Menard WE, Leirer VO. Icons improve older and younger
adults' comprehension of medication information. J Gerontol B Psychol Sci Soc
Sci 1998 Jul;53(4):P240-54.</p>
<p>Morrow DG, Leirer VO, Andrassy JM, Hier CM, Menard WE. The influence of list
format and category headers on age differences in understanding medication
instructions. Exp Aging Res 1998 Jul-Sep;24(3):231-56.</p>
<p>Mrvos R, Dean BS, Krenzelok EP. Illiteracy: a contributing factor to
poisoning. Vet Hum Toxicol 1993 Oct;35(5):466-8.</p>
<p>Murphy PW, Davis TC. When low literacy blocks compliance. RN 1997
Oct;60(10):58-63; quiz 64.</p>
<p>Murphy PW, Davis TC, Jackson RH, Decker BC, Long SW. Effects of literacy on
health care of the aged: implications for health professionals. Educ Gerontol
1993 Jun;19(4):311-16.</p>
<p>Patterson C, Teale C. Influence of written information on patients' knowledge
of their diagnosis. Age Ageing 1997 Jan;26(1):41-2.</p>
<p>Price JH, Everett SA. Developing cancer pamphlets for economically
disadvantaged African Americans. Patient Educ Couns 1996 Jul;28(2):159-67.</p>
<p>Weinrich SP, Weinrich MC, Boyd MD, Atwood J, Cervenka B. Teaching older
adults by adapting for aging changes. Cancer Nurs 1994 Dec;17(6):494-500.</p>
<p>Weiss BD, Coyne C. Communicating with patients who cannot read. N Engl J Med
1997 Jul 24;337(4):272-4.</p>
<p>Wilson FL. Measuring patients' ability to read and comprehend: a first step
in patient education. Nursingconnections 1995 Winter;8(4):17-25.</p>
<p>Wilson FL, McLemore R. Patient literacy levels: a consideration when
designing patient education programs. Rehabil Nurs 1997 Nov-Dec;22(6):311-7.</p>
<p><a href="hliteracy.html#top"><font
size="-1"><i>Return to the top</i></font></a></p>
<hr />
<h3><a name="220">III. E. Client Communication</a></h3>
<hr />
<p>Benbassat J, Pilpel D, Tidhar M. Patients' preferences for participation in
clinical decision making: a review of published surveys. Behav Med 1998
Summer;24(2):81-8.</p>
<p>Chapple A, Campion P, May C. Clinical terminology: anxiety and confusion
amongst families undergoing genetic counseling. Patient Educ Couns 1997
Sep-Oct;32(1-2):81-91.</p>
<p>Crane JA. Patient comprehension of doctor-patient communication on discharge
from the emergency department. J Emerg Med 1997 Jan-Feb;15(1):1-7.</p>
<p>Davidhizar R, Giger JN. When touch is not the best approach. J Clin Nurs 1997
May;6(3):203-6.</p>
<p>Hornberger J, Itakura H, Wilson SR. Bridging language and cultural barriers
between physicians and patients. Public Health Rep 1997
Sep-Oct;112(5):410-7.</p>
<p>Kai J. Parents' difficulties and information needs in coping with acute
illness in preschool children: a qualitative study. BMJ 1996 Oct
19;313(7063):987-90. Comment in: BMJ 1996 Oct 19;313(7063):954-5; BMJ 1997 Feb
1;314(7077):373; BMJ 1997 Feb 1;314(7077):373-4.</p>
<p>Liaw ST, Young D, Farish S. Improving patient-doctor concordance: an
intervention study in general practice. Fam Pract 1996 Oct;13(5):427-31.</p>
<p>Mandl KD, Kohane IS, Brandt AM. Electronic patient-physician communication:
problems and promise. Ann Intern Med 1998 Sep 15;129(6):495-500.</p>
<p>McMahon SR, Rimsza ME, Bay RC. Parents can dose liquid medication accurately.
Pediatrics 1997 Sep;100(3 Pt 1):330-3.</p>
<p>Olson RM, Blank D, Cardinal E, Hopf G, Chalmers RK. Understanding
medication-related needs of low-literacy patients. J Am Pharm Assoc (Wash) 1996
Jul;NS36(7):424-9.</p>
<p>Physician-patient communication in the emergency department. Part 2:
Communication strategies for specific situations. SAEM Task Force on
Physician-Patient Communication. Acad Emerg Med 1996 Dec;3(12):1146-53.</p>
<p><a href="hliteracy.html#top"><font
size="-1"><i>Return to the top</i></font></a></p>
<hr />
<h3><a name="240">III. F. Disease/Content Specific (e.g., diabetes,
tobacco)</a></h3>
<hr />
<p>Bauman A. The comprehensibility of asthma education materials. Patient Educ
Couns 1997 Dec;32(1 Suppl):S51-9.</p>
<p>Brown SA. Meta-analysis of diabetes patient education research: variations in
intervention effects across studies. Res Nurs Health 1992 Dec;15(6):409-19.</p>
<p>Chan A, Woodruff RK. Communicating with patients with advanced cancer. J
Palliat Care 1997 Autumn;13(3):29-33.</p>
<p>Ciampa C. Tobacco education in low-literacy individuals. Indiana Med 1996
Mar-Apr;89(2):188-92.</p>
<p>Day JL, Rayman G, Hall L, Davies P. 'Learning Diabetes'--a multi-media
learning package for patients, carers and professionals to improve chronic
disease management. Med Inform (Lond) 1997 Jan-Mar;22(1):91-104.</p>
<p>Doak LG, Doak CC, Meade CD. Strategies to improve cancer education materials.
Oncol Nurs Forum 1996 Sep;23(8):1305-12.</p>
<p>Drass JA, Feldman RH. Knowledge about hypoglycemia in young women with type I
diabetes and their supportive others. Diabetes Educ 1996 Jan-Feb;22(1):34-8.</p>
<p>Foltz A, Sullivan J. Reading level, learning presentation preference, and
desire for information among cancer patients. J Cancer Educ 1996
Spring;11(1):32-8.</p>
<p>Hallowell N, Murton F, Statham H, Green JM, Richards MP. Women's need for
information before attending genetic counselling for familial breast or ovarian
cancer: a questionnaire, interview, and observational study. BMJ 1997 Jan
25;314(7076):281-3.</p>
<p>Hill J. A practical guide to patient education and information giving.
Baillieres Clin Rheumatol 1997 Feb;11(1):109-27.</p>
<p>Jacobson TA, Thomas DM, Morton FJ, Offutt G, Shevlin J, Ray S. Use of a
low-literacy patient education tool to enhance pneumococcal vaccination rates. A
randomized controlled trial. JAMA 1999 Aug 18;282(7):646-50.</p>
<p>Kicklighter JR, Stein MA. Factors influencing diabetic clients' ability to
read and comprehend printed diabetic diet material. Diabetes Educ 1993
Jan-Feb;19(1):40-6.</p>
<p>Larson I, Schumacher HR. Comparison of literacy level of patients in a VA
arthritis center with the reading level required by educational materials.
