Post-Assessment Resources

For cancer programs and practices taking the initiative to enhance their patient-centered care through integrating key attributes of a health literate organization into their program, a first step is completing the Gap Assessment Tool. Once your assessment is complete, return to this page for resources and tools to support your improvement plan(s). Assessment Domains 1- 6 (below) address criteria found in the gap assessment tool. Additional resources follow.

Download the Post-Assessment Incorporation Tool and Work Planner Excel file:

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1. Health Literacy Program

AHRQ Health Literacy Universal Precautions Toolkit
Agency for Healthcare Research and Quality Health Literacy Universal Precautions Toolkit 2nd edition (2017). US Department of Health & Human Services. Rockville, MD.
Provides evidence-based guidance to practices to promote better understanding by all patients.

AHRQ Health Literacy Tools for Use in Pharmacies
Agency for Healthcare Research and Quality (2017). US Department of Health & Human Services. Rockville, MD.
Health literacy tools for pharmacists, includes pharmacy health literacy assessment tool.

Building Health Literate Organizations: A Guidebook to Achieving Organizational Change
Abrams, MA, Kurtz-Rossi, Riffenburgh A, Savage B. Building Health Literate Organization: A Guidebook to Achieving Organizational Change. Unity Point Health, 2014. Health Literacy Iowa.
Includes background, resources, examples, and lessons learned to help build a health literate healthcare organization.

Cancer Health Literacy Tools

  • Cancer Health Literacy Tool – 30 (CHLT-30) – mainly used for research
  • Cancer Health Literacy Tool – 6 (CHLT-6) – clinical application

Dumenci, L., Matsuyama, R., Riddle, D.L., Cartwright, L.A., Perera, R.A., Chung, H., Simonoff, L.A. (Measurement of Cancer Health Literacy and Identification of Patients with Limited Cancer Health Literacy, J Health Commun. 2014;19(2):205-224.

CDC – Health Literacy
Centers for Disease Control health literacy website.
Information, tools, and links on health literacy research, practice, and evaluation. Outlines steps to developing an organization plan. Includes health literacy activities by state.

Full Index Score Sheet
Centers for Disease Control and Prevention: Clear Communication Index Score Sheet.
Assessment tool with scoring index to assess materials.

The Health Literacy Environment of Hospitals and Health Center
Rudd RE, Anderson JE. The Health Literacy Environment of Hospitals and Health Centers; Partners for Action: Making Your Facility Literacy-Friendly (2006). Harvard School of Public Health. Boston, MA.
Tool to assess health literacy environment – navigation, print communication, oral exchange, technology, polices & protocols.  Contains rating scales and how to interpret scores.

Health Literacy Data Map
The University of North Carolina at Chapel Hill (2014).
Search for health literacy levels of your population based on interactive, searchable, national map of health literacy estimates. This site gives you the ability to zoom from state level to county/parish level.

Health Literacy Tool Shed
Collaboration between Communicate Health, Inc., Boston University, and TRI International.
Online database of health literacy measures.

National Action Plan to Improve Health Literacy
U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2010). Washington, DC.
Action Plan that contains 7 goals to improve health literacy and strategies for achieving them.

National Center for Cultural Competence
Georgetown University Center for Child and Human Development. Washington, DC.
This website offers a framework and resources for cultural competence.

National Culturally and Linguistically Appropriate Services (CLAS) Standards (HHS Office of Minority Health)
Office of Minority Health. US Department of Health and Human Services.
Resources to help organizations address the cultural and language differences between the people who provide information and services and the people they serve.

REALM-SF
Tool to roughly assess health literacy level based on education.

Virginia Adult ESOL Health Literacy Toolkit
Singleton, K. Virginia Adult ESOL Health Literacy Toolkit (2013). Virginia Adult Learning Resource Center, Virginia Commonwealth University.
Toolkit offers explanations, tips, materials, and links to help ESOL teachers and programs better understand and address the health literacy challenges faced by adult English language learners in U.S. health care.

2. Staff Training

Ask Me 3
Institute for Healthcare Improvement. Boston, MA.
Ask Me 3® are three specific questions that patients and families should ask of their providers to better understand their health conditions and what they need to do to become more activity members of the health care team. Education module, video, posters, and fliers.

CPEM Health Literacy Action: Toolkit for Patient Educators
Cancer Patient Education Network.
Toolkit developed by a taskforce from 7 major healthcare centers. Includes PowerPoint presentations and scripts for staff training.

Health Literacy Advisor™ – Software to Assess Documents
Health Literacy Innovations.
Software tool to help assess and improve readability of documents. Available in English and Spanish and works entirely within Microsoft Word.

Workforce Diversity Program
Office of Financial Management. Olympia, WA.
Offers suggestions on measuring diversity, managing cultural change, and tips for managers and supervisors.

3. Health Information

AHRQ – Questions are the Answer
Questions to Ask Your Doctor (2012). Agency for Healthcare Research & Quality. Department of Health & Human Services. Rockville, MD.
Questions for individuals to ask their doctor and healthcare team to empower them to better participate in their care. Examples of question to ask before, during, and after appointment. Section where patients can build their own questions.

