Health Literacy

Health literacy is how well individuals can access, understand and apply health information, so they can make good decisions about their health. 

Australian Commission for Safety and Quality in Health Care—Communicating for safety standard
https://www.safetyandquality.gov.au/standards/nsqhs-standards/communicating-safety-standard

Meade, C. D. (2024). Literacy and health literacy. In  Community/public health nursing: Promoting the health of populations. Elsevier.

Resources For Health Professionals

Teach-Back

Teach-back https://teachback.org/
(For health service professionals) Teach-back is a simple yet effective communication tool used to check understanding.

Example video:Teach back - a technique for clear communication, North Western Melbourne Primary Health Network. Extended version of video

Check-back https://checkback.org/
(For consumers) This module will help build your skills and confidence so you can use check-back whenever you are talking with a health worker. 

Health Literacy  Live PubMed Search

Barati, M., Amouzeshi, Z., & Nikraftar, F. (2024). The impact of self-care training using the teach-back method on health anxiety in patients with coronary artery disease: A randomized controlled clinical trial. Journal of Education and Health Promotion, 13, 469. https://doi.org/10.4103/jehp.jehp_171_24

Boumendil, K., Yakubu, N. A., Al Wachami, N., Arraji, M., Iderdar, Y., Mourajid, Y., Bouchachi, F. Z., & Chahboune, M. (2025). How nurses' interventions promote health literacy in patients with non-communicable diseases: A systematic review. Journal of Clinical Nursing, 10.1111/jocn.17669. Advance online publication. https://doi.org/10.1111/jocn.17669

Carroll, A. R., Johnson, J. A., Stassun, J. C., Greevy, R. A., Mixon, A. S., & Williams, D. J. (2024). Health literacy-informed communication to reduce discharge medication errors in hospitalized children: A randomized clinical trial. JAMA Network Open, 7(1), e2350969. https://doi.org/10.1001/jamanetworkopen.2023.50969

Ha Dinh, T. T., Bonner, A., Clark, R., Ramsbotham, J., & Hines, S. (2016). The effectiveness of the teach-back method on adherence and self-management in health education for people with chronic disease: A systematic review. JBI Database of Systematic Reviews and Implementation Reports, 14(1), 210–247. https://doi.org/10.11124/jbisrir-2016-2296

Jiang, Y., Wu, Y., Deng, Q., Zhou, R., Jin, Q., Qian, S., Jin, S., Tung, T. H., Ji, W., & Zhang, M. (2024). Using teach-back in patient education to improve patient satisfaction and the clarity of magnetic resonance imaging. Patient Education and Counseling, 123, 108195. https://doi.org/10.1016/j.pec.2024.108195

Oh, E. G., Lee, H. J., Yang, Y. L., & Kim, Y. M. (2021). Effectiveness of discharge education with the Teach-Back method on 30-day readmission: A systematic review. Journal of Patient Safety, 17(4), 305–310. https://doi.org/10.1097/PTS.0000000000000596

Oh, E. G., Lee, J. Y., Lee, H. J., & Oh, S. (2023). Effects of discharge education using teach-back methods in patients with heart failure: A randomized controlled trial. International Journal of Nursing Studies, 140, 104453. https://doi.org/10.1016/j.ijnurstu.2023.104453

Talevski, J., Wong Shee, A., Rasmussen, B., Kemp, G., & Beauchamp, A. (2020). Teach-back: A systematic review of implementation and impacts. PloS One, 15(4), e0231350. https://doi.org/10.1371/journal.pone.0231350

Communicating with consumers – Other tools:

Conversational Health Literacy Assessment Tool (CHAT)

Clinical Excellence Commission, NSW Government. (2020). Conversational Health Literacy Assessment Tool

O'Hara, J., Hawkins, M., Batterham, R., Dodson, S., Osborne, R. H., & Beauchamp, A. (2018). Conceptualisation and development of the Conversational Health Literacy Assessment Tool (CHAT). BMC Health Services Research, 18(1), 199. https://doi.org/10.1186/s12913-018-3037-6

MacAskill, W., Rolleston, R. M., Brumpton, K. & Pinidiyapathirage, J. (2022).  Assessing health literacy of Aboriginal and Torres Strait Islander peoples presenting to general practice. Australian Journal of General Practice, 51(8). https://doi.org/10.31128/ajgp-07-21-6100
Article includes Conversational Health Literacy Assessment Tool (CHAT) questions presented in combination with yarning.

Chunk and Check

The Chunk and Check technique involves breaking down the information that you want to discuss, and that you need the person to understand, into smaller, more manageable forms rather than providing it all at once. ‘Chunking’ means breaking down longer and more complex explanations into digestible pieces, or ‘chunks’. This can help patient understanding and recall because smaller pieces of information are easier to process.