Arthritis Care Res 1992 Mar;5(1):13-6.</p>
<p>Lerman C, Schwartz MD, Miller SM, Daly M, Sands C, Rimer BK. A randomized
trial of breast cancer risk counseling: interacting effects of counseling,
educational level, and coping style. Health Psychol 1996 Mar;15(2):75-83.</p>
<p>Meade CD, McKinney WP, Barnas GP. Educating patients with limited literacy
skills: the effectiveness of printed and videotaped materials about colon
cancer. Am J Public Health 1994 Jan;84(1):119-21.</p>
<p>Michielutte R, Alciati MH, el Arculli R. Cancer control research and literacy
[editorial]. J Health Care Poor Underserved 1999 Aug;10(3):281-97.</p>
<p>Millar WJ. Reaching smokers with lower educational attainment. Health Rep
1996 Autumn;8(2):11-9(Eng); 13-22(Fre).</p>
<p>Nurss JR, el-Kebbi IM, Gallina DL, Ziemer DC, Musey VC, Lewis S, Liao Q,
Phillips LS. Diabetes in urban African Americans: functional health literacy of
municipal hospital outpatients with diabetes. Diabetes Educ 1997
Sep-Oct;23(5):563-8.</p>
<p>O'Loughlin JL, Lampron GP, Sacks-Silver GE. Evaluation of a smoking cessation
guide for low income, functionally illiterate women: a pilot study. Can J Public
Health 1990 Nov-Dec;81(6):471-2.</p>
<p>O'Neill P, Humphris GM, Field EA. The use of an information leaflet for
patients undergoing wisdom tooth removal. Br J Oral Maxillofac Surg 1996
Aug;34(4):331-4.</p>
<p>Olver IN, Turrell SJ, Olszewski NA, Willson KJ. Impact of an information and
consent form on patients having chemotherapy. Med J Aust 1995 Jan
16;162(2):82-3. Comment in: Med J Aust 1995 Aug 7;163(3):161.</p>
<p>Parker RM, Williams MV, Baker DW, Nurss JR. Literacy and contraception:
exploring the link. Obstet Gynecol 1996 Sep;88(3 Suppl):72S-77S.</p>
<p>Perez Escamilla R, Himmelgreen D, Segura Millan S, Gonzalez A, Mendez I,
Haldeman L. Research and professional briefs. Knowledge of folic acid and neural
tube defects among inner-city residents: have they heard about it? J Am Diet
Assoc 1999 Jan;99(1):80-3.</p>
<p>Pierce JP, Lee L, Gilpin EA. Smoking initiation by adolescent girls, 1944
through 1988. An association with targeted advertising. JAMA 1994 Feb
23;271(8):608-11. Comment in: JAMA 1994 Feb 23;271(8):629-30.</p>
<p>Reid JC, Klachko DM, Kardash CA, Robinson RD, Scholes R, Howard D. Why people
don't learn from diabetes literature: influence of text and reader
characteristics. Patient Educ Couns 1995 Feb;25(1):31-8.</p>
<p>Robinson JK, Rigel DS, Amonette RA. What promotes skin self-examination? J Am
Acad Dermatol 1998 May;38(5 Pt 1):752-7.</p>
<p>Roche RA, Stovall CE, Suarez L, Goldman DA, Wright SA, Mendez MC. Language
differences in interpretation of breast cancer health messages. J Cancer Educ
1998 Winter;13(4):226-30.</p>
<p>Ryan EB, Butler RN. Communication, aging, and health: toward understanding
health provider relationships with older clients. Health Commun
1996;8(3):191-97.</p>
<p>Williams MV, Baker DW, Honig EG, Lee TM, Nowlan A. Inadequate literacy is a
barrier to asthma knowledge and self-care. Chest 1998 Oct;114(4):1008-15.</p>
<p>Williams MV, Baker DW, Parker RM, Nurss JR. Relationship of functional health
literacy to patients' knowledge of their chronic disease. A study of patients
with hypertension and diabetes. Arch Intern Med 1998 Jan 26;158(2):166-72.</p>
<p>Wilson SR, Scamagas P, German DF, Hughes GW, Lulla S, Coss S, Chardon L,
Thomas RG, Starr Schneidkraut N, Stancavage FB, et al. A controlled trial of two
forms of self-management education for adults with asthma. Am J Med 1993
Jun;94(6):564-76. Comment in: Am J Med 1993 Jun;94(6):561-3; Am J Med 1995
May;98(5):517-8.</p>
<p>Wolfe C, Doherty I, Raju KS, Holtom R, Richardson P. First steps in the
development of an information and counselling service for women with an abnormal
smear result. Eur J Obstet Gynecol Reprod Biol 1992 Jul 24;45(3):201-6.</p>
<p>Yasenchak PA, Bridle MJ. A low-literacy skin care manual for spinal cord
injury patients. Patient Educ Couns 1993 Nov;22(1):1-5.</p>
<p><a href="hliteracy.html#top"><font
size="-1"><i>Return to the top</i></font></a></p>
<hr />
<h2><a name="250">IV. Ideas</a></h2>
<h3><a name="260">IV. A. Theory</a></h3>
<hr />
<p>Adelsward V, Sachs L. The meaning of 6.8: numeracy and normality in health
information talks. Soc Sci Med 1996 Oct;43(8):1179-87.</p>
<p>Alonzo AA, Reynolds NR. Responding to symptoms and signs of acute myocardial
infarction--how do you educate the public?: a social-psychologic approach to
intervention. Heart Lung 1997 Jul-Aug;26(4):263-72.</p>
<p>Cameron C. Patient compliance: recognition of factors involved and
suggestions for promoting compliance with therapeutic regimens. J Adv Nurs 1996
Aug;24(2):244-50.</p>
<p>Coyne IT. Parent participation: a concept analysis. J Adv Nurs 1996
Apr;23(4):733-40.</p>
<p>Emden C. Theoretical perspectives on narrative inquiry. Collegian 1998
Apr;5(2):30-5.</p>
<p>Gallagher SM. Powerlessness as a factor in health defeating behavior. Ostomy
Wound Manage 1997 Mar;43(2):34-8, 40, 42.</p>
<p>Gesler WM. Words in wards: language, health and place. Health Place 1999
Mar;5(1):13-25.</p>
<p>Lipkin M Jr. Patient education and counseling in the context of modern
patient-physician-family communication. Patient Educ Couns 1996
Jan;27(1):5-11.</p>
<p>Parle M, Maguire P, Heaven C. The development of a training model to improve
health professionals' skills, self-efficacy and outcome expectancies when
communicating with cancer patients. Soc Sci Med 1997 Jan;44(2):231-40.</p>
<p>Patterson RE, Kristal AR, White E. Do beliefs, knowledge, and perceived norms
about diet and cancer predict dietary change? Am J Public Health 1996
Oct;86(10):1394-400.</p>
<p>Rudd R, Zahner L, Banh M. Findings from a National Survey of State Directors
of Adult Education. Boston (MA): NCSALL/World Education; 1999. 20 p. (NCSALL
reports; no. 9).</p>
<p>Sandiford P, Cassel J, Sanchez G, Coldham C. Does intelligence account for
the link between maternal literacy and child survival? Soc Sci Med 1997
Oct;45(8):1231-9.</p>
<p>Tecce Decarlo MJ. Health literacy: a participatory curriculum enacted in the
United States and Honduras [dissertation]. State College (PA): University of
Pennsylvania; 1997. 272 p.</p>
<p><a href="hliteracy.html#top"><font
size="-1"><i>Return to the top</i></font></a></p>
<hr />
<h3><a name="270">IV. B. Measurement Techniques</a></h3>
<hr />
<p>Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss J. Development of a
brief test to measure functional health literacy. Patient Educ Couns 1999
Sept;38:33-42.</p>
<p>Brez SM, Taylor M. Assessing literacy for patient teaching: perspectives of
adults with low literacy skills. J Adv Nurs 1997 May;25(5):1040-7.</p>
<p>Brown JA, Nederend SE, Hays RD, Short PF, Farley DO. Special issues in
assessing care of Medicaid recipients. Med Care 1999 Mar;37(3
Suppl):MS79-88.</p>
<p>Clark NM, Gong M, Schork MA, Maiman LA, Evans D, Hurwitz ME, Roloff D,
Mellins RB. A scale for Assessing Health Care Providers' Teaching and
Communication Behavior regarding asthma. Health Educ Behav 1997
Apr;24(2):245-56.</p>
<p>Davis TC, Crouch MA, Long SW, Jackson RH, Bates P, George RB, Bairnsfather
LE. Rapid assessment of literacy levels of adult primary care patients. Fam Med
1991 Aug;23(6):433-5.</p>
<p>Davis TC, Long SW, Jackson RH, Mayeaux EJ, George RB, Murphy PW, Crouch MA.
