Health Literacy and Research Participation

Studies have shown that health literacy may affect patients' ability to understand informed consent  documents and research participation:



The Partnership to Improve Diabetes Education study (PRIDE) seeks to develop a sustainable model for improved diabetes care through health communication. PRIDE modules are designed to be used interactively between a health professional and a patient. Patients with low literacy, low numeracy, and/or linguistic needs can experience challenges understanding diabetes information and applying concepts to their self-management. The authors designed a toolkit of education materials that are sensitive to patients' literacy and numeracy levels, language preferences, and cultural norms and that encourage shared goal setting to improve diabetes self-management and health outcomes. The PRIDE toolkit was developed to facilitate diabetes self-management education and support.


The Diabetes Nutrition Education Study (DINES) examines the impact of certified diabetes education, and the role of different educational approaches to medical nutrition therapy. The role of patient health literacy level is also assessed. 

DNT for Adolescents

The Diabetes Numeracy Test (DNT) was adapted for type 1 diabetes and was administered to 2 samples of adolescents. Sample 1 was administered the 39-item version of the DNT (DNT-39) with measures of self-management, responsibility, reading, and glycemic control (A1C). Sample 2 was administered the 14-item version of the DNT (DNT-14) with measures of self-management, responsibility, problem solving, and A1C. Both versions of the DNT showed adequate internal reliability. 


The Rapid Education/Encouragement and Communications for Health (REACH) study is a tailored, text messaging intervention to support the self-care adherence of disadvantaged patients with  type 2 diabetes mellitus (T2DM). Among adults with T2DM, adherence to recommended self-care activities is suboptimal, especially among racial and ethnic minorities with low income. Self-care nonadherence is associated with having worse glycemic control and diabetes complications. Text messaging interventions are improving the self-care of adults with T2DM, but few have been tested with disadvantaged populations.

Heart Disease


Many people who have recently left the hospital have difficulties managing their medications, and medication errors are common. Patients with low health literacy levels may have a particularly difficult time understanding medication dosing and instructions. This study will evaluate a literacy-focused program that provides educational assistance from pharmacists at the time of hospital discharge to people hospitalized with heart problems.


Patients with inadequate health literacy often have poorer health outcomes and increased utilization and costs, compared to those with adequate health literacy skills. The Institute of Medicine has recommended that health literacy assessment be incorporated into health care information systems, which would facilitate large-scale studies of the effects of health literacy, as well as evaluation of system interventions to improve care by addressing health literacy. As part of the Health Literacy Screening (HEALS) study, a brief health literacy screen (BHLS) was incorporated into the electronic health record (EHR) at a large academic medical center


The period following hospital discharge is a vulnerable time for patients when errors and poorly coordinated care are common. Suboