The Item Set for Addressing Health Literacy focuses on assessing providers' activities to foster and improve the health literacy of patients. Health literacy is commonly defined as patients' ability to obtain, process, and understand the basic health information and services they need to make appropriate health decisions. While health literacy depends in part on individuals' skills, it also depends on the complexity of health information and how it is communicated.

The primary goal of these supplemental items for the Clinician & Group Surveys is to measure, from the patients' perspective, how well health information is communicated to them by health care professionals. It is part of a larger effort by the Agency for Healthcare Research and Quality to encourage a greater emphasis in the provider community on patient-centered care.

The Item Set for Addressing Health Literacy has been incorporated into the Supplemental Items for the Adult Survey ( PDF [ PDF file - 530.42 KB] ), which also includes instructions for placing the items into the core questionnaire. The items are available in English and Spanish.

Read About the Item Set for Addressing Health Literacy. ( PDF [ PDF file - 286.78 KB] )

To download both the supplemental items and the descriptive document, go to: Get Clinician & Group Surveys and Instructions.

Learn more from a CAHPS Webcast: Using CAHPS Item Sets that Address Cultural Competence and Health Literacy, April 5, 2011.

Topics Covered by the Health Literacy Item Set

The Item Set for Addressing Health Literacy covers the following five topic areas:

  • Communication with providers (doctors).
  • Disease self-management.
  • Communication about medicines.
  • Communication about tests.
  • Communication about forms.

Quality Measures from the Item Set for Addressing Health Literacy

Users of this item set can calculate and report only one composite measure:

  • How Well Doctors Communicate About Medicines.

The remaining questions in the item set cannot be rolled up into composite measures.

Learn more about this measure in About the Item Set for Addressing Health Literacy. ( PDF [ PDF file - 286.78 KB] )

Use of this Item Set To Improve Health Literacy

The Item Set for Addressing Health Literacy was developed to provide health care providers with data that could help them improve their health literacy practices. The survey can be used to:

  • Identify specific topic areas for quality improvement (e.g., communication about test results, medications, and forms).
  • Recognize particular behaviors that inhibit effective communication (e.g., talking too fast, using medical jargon).
  • Assist in designing a safer, shame-free environment where patients feel comfortable discussing their health care concerns (e.g., showing interest in questions, explaining forms).
  • Measure the effect of behaviors that promote effective communication (e.g., confirming understanding through teach-back, using visual aids).

To assist providers in determining how to address an area needing improvement, the Agency for Healthcare Research and Quality has mapped each item in the Item Set for Addressing Health Literacy to a health literacy practice recommended by the American Medical Association (AMA) Foundation and the AMA in their 2007 monograph Health Literacy and Patient Safety: Help Patients Understand.

Review the Health Literacy Quality Improvement Crosswalk in About the Item Set for Addressing Health Literacy. ( PDF [ PDF file - 286.78 KB] )