Rapid estimate of adult literacy in medicine: a shortened screening instrument.
Fam Med 1993 Jun;25(6):391-5.</p>
<p>Davis TC, Michielutte R, Askov EN, Williams MV, Weiss BD. Practical
assessment of adult literacy in health care. Health Educ Behav 1998
Oct;25(5):613-24.</p>
<p>Devins GM, Binik YM, Mandin H, Letourneau PK, Hollomby DJ, Barre PE, Prichard
S. The Kidney Disease Questionnaire: a test for measuring patient knowledge
about end-stage renal disease. J Clin Epidemiol 1990;43(3):297-307.</p>
<p>Eyre SL. The vernacular term interview: eliciting social knowledge related to
sex among adolescents. J Adolesc 1997 Feb;20(1):9-27.</p>
<p>Hanson-Divers EC. Developing a medical achievement reading test to evaluate
patient literacy skills: a preliminary study. J Health Care Poor Underserved
1997 Feb;8(1):56-69.</p>
<p>Hayes RP, Baker DW. Methodological problems in comparing English-speaking and
Spanish-speaking patients' satisfaction with interpersonal aspects of care. Med
Care 1998 Feb;36(2):230-6.</p>
<p>Hornberger J, Thom D, MaCurdy T. Effects of a self-administered previsit
questionnaire to enhance awareness of patients' concerns in primary care. J Gen
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<p>Mehta S, Binns HJ. What do parents know about lead poisoning? The Chicago
Lead Knowledge Test. Pediatric Practice Research Group. Arch Pediatr Adolesc Med
1998 Dec;152(12):1213-8.</p>
<p>Murphy PW, et al. Rapid Estimate of Adult Literacy in Medicine (REALM): a
quick reading test for patients. J Read 1993 Oct;37(2):124-30.</p>
<p>Nurss JR, Baker DW, Davis TC, Parker RM, Williams MV. Difficulties in
functional health literacy screening in Spanish-speaking adults. J Read 1995
May;38(8):632-37.</p>
<p>Parikh NS, Parker RM, Nurss JR, Baker DW, Williams MV. Shame and health
literacy: the unspoken connection. Patient Educ Couns 1996 Jan;27(1):33-9.</p>
<p>Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health
literacy in adults: a new instrument for measuring patients' literacy skills. J
Gen Intern Med 1995 Oct;10(10):537-41.</p>
<p>Weiss BD, Reed R, Kligman EW, Abyad A. Literacy and performance on the
Mini-Mental State Examination. J Am Geriatr Soc 1995 Jul;43(7):807-10.</p>
<p>Witte K. Preventing teen pregnancy through persuasive communications:
realities, myths, and the hard-fact truths. J Community Health 1997
Apr;22(2):137-54.</p>
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size="-1"><i>Return to the top</i></font></a></p>
<hr />
<h3><a name="280">IV. C. Communicating Risk</a></h3>
<hr />
<p>Ball LK, Evans G, Bostrom A. Risky business: challenges in vaccine risk
communication. Pediatrics 1998 Mar;101(3 Pt 1):453-8.</p>
<p>Bottorff JL, Ratner PA, Johnson JL, Lovato CY, Joab SA. Communicating cancer
risk information: the challenges of uncertainty. Patient Educ Couns 1998
Jan;33(1):67-81.</p>
<p>Brooks KL, DeJoy DM. Hazard and risk communication aspects of in-use
medication information leaflets. Int J Cognit Ergon 1998;2(1-2):75-92.</p>
<p>Bruhn CM. Consumer concerns: motivating to action. Emerg Infect Dis 1997
Oct-Dec;3(4):511-5.</p>
<p>Castaldini M, Saltmarch M, Luck S, Sucher K. The development and pilot
testing of a multimedia CD-ROM for diabetes education. Diabetes Educ 1998
May-Jun;24(3):285-6, 291-2, 295-6.</p>
<p>Connelly NA, Knuth BA. Evaluating risk communication: examining target
audience perceptions about four presentation formats for fish consumption health
advisory information. Risk Anal 1998 Oct;18(5):649-59.</p>
<p>Deahl ST 2nd, Kromer ME. A taxonomy for lay risk perceptions of dentistry. J
Public Health Dent 1996 Summer;56(4):213-8.</p>
<p>Edwards A, Matthews E, Pill R, Bloor M. Communication about risk: diversity
among primary care professionals. Fam Pract 1998 Aug;15(4):296-300.</p>
<p>Edwards A, Matthews E, Pill R, Bloor M. Communication about risk: the
responses of primary care professionals to standardizing the 'language of risk'
and communication tools. Fam Pract 1998 Aug;15(4):301-7.</p>
<p>Edwards A, Pill R, Stott N. Communicating risk. Use of standard terms is
unlikely to result in standard communication [letter]. BMJ 1996 Dec
7;313(7070):1483. Comment on: BMJ 1996 Sep 28;313(7060):799-802.</p>
<p>Edwards A, Prior L. Communication about risk--dilemmas for general
practitioners. The Department of General Practice Working Group, University of
Wales College of Medicine. Br J Gen Pract 1997 Nov;47(424):739-42.</p>
<p>Freeman TR, Bass MJ. Risk language preferred by mothers in considering a
hypothetical new vaccine for their children. CMAJ 1992 Oct 1;147(7):1013-7.</p>
<p>Kavanagh AM, Broom DH. Embodied risk: my body, myself? Soc Sci Med 1998
Feb;46(3):437-44.</p>
<p>Lieu TA, Glauber JH, Fuentes-Afflick E, Lo B. Effects of vaccine information
pamphlets on parents' attitudes. Arch Pediatr Adolesc Med 1994
Sep;148(9):921-5.</p>
<p>Malenka DJ, Baron JA, Johansen S, Wahrenberger JW, Ross JM. The framing
effect of relative and absolute risk. J Gen Intern Med 1993 Oct;8(10):543-8.