AHRQ Share Approach
Shared Decision Making Toolkit. Agency for Healthcare Research and Quality SHARE Approach to Shared Decision Making (2017). US Department of Health & Human Services. Rockville, MD.
SHARE approach workshop with facilitator’s training guide and slides. Includes implementation success stories.

CDC – Simply Put Guide for Creating Easy-to-Understand Materials
Simply Put: A Guide for Creating Easy-to-Understand Materials 3rd edition (2010). Centers for Disease Control. U.S. Department of Health and Human Services. Atlanta, GA.
Guide to help transform scientific and technical information into materials that are easy to understand. Suggestions for font, images, layout and design, organizing messages.  Provides checklist for easy-to-understand print materials; formulas for calculating readability.

CMS – Toolkit for Making Written Material Clear and Effective
Centers for Medicare & Medicaid Services. Toolkit for Making Written Material Clear and Effective (2012). Baltimore, MD.
Resource to help make written material in printed formats easier for people to read, understand, and use. Definition of “low literacy skills.”

Federal Plain Language Guidelines
PlainLanguage.gov.  Improving Communication form the Federal Government to the Public. The Plain Language Action and Information Network.
Tips, tools, and resources to improve use of plain language in communication.  List of simple words and phrases to use for plain language “instead of.”

Health Literacy Tool Shed
Website. Collaboration between CommunicateHealth, Inc.,Boston University, and TRI International.
Online database of health literacy measures.

Oncotalk®
This website includes resources for oncology professional to improve communication and resources for oncology faculty to teach communications skills. Videos with role modeling between clinicians and patients of fundamental communication skills.

Program for Readability in Science & Medicine (PRISM)

PRISM Readability Toolkit. Ridpath JR, Greene SM, Wiese CJ; PRISM Readability Toolkit. 3rd ed (2007). Seattle: Group Health Research Institute.
Plain language resources for research. Free web-based plain language training for those involved in research and developing informed consents.

Simple Questions to ask about Patient’s Interest in Shared Decision Making. Johns Hopkins.
(This information is located on back of employee badge at Johns Hopkins):

  1. How much do you know about your cancer?
  2. How much do you want to know about your cancer?
  3. What are you most worried about?
  4. What are you hoping for?
  5. Who else in your family do you want to have involved in the discussions about your cancer?
  6. Tell me 3 things that give you joy.

Shared Decision Making Fact Sheet
National Learning Consortium. Shared Decision Making Fact Sheet (2013).
Simple two-page facts sheet describing shared decision making.

Vital Talk
Company that provides resources and courses to improve communications of clinicians. Videos that show various communication tools like – how to establish rapport, responding to emotions.

4. Navigation

The Health Literacy Environment Activity Packet – First Impression and Walking Interview
Rudd RE. The Health Literacy Environment Activity Packet – First Impression and Walking Interview: Eliminating Barriers – Increasing Access (2010). Health Literacy Studies. Harvard.

The Harvard T.H. Chan School of Public Health: Health Literacy Studies website.
Guidance on how to plan and conduct an environmental assessment (telephone, website, entrance and parking). Provides forms to be completed during assessment.

LINCS: Literacy Information and Communication System
Literacy Information and Communication System. US. Department of Education, Office of Career, Technical, and Adult Education.
A searchable data base of over 7,000 local literacy programs within the National Literacy Directory.

National Center for Cultural Competence
Website. Georgetown University Center for Child and Human Development. Washington, DC.
Framework and resources for cultural competence.

5. Technology

AHRQ Guide for Developers and Purchasers of Health IT
Accessible Health Information Technology (IT) for Populations with Limited Literacy: A Guide for Developers and Purchasers of Health IT (2007). Agency for Healthcare Research and Quality. US Department of Health and Human Services. Rockville, MD.
Guide and checklist for health IT with guidance for content development across multiple online platforms.

Health Literacy Online
Health Literacy Online: A Guide for Simplifying the User Experience 2nd edition (2016). Office of Disease Prevention and Health Promotion. US Department of Health and Human Services. Washington, DC.
Guide to why and how to design health websites and other digital health information tools.

Usability
Usability.gov. US Department of Health & Human Services. Washington, DC.
Guidelines, templates, and instructions for how to improve website/online user experience.

6. Quality Measurement and Improvement

CAHPS Cancer Care Survey Tools
Consumer Assessment of Healthcare Providers and Systems (CAHPS®) from the Agency for Healthcare Research and Quality (AHRQ). US Department of Health & Human Services. Rockville, MD.

Surveys that ask consumers and patients to report on and evaluate their experiences with health care. Measuring patients’ experiences of care using a standardized CAHPS survey is one way to assess the patient-centeredness of care.

Path to Improvement
North Carolina Program on Health Literacy (2014). Cecil G. Sheps Center for Health Services Research. University of North Carolina at Capel Hill.
Two-page quick reference sheet on 6 steps to improving health literacy