Chunk and Check is often used as a part of the Teach-Back.

Cork, T., & White, S. (2022). Exploring community pharmacists' use of health literacy interventions in their everyday practice. Research in Social & Administrative Pharmacy, 18(11), 3948–3952. https://doi.org/10.1016/j.sapharm.2022.06.007

Ask Me 3

Ask Me 3 - Institute for Healthcare Improvement
Ask Me 3® is an educational program that encourages patients and families to ask three specific questions of their providers to better understand their health conditions and what they need to do to stay healthy. The three questions to ask at the end of every appointment or consultation:

• What is my main problem?
• What do I need to do?
• Why is it important for me to do this?

Motivational Interviewing

Motivational interviewing is a communication style that providers can use to help facilitate client change. "Motivational interviewing is a collaborative conversation style for strengthening a person's own motivation and commitment to change." (Miller, 2013).

Agency for Clinical Innovation, NSW Government. Motivational interviewing.

Motivational Interviewing Network of Trainers

Lub, D. L., Hall, K., Gibbie, T. (2012). Motivational interviewing techniques: Facilitating behaviour change in the general practice setting. Australian Family Physician, 41(9). RACGP

Madson, M. B., Loignon, A. C., & Lane, C. (2009). Training in motivational interviewing: A systematic review. Journal of Substance Abuse Treatment, 36(1), 101-109 https://doi.org/10.1016/j.jsat.2008.05.005

Miller W. R. (2023). The evolution of motivational interviewing. Behavioural and Cognitive Psychotherapy, 51(6), 616–632. https://doi.org/10.1017/S1352465822000431

Clinicians' Pocket Guide for Motivational Interviewing. Content last reviewed August 2023. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/evidencenow/tools/pocket-guide-motivation.html

Motivational Interviewing Online courses
Introductory Motivational Interviewing – Mental Health Coordinating Council.
Applied Motivational Interviewing – Mental Health Coordinating Council. 

Plain Language

Verbal Communication

National Center for Health Marketing (U.S.) (2007). Plain language thesaurus for health communications.

Center for Health Care Strategies – Improving verbal communication to promote patient health literacy.

Charpentier, V., Gotlieb, R., Praska, C. E., Hendrickson, M., Pitt, M. B., & Marmet, J. (2021). Say what? Quantifying and classifying jargon use during inpatient rounds. Hospital Pediatrics, 11(4), 406–410. https://doi.org/10.1542/hpeds.2020-002790

Written Communication

Writing in plain language (or plain English or Easy English) is a way of writing and organising information so that a person can read, understand and act on the information when they first read it.

Australian Government Style Manual – Plain language and word choice

Australian Government Style Manual – The basics of plain language

Government of South Australia - Online Accessibility Toolkit

Australian Commission on Safety and Quality in Health Care – Writing health information for consumers.

Test the readability of your content:

• https://readable.com/
• https://hemingwayapp.com/
• If you are editing in Word see how to turn on Flesch-Kincaid
• Sydney Health Literacy Lab - Health Literacy Editor

Ayre, J., Bonner, C., Muscat, D. M., Cvejic, E., Mac, O., Mouwad, D., Shepherd, H. L., Aslani, P., Dunn, A. G., & McCaffery, K. J. (2024). Online plain language tool and health information quality: a randomized clinical trial. JAMA Network Open, 7(10), e2437955. https://doi.org/10.1001/jamanetworkopen.2024.37955

Centers for Disease Control and Prevention (CDC) - Health literacy and plain language training - 2024 Video. 

Shared Decision Making

Shared decision making is not just about providing education, and it is not the same as informed consent. It involves discussing the risks and benefits of each option available, taking into consideration the person’s values, preferences and circumstances. NSW Agency for Clinical Innovation

Shared decision making involves discussion and collaboration between a consumer and their healthcare provider. It is about bringing together the consumer's values, goals and preferences with the best available evidence about benefits, risks and uncertainties of treatment, in order to reach the most appropriate healthcare decisions for that person. Australian Commission on Safety and Quality in Health Care

Shared decision making resources for clinicians (ACSQHC).

Shared Decision Making Live PubMed Search

Montori, V.M., Ruissen M.M., Hargraves, I.G., Brito, J.P., & Kunneman, M., (2023).  Shared decision-making as a method of care. BMJ Evidence-Based Medicine, 28, 213-217. https://doi.org/10.1136/bmjebm-2022-112068

Stacey, D., Lewis, K. B., Smith, M., Carley, M., et.al. (2024). Decision aids for people facing health treatment or screening decisions. The Cochrane Database of Systematic Reviews, 1(1), CD001431. https://doi.org/10.1002/14651858.CD001431.pub6