Comment in: J Gen Intern Med 1994 Apr;9(4):237.</p>
<p>Mann CE. Searching for HIV/AIDS information on the World Wide Web. J Assoc
Nurses AIDS Care 1999 Mar-Apr;10(2):79-81.</p>
<p>Mechanic D. Public trust and initiatives for new health care partnerships.
Milbank Q 1998;76(2):281-302.</p>
<p>Paskett ED, Tatum C, Wilson A, Dignan M, Velez R. Use of a photoessay to
teach low-income African American women about mammography. J Cancer Educ 1996
Winter;11(4):216-20.</p>
<p>Reynolds DL, Chambers LW. Healthy communications: producing a health report
(Infowatch) for monitoring and promoting health in local communities. Can J
Public Health 1992 Jul-Aug;83(4):271-3.</p>
<p>Wadey V, Frank C. The effectiveness of patient verbalization on informed
consent. Can J Surg 1997 Apr;40(2):124-8. Comment in: Can J Surg 1997
Apr;40(2):86.</p>
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size="-1"><i>Return to the top</i></font></a></p>
<hr />
<h3><a name="290">IV. D. Cross-Cultural/Cultural Competency</a></h3>
<hr />
<p>American College of Obstetricians and Gynecologists (ACOG), Committee on
Health Care for Underserved Women. ACOG committee opinion. Cultural competency
in health care. Number 201, March 1998. Int J Gynaecol Obstet 1998
Jul;62(1):96-9.</p>
<p>Baker DW, Hayes R, Fortier JP. Interpreter use and satisfaction with
interpersonal aspects of care for Spanish-speaking patients. Med Care 1998
Oct;36(10):1461-70.</p>
<p>Baker DW, Parker RM, Williams MV, Coates WC, Pitkin K. Use and effectiveness
of interpreters in an emergency department. JAMA 1996 Mar 13;275(10):783-8.</p>
<p>Barrett B, Shadick K, Schilling R, Spencer L, del Rosario S, Moua K, Vang M.
Hmong/medicine interactions: improving cross-cultural health care. Fam Med 1998
Mar;30(3):179-84.</p>
<p>Blackford J, Street A, Parsons C. Breaking down language barriers in clinical
practice. Contemp Nurse 1997 Mar;6(1):15-21.</p>
<p>Breckenridge L. Family mental health and education at the refugee women's
alliance: A working bibliography of resources. Seattle (WA): Refugee Women's
Alliance (Seattle); 1992 Apr. 30 p. Available from: ERIC Document Reproduction
Service, Springfield, VA; No. ED359836.</p>
<p>Burhansstipanov L, Barry KC, compilers. Cancer education resources for
American Indians and Alaska Natives. Bethesda (MD): National Cancer Institute,
Cancer Information Service; 1994 Jan. Supplement to Native American monograph
no. 1: Documentation of the cancer research needs of American Indians and Alaska
Natives. Available from: ERIC Document Reproduction Service, Springfield, VA;
No. ED398012.</p>
<p>Chachkes E, Christ G. Cross cultural issues in patient education. Patient
Educ Couns 1996 Jan;27(1):13-21.</p>
<p>Champion VL, Scott CR. Reliability and validity of breast cancer screening
belief scales in African American women. Nurs Res 1997 Nov-Dec;46(6):331-7.</p>
<p>Cheek J, Fuller J, Gilchrist S, Maddock A, Ballantyne A. Vietnamese women and
Pap smears: issues in promotion. Aust N Z J Public Health 1999
Feb;23(1):72-6.</p>
<p>Corkery E, Palmer C, Foley ME, Schechter CB, Frisher L, Roman SH. Effect of a
bicultural community health worker on completion of diabetes education in a
Hispanic population. Diabetes Care 1997 Mar;20(3):254-7.</p>
<p>David RA, Rhee M. The impact of language as a barrier to effective health
care in an underserved urban Hispanic community. Mt Sinai J Med 1998
Oct-Nov;65(5-6):393-7.</p>
<p>Dhooper SS, Tran TV. Understanding and responding to the health and mental
health needs of Asian refugees. Soc Work Health Care 1998;27(4):65-82.</p>
<p>Downs K, Bernstein J, Marchese T. Providing culturally competent primary care
for immigrant and refugee women. A Cambodian case study. J Nurse Midwifery 1997
Nov-Dec;42(6):499-508.</p>
<p>Fitzgibbon ML, Stolley MR, Avellone ME, Sugerman S, Chavez N. Involving
parents in cancer risk reduction: a program for Hispanic American families.
Health Psychol 1996 Nov;15(6):413-22.</p>
<p>Jackson JC, Rhodes LA, Inui TS, Buchwald D. Hepatitis B among the Khmer.
Issues of translation and concepts of illness. J Gen Intern Med 1997
May;12(5):292-8.</p>
<p>Lobell M, Bay RC, Rhoads KV, Keske B. Barriers to cancer screening in
Mexican-American women . Mayo Clin Proc 1998 Apr;73(4):301-8. Comment in: Mayo
Clin Proc 1998 Apr;73(4):386-8; Mayo Clin Proc 1998 Jul;73(7):705.</p>
<p>Longo PJ, Donahue V. Amplifying the health literacy of migrant farmworkers.
Richmond (VA): Virginia Adult Educators Research Network; 1997. 29 p.</p>
<p>Lyons GK, Woodruff SI, Candelaria JI, Rupp JW, Elder JP. Development of a
protocol to assess dietary intake among Hispanics who have low literacy skills
in English. J Am Diet Assoc 1996 Dec;96(12):1276-9.</p>
<p>Nuestra familia: primaria para adultos. Segunda parte. Edicion experimental
[Our family: primer for adults. Part two. Experimental edition]. Mexico City:
Instituto Nacional para la Educacion de los Adultos; 1990. 652 p. (Spa).
Available from: ERIC Document Reproduction Service, Springfield, VA; No.
ED392298.</p>
<p>Poss JE. The meanings of tuberculosis for Mexican migrant farmworkers in the
United States. Soc Sci Med 1998 Jul;47(2):195-202.</p>
<p>Sadler GR, Nguyen F, Doan Q, Au H, Thomas AG. Strategies for reaching Asian
Americans with health information. Am J Prev Med 1998 Apr;14(3):224-8.</p>
<p>Sarwar Z. Helping Asian women to understand the menopause. Community Nurse
1998 Apr;4(3):12-3.</p>
<p>Schur CL, Albers LA. Language, sociodemographics, and health care use of
Hispanic adults. J Health Care Poor Underserved 1996 May;7(2):140-58.</p>
<p>Setness PA. Culturally competent healthcare [editorial]. Postgrad Med 1998
Feb;103(2):13-6. Comment in: Postgrad Med 1998 Jun;103(6):38.</p>
<p>Tuffnell DJ, Nuttall K, Raistrick J, Jackson TL. Use of translated written
material to communicate with non-English speaking patients. BMJ 1994 Oct
15;309(6960):992.</p>
<p>Weidmer B, Brown J, Garcia L. Translating the CAHPS 1.0 survey instruments
into Spanish. Med Care 1999 Mar;37(3 Suppl):MS89-96.</p>
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size="-1"><i>Return to the top</i></font></a></p>
<hr />
<h3><a name="300">IV. E. International Experiences</a></h3>
<hr />
<p>Connor JV. Environmental education in the developing world. New York: UNICEF
Programs Publications; 1990. 25 p.</p>
<p>de Almeida MD, Graca P, Lappalainen R, Giachetti I, Kafatos A, Remaut de
Winter A, Kearney JM. Sources used and trusted by nationally-representative
adults in the European Union for information on healthy eating. Eur J Clin Nutr
1997 Jun;51 Suppl 2:S16-22.</p>
<p>Dexter ER, LeVine SE, Velasco PM. Maternal schooling and health-related
language and literacy skills in rural Mexico. Comp Educ Rev 1998
May;42(2):139-62.</p>
<p>Gopaldas T, Christian PS, Abbi RD, Gujral S. Does growth monitoring work as
it ought to in countries of low literacy? J Trop Pediatr 1990
Dec;36(6):322-7.</p>
<p>Gordon D. MDs' failure to use plain language can lead to the courtroom. CMAJ
1996 Oct 15;155(8):1152-4.</p>
<p>Gupta MC, Mehrotra M, Arora S, Saran M. Relation of childhood malnutrition to
parental education and mothers' nutrition related KAP. Indian J Pediatr 1991
Mar-Apr;58(2):269-74.</p>
<p>Gupta VM. Communication: cornerstone to success in implementation of health
programmes. Indian J Public Health 1996 Jul-Sep;40(3):62-7.</p>
<p>LeVine RA, Dexter E, Velasco P, LeVine S, Joshi AR, Stuebing KW, Tapia Uribe
FM. Maternal literacy and health care in three countries: a preliminary report.
Health Transit Rev 1994 Oct;4(2):186-91.</p>
<p>M'Jamtu-Sie N. Health information for the grass roots. World Health Forum
1996;17(3):277-82.</p>
<p>McAuliffe JF, Falcao L, Duncan B. Understanding of growth monitoring charts
by literate and illiterate mothers in northeast Brazil. J Trop Pediatr 1993
Dec;39(6):370-2.</p>
<p>Medel Anonuevo C. Women reading the world - policies and practices of
literacy in Asia. Hamburg (Germany): United Nations Educational, Scientific, and
Cultural Organization, Institute for Education; 1996. 129 p. (UIE studies;
6).</p>
<p>Moriyama M, Harnisch DL, Matsubara S. The development of graphic symbols for
medical symptoms to facilitate communication between health care providers and
receivers. Tohoku J Exp Med 1994 Dec;174(4):387-98.</p>
<p>Najera Aguilar P, Lazcano Ponce EC, de Ruiz PA, Ramirez Sanchez T, Cantoral
Uriza L, Hernandez Avila M. Factors associated with Mexican women's familiarity
with the purpose of the Pap test. Bull Pan Am Health Organ 1996
Dec;30(4):348-53.</p>
<p>Ngoh LN, Shepherd MD. Design, development, and evaluation of visual aids for
communicating prescription drug instructions to nonliterate patients in rural
Cameroon. Patient Educ Couns 1997 Jul;31(3):245-61. Corrected and republished
article originally printed in Patient Educ Couns 1997 Mar;30(3):257-70.</p>
<p>Nishino Y, Schunck M. Single Thai women's interpersonal communication and
mass media reception on AIDS. AIDS Educ Prev 1997 Apr;9(2):181-200.</p>
<p>Nutbeam D. Promoting health and preventing disease: an international
perspective on youth health promotion. J Adolesc Health 1997
May;20(5):396-402.</p>
<p>Petridou E, Skalkidis Y, Pailopoulos V, Pailopoulos Z, Toupadaki N, Tzonou A.
Adaptation of the European Code Against Cancer (ECAC) to the cultural needs of
low income women in Greece: comparative effectiveness of health education
approaches. Soz Praventivmed 1990;35(6):220-4.</p>
<p>Pitts M, McMaster J, Hartmann T, Mausezahl D. Lay beliefs about diarrhoeal
diseases: their role in health education in a developing country. Soc Sci Med
1996 Oct;43(8):1223-8.</p>
<p>Puchner LD. Early childhood, family, and health issues in literacy:
international perspectives. Philadelphia: University of Pennsylvania, National
Center on Adult Literacy; 1993 Jun. 40 p. (LRC/NCAL international paper;
IP93-2). Available from: ERIC Document Reproduction Service, Springfield, VA;
No. ED360522.</p>
<p>Rahman M, Islam MA, Mahalanabis D. Mothers' knowledge about vaccine
preventable diseases and immunization coverage in a population with high rate of
illiteracy. J Trop Pediatr 1995 Dec;41(6):376-8.</p>
<p>Sanwal AK, Kumar S, Sahni P, Nundy S. Informed consent in Indian patients. J
R Soc Med 1996 Apr;89(4):196-8.</p>
<p>Seow A, Wong ML, Smith WC, Lee HP. Beliefs and attitudes as determinants of
cervical cancer screening: a community-based study in Singapore. Prev Med 1995
Mar;24(2):134-41.</p>
<p>Smitasiri S, Dhanamitta S. Nutri-action analysis as a research strategy to
improve nutrition information, education and communication interventions in
Asia. Biomed Environ Sci 1996 Sep;9(2-3):290-5.</p>
<p>Smith CA. Women's acquisition of literacy skills and health knowledge in
Nepal: a comparative study of nonformal education approaches [dissertation].
Amherst (MA): University of Massachusetts; 1997. 267 p.</p>
<p>Songwathana P, Manderson L. Perceptions of HIV/AIDS and caring for people
with terminal AIDS in southern Thailand. AIDS Care 1998 Jun;10 Suppl
2:S155-65.</p>
<p>Steinberg S. Childbearing research: a transcultural review. Soc Sci Med 1996
Dec;43(12):1765-84.</p>
<p>Vander Stichele RH, Bogaert MG. European legislation and research projects
regarding patient education for medication. Drug Inf J 1995;29(1):285-90.</p>
<p>Wang C, Burris MA, Ping XY. Chinese village women as visual anthropologists:
a participatory approach to reaching policymakers. Soc Sci Med 1996
May;42(10):1391-400.</p>
<p>Work DR. Improving drug labels with pictograms. Int Pharm J 1990
Jul-Aug;4:153-7.</p>
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size="-1"><i>Return to the top</i></font></a></p>
<hr />
<h2><a name="310">V. Internet Resources</a></h2>
<hr />
<p><b>DATABASES</b></p><br />
<p>NALD: National Adult Literacy Database [database on the Internet].
Fredericton (New Brunswick, Canada): National Adult Literacy Database, Inc.
[revised 2000 Jan 7; cited 2000 Jan 18]. Available from: <a
href="http://www.nald.ca/index.htm">http://www.nald.ca/index.htm</a> Use search
function to locate specific health resources.</p>
<p><b>LISTSERV</b></p><br />
<p>Literacy NIFL-Health Forum [listserv on the Internet]. Washington: National
Institute for Literacy; [revised 1999 Jan 26; cited 2000 Jan 18]. Available
from: <a
href="http://novel.nifl.gov/nifl-health/">http://novel.nifl.gov/nifl-health/</a></p>
<p><b>ORGANIZATIONS</b></p><br />
<p>American Association for the Advancement of Science [homepage on the
Internet]. Washington: The Association; c1998 [revised 2000 Jan 5; cited 2000
Jan 15]. Available from: <a href="http://www.aaas.org/">http://www.aaas.org/</a>
See specifically Project 2061 and EHR programs.</p>
<p>HealthCOMM: health communication around the world [homepage on the Internet].
Annandale (VA): National Communication Association; [updated 1999 Dec 10; cited
2000 Jan 15]. Available from: <a
href="http://www.sla.purdue.edu/healthcomm/">http://www.sla.purdue.edu/healthcomm/</a></p>
<p>Health Literacy Center: specializing in plain English communication [homepage
on the Internet]. Biddleford (ME): University of New England; [revised 1999 Jun
7; cited 2000 Jan 15]. Available from: <a
href="http://www.une.edu/com/othrdept/hlit/index.htm">http://www.une.edu/com/othrdept/hlit/index.htm</a></p>
<p>NCHE: National Center for Health Education [homepage on the Internet]. New
York: The Center; 1997 [revised 1999 Oct 18; cited 2000 Jan 15]. Available from:
<a href="http://www.nche.org/">http://www.nche.org/</a></p>
<p>Literacy Online [homepage on the Internet]. Philadelphia: University of
Pennsylvania; c1999 [updated 1999 Nov 1; cited 2000 Feb 15]. Available from: <a
href="http://www.literacyonline.org/">http://www.literacyonline.org/</a></p>
<p>National LINCS [homepage on the Internet]. Washington: National Institute for
Literacy; [revised 1999 Dec 10; cited 2000 Jan 15]. Available from: <a
href="http://www.nifl.gov/">http://www.nifl.gov/</a></p>
<p>National Literacy and Health Program [homepage on the Internet]. Ottawa:
Canadian Public Health Association; [updated 1999 Mar 3; cited 2000 Jan 18].
Available from: <a
href="http://www.nlhp.cpha.ca/">http://www.nlhp.cpha.ca/</a></p>
<p>National Network for Health [homepage on the Internet]. Washington: Dept. of
Agriculture (US); [updated 1999 Nov 24; cited 2000 Jan 15]. Available from: <a
href="http://www.nnh.org/">http://www.nnh.org/</a></p>
<p>SciPICH: Science Panel on Interactive Communication and Health [homepage on
the Internet]. Washington: The Panel; [updated 1999 Nov 22; cited 2000 Jan 15].
Available from: <a href="http://www.scipich.org/">http://www.scipich.org/</a>
Sponsored by the Office of Disease Prevention and Health Promotion, U.S. Dept.
of Health and Human Services</p>
<p>U.S. Department of Education [homepage on the Internet]. Washington: The
Department; [revised 2000 13 Jan; cited 2000 Jan 18]. Available from: <a
href="http://www.ed.gov/">http://www.ed.gov/</a></p>
<p>World education [homepage on the Internet]. Boston: World Education; [revised
2000 Jan 5; cited 2000 Jan 15] Available from: <a
href="http://www.worlded.org/">http://www.worlded.org/</a></p>
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<h2><a name="320">Appendix: Readability</a></h2>
<hr />
<p>Albright J, de Guzman C, Acebo P, Paiva D, Faulkner M, Swanson J. Readability
of patient education materials: implications for clinical practice. Appl Nurs
Res 1996 Aug;9(3):139-43.</p>
<p>Alexander RE. Patient understanding of postsurgical instruction forms. Oral
Surg Oral Med Oral Pathol Oral Radiol Endod 1999 Feb;87(2):153-8.</p>
<p>Amery WK, Van Winkel M . Patient package inserts for prescription drugs in an
international pharmaceutical company. Drug Inf J 1995;29(1):51-60.</p>
<p>Baker GC. Writing easily read patient education handouts: a computerized
approach. Semin Dermatol 1991 Jun;10(2):102-6.</p>
<p>Baker LM, Wilson FL. Consumer health materials recommended for public
libraries: too tough to read? Public Libr 1996 Mar-Apr;35(2):124-30.</p>
<p>Baker LM, Wilson FL, Kars M. The readability of medical information on
InfoTrac: does it meet the needs of people with low literacy skills? Ref User
Serv Q 1997 Winter;37(2):155-60.</p>
<p>Baker SJ . Who can read consumer product information? Aust J Hosp Pharm
1997;27(2):126-31.</p>
<p>Bandesha G, Raynor DK, Teale C . Preliminary investigation of patient
information leaflets as package inserts. Int J Pharm Pract 1996 Dec;4:246-8.</p>
<p>Basara LR, Juergens JP. Patient package insert readability and design. Am
Pharm 1994 Aug;NS34(8):48-53.</p>
<p>Beaver K, Luker K. Readability of patient information booklets for women with
breast cancer. Patient Educ Couns 1997 Jun;31(2):95-102.</p>
<p>Beckman HT, Lueger RJ. Readability of self-report clinical outcome measures.
J Clin Psychol 1997 Dec;53(8):785-9.</p>
<p>Bell JH, Johnson RE. Effect of lowering the reading level of a health
education pamphlet on increasing comprehension by ESL adults. TESL Can J 1992
Fall;10(1):9-26.</p>
<p>Bradley B, Singleton M, Li Wan Po A. Readability of patient information
leaflets on over-the-counter (OTC) medicines. J Clin Pharm Ther 1994
Feb;19(1):7-15.</p>
<p>Briguglio J, Cardella JF, Fox PS, Hopper KD, TenHave TR. Development of a
model angiography informed consent form based on a multiinstitutional survey of
current forms. J Vasc Interv Radiol 1995 Nov-Dec;6(6):971-8.</p>
<p>Brownson K. Education handouts. Are we wasting our time? J Nurses Staff Dev
1998 Jul-Aug;14(4):176-82.</p>
<p>Cardinal BJ, Martin JJ, Sachs ML. Readability of written informed consent
forms used in exercise and sport psychology research. Res Q Exerc Sport 1996
Sep;67(3):360-2.</p>
<p>Cardinal BJ, Sachs ML. An analysis of the readability of exercise promoting
literature with implications and suggestions for practice. Res Q Exerc Sport
1992 Jun;63(2):186-90.</p>
<p>Coey L. Readability of printed educational materials used to inform potential
and actual ostomates. J Clin Nurs 1996 Nov;5(6):359-66.</p>
<p>Cory J, Bottum C, Haddock C. Evaluating print health education materials.
Cancer Pract 1995 Jan-Feb;3(1):54-6.</p>
<p>Coulter A. Evidence based patient information. BMJ 1998 Jul 25;317:225-6.</p>
<p>Dollahite J, Thompson C, McNew R. Readability of printed sources of diet and
health information. Patient Educ Couns 1996 Mar;27(2):123-34.</p>
<p>Evanoski CA. Health education for patients with ventricular tachycardia:
assessment of readability. J Cardiovasc Nurs 1990 Feb;4(2):1-6.</p>
<p>Feldman SR, Quinlivan A, Williford P, Bahnson JL, Fleischer AB Jr. Illiteracy
and the readability of patient education materials. A look at Health Watch. N C
Med J 1994 Jul;55(7):290-2.</p>
<p>Feldman SR, Vanarthos J, Fleischer AB Jr. The readability of patient
education materials designed for patients with psoriasis. J Am Acad Dermatol
1994 Feb;30(2 Pt 1):284-6.</p>
<p>Gabriel V, Stephenson TJ. Readability of patient information leaflets. J
Pediatr Pharm Pract 1998;3(1):29-32.</p>
<p>Gannon K. OTC labeling guidelines proposed by NDMA, PPSI. Drug Top 1991 Mar
25;135:32.</p>
<p>Gannon K. Should OTCs be mandated to carry more readable labels? Drug Top
1993 Jul 5;137:34.</p>
<p>Glanz K, Rudd J. Readability and content analysis of print cholesterol
education materials. Patient Educ Couns 1990 Oct;16(2):109-18.</p>
<p>Glazer HR, Kirk LM, Bosler FE. Patient education pamphlets about prevention,
detection, and treatment of breast cancer for low literacy women. Patient Educ
Couns 1996 Mar;27(2):185-9.</p>
<p>Goldstein AO, Frasier P, Curtis P, Reid A, Kreher NE. Consent form
readability in university-sponsored research. J Fam Pract 1996
Jun;42(6):606-11.</p>
<p>Grossman SA, Piantadosi S, Covahey C. Are informed consent forms that
describe clinical oncology research protocols readable by most patients and
their families? J Clin Oncol 1994 Oct;12(10):2211-5.</p>
<p>Guidry JJ, Fagan P. The readability levels of cancer-prevention materials
targeting African Americans. J Cancer Educ 1997 Summer;12(2):108-13.</p>
<p>Hammerschmidt DE, Keane MA. Institutional Review Board (IRB) review lacks
impact on the readability of consent forms for research. Am J Med Sci 1992
Dec;304(6):348-51.</p>
<p>Hearth-Holmes M, Murphy PW, Davis TC, Nandy I, Elder CG, Broadwell LH, Wolf
RE. Literacy in patients with a chronic disease: systemic lupus erythematosus
and the reading level of patient education materials. J Rheumatol 1997
Dec;24(12):2335-9. Comment in: J Rheumatol 1998 Aug;25(8):1649-50.</p>
<p>Hedl JJ Jr, Glazer-Waldman HR, Parker HJ, Hopkins KM. Readability and writing
style analysis of selected allied health professional journals. J Allied Health
1991 Winter;20(1):25-37.</p>
<p>Hobbie C. Maximizing healthy communication: readability of parent educational
materials. J Pediatr Health Care 1995 Mar-Apr;9(2):92-3.</p>
<p>Hochhauser M. Can patients understand their consent forms? Benders Health
Care Law Mon 1997 Apr: 8-10.</p>
<p>Hochhauser M . Writing, reading and understanding research consent forms.
Appl Clin Trials 1997 May;6:66-8, 70.</p>
<p>Holm S. [Written patient information. Analysis of Danish biomedical research
programs]. Ugeskr Laeger 1992 Aug 31;154(36):2432-5. (Dan).</p>
<p>Hopper KD, TenHave TR, Hartzel J. Informed consent forms for clinical and
research imaging procedures: how much do patients understand? AJR Am J
Roentgenol 1995 Feb;164(2):493-6.</p>
<p>Hopper KD, TenHave TR, Tully DA, Hall TE. The readability of currently used
surgical/procedure consent forms in the United States. Surgery 1998
May;123(5):496-503.</p>
<p>Hurst K, Thompson D. A software package to determine the readability of
nursing articles. Nurs Stand 1992 Feb 5-11;6(20):43.</p>
<p>Hussey LC. Strategies for effective patient education material design. J
Cardiovasc Nurs 1997 Jan;11(2):37-46.</p>
<p>It's on paper but do they understand it? Simple testing gets written handouts
on target. Hosp Case Manage 1999 Apr;7(4):75-6, 80.</p>
<p>Jesson J, Pocock R, Jepson M, Kendall H. Consumer readership and views on
pharmacy health education literature: market research survey. J Soc Adm Pharm
1994;11(1):29-36.</p>
<p>Johnson HH. Readability study of client health education materials: a
resource for assuring the effectiveness of written materials. Raleigh (NC):
North Carolina State Dept. of Environment, Health, and Natural Resources; 1994
May. 128 p. Available from: ERIC Document Reproduction Service, Springfield, VA;
No. ED382934.</p>
<p>Jubelirer SJ. Level of reading difficulty in educational pamphlets and
informed consent documents for cancer patients. W V Med J 1991
Dec;87(12):554-7.</p>
<p>Ledbetter C, Hall S, Swanson JM, Forrest K. Readability of commercial versus
generic health instructions for condoms. Health Care Women Int
1990;11(3):295-304.</p>
<p>Ley P, Florio T. The use of readability formulas in health care. Psychol
Health Med 1996 Feb;7(1):7-28.</p>
<p>MacDiarmid SA, Goodson TC, Holmes TM, Martin PR, Doyle RB. An assessment of
the comprehension of the American Urological Association Symptom Index. J Urol
1998 Mar;159(3):873-4.</p>
<p>Macey BA, Bouman CC. An evaluation of validity, reliability, and readability
of the Critical Care Family Needs Inventory. Heart Lung 1991 Jul;20(4):398-403.
Comment in: Heart Lung 1992 Mar;21(2):199-200.</p>
<p>Mader TJ, Playe SJ. Emergency medicine research consent form readability
assessment. Ann Emerg Med 1997 Apr;29(4):534-9.</p>
<p>Mailloux SL, Johnson ME, Fisher DG, Pettibone TJ. How reliable is
computerized assessment of readability? Comput Nurs 1995
Sep-Oct;13(5):221-5.</p>
<p>Meade CD, Diekmann J, Thornhill DG. Readability of American Cancer Society
patient education literature. Oncol Nurs Forum 1992 Jan-Feb;19(1):51-5.</p>
<p>Melman ST, Kaplan JM, Caloustian ML, Weinberger JA, Smith J, Anbar RD.
Readability of the childhood immunization information forms. Arch Pediatr
Adolesc Med 1994 Jun;148(6):642-4.</p>
<p>Merritt SL, Gates MA, Skiba K. Readability levels of selected
hypercholesterolemia patient education literature. Heart Lung 1993
Sep-Oct;22(5):415-20.</p>
<p>Message on a bottle. Manuf Chem 1994 Oct;65:17, 19-20.</p>
<p>Michielutte R, Bahnson J, Beal P. Readability of the public education
literature on cancer prevention and detection. J Cancer Educ
1990;5(1):55-61.</p>
<p>Morgan PP. Illiteracy can have major impact on patients' understanding of
health care information. CMAJ 1993 Apr 1;148(7):1196-7. Comment in: CMAJ 1993
Nov 15;159(10):1379, 1382.</p>
<p>Mumford ME. A descriptive study of the readability of patient information
leaflets designed by nurses. J Adv Nurs 1997 Nov;26(5):985-91.</p>
<p>Murphy J, Gamble G, Sharpe N. Readability of subject information leaflets for
medical research. N Z Med J 1994 Dec 14;107(991):509-10.</p>
<p>Newton JT. The readability and utility of general dental practice patient
information leaflets: an evaluation. Br Dent J 1995 May 6;178(9):329-32.</p>
<p>Nieto L. Medicine labeling: future becomes clear. Chem Drug 1993
Jul;240:67.</p>
<p>Nunn DS. Ampul labeling-way forward. Pharm J 1992 Mar 14;248:361-3.</p>
<p>Ormrod J, Robinson M. How readable are health education leaflets? Health
Visit 1994 Dec;67(12):424-5.</p>
<p>Ott BB, Hardie TL. Readability of advance directive documents. Image J Nurs
Sch 1997 Spring;29(1):53-7.</p>
<p>Ott BB, Hardie TL. Readability of written materials: implications for
critical care nurses. Dimens Crit Care Nurs 1995 Nov-Dec;14(6):328-34.</p>
<p>Owens PM, Johnson EM, Frost CD, Porter KA, O'Hare E. Reading, readability,
and patient education materials. Cardiovasc Nurs 1993 Mar-Apr;29(2):9-13.</p>
<p>Petterson T. How readable are the hospital information leaflets available to
elderly patients? Age Ageing 1994 Jan;23(1):14-6.</p>
<p>Petterson T, Dornan TL, Albert T, Lee P. Are information leaflets given to
elderly people with diabetes easy to read? Diabet Med 1994
Jan-Feb;11(1):111-3.</p>
<p>Priestley KA, Campbell C, Valentine CB, Denison DM, Buller NP. Are patient
consent forms for research protocols easy to read? BMJ 1992 Nov
21;305(6864):1263-4.</p>
<p>Primas P, Lefor N, Johnson J, Helms SM, Coats L, Coe MK. Prenatal literature
testing: a pilot project. J Community Health 1992 Feb;17(1):61-7.</p>
<p>Reed J, Conneely J, Gorham P, Coxhead S. Assessing the written information
given to families prior to their attendance at a child development centre. Child
Care Health Dev 1993 Sep-Oct;19(5):317-25.</p>
<p>Riche JM. Text and reader characteristics affecting the readability of
patient literature. Read Improv 1991 Winter;28(4):287-92.</p>
<p>Rivera R, Reed JS, Menius D. Evaluating the readability of informed consent
forms used in contraceptive clinical trials. Int J Gynaecol Obstet 1992
Jul;38(3):227-30.</p>
<p>Sansgiry SS, Cady PS, Patil S. Readability of over-the-counter medication
labels. J Am Pharm Assoc (Wash) 1997 Sep-Oct;NS37(5):522-8.</p>
<p>Sarma M, Alpers JH, Prideaux DJ, Kroemer DJ. The comprehensibility of
Australian educational literature for patients with asthma. Med J Aust 1995 Apr
3;162(7):360-3.</p>
<p>Sarna L, Ganley BJ. A survey of lung cancer patient-education materials.
Oncol Nurs Forum 1995 Nov-Dec;22(10):1545-50. Comment in: Oncol Nurs Forum 1996
Apr;23(3):422.</p>
<p>Siminerio LM, Frith M. Need to assess readability of written materials for
diabetes education curricula. Diabetes Care 1993 Jan;16(1):391-3.</p>
<p>Slaten D, Parrott R, Steiner C. Readability of skin cancer prevention
brochures targeting parents of young children. J Am Acad Dermatol 1999 Jun;40(6
Pt 1):997-9.</p>
<p>Smith H, Gooding S, Brown R, Frew A. Evaluation of readability and accuracy
of information leaflets in general practice for patients with asthma. BMJ 1998
Jul 25;317(7153):264-5. Comment in: BMJ 1998 Jul 25;317(7153):225-6; BMJ 1999
Feb 13;318(7181):462.</p>
<p>Stephens ST. Patient education materials: are they readable? Oncol Nurs Forum
1992 Jan-Feb;19(1):83-5.</p>
<p>Swanson JM, Forrest K, Ledbetter C, Hall S, Holstine EJ, Shafer MR.
Readability of commercial and generic contraceptive instructions. Image J Nurs
Sch 1990 Summer;22(2):96-100.</p>
<p>Tarnowski KJ, Allen DM, Mayhall C, Kelly PA. Readability of pediatric
biomedical research informed consent forms. Pediatrics 1990 Jan;85(1):58-62.</p>
<p>Thomas LG, Corwin EJ. The readability of printed education materials
regarding hormone replacement therapy. J Am Acad Nurse Pract 1998
Oct;10(10):447-52.</p>
<p>Tips for improving patient education materials: the right readability level
is one key to success. Health Care Food Nutr Focus 1997 Oct;14(2):1, 3.</p>
<p>Vnuk AK. An analysis of breastfeeding print educational material. Breastfeed
Rev 1997;5(2):29-35.</p>
<p>Wagner L, Davis S, Handelsman MM. In search of the abominable consent form:
the impact of readability and personalization. J Clin Psychol 1998
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<p>Wells JA. Readability of HIV/AIDS educational materials: the role of the
medium of communication, target audience, and producer characteristics. Patient
Educ Couns 1994 Dec;24(3):249-59.</p>
<p>Wells JA, Ruscavage D, Parker B, McArthur L. Literacy of women attending
family planning clinics in Virginia and reading levels of brochures on HIV
prevention. Fam Plann Perspect 1994 May-Jun;26(3):113-5, 131.</p>
<p>White LJ, Jones JS, Felton CW, Pool LC. Informed consent for medical
research: common discrepancies and readability. Acad Emerg Med 1996
Aug;3(8):745-50.</p>
<p>Williams DM, Counselman FL, Caggiano CD. Emergency department discharge
instructions and patient literacy: a problem of disparity. Am J Emerg Med 1996
Jan;14(1):19-22.</p>
<p>Williams DM, Potter LS. Current oral contraceptive use instructions: an
analysis of patient package inserts. Fam Plann Perspect 1992
May-Jun;24(3):111-5.</p>
<p>Wilson FL. Patient education materials nurses use in community health. West J
Nurs Res 1996 Apr;18(2):195-205.</p>
<p>Wong IC. Readability of patient information leaflets on antiepileptic drugs
in the UK. Seizure 1999 Feb;8(1):35-7.</p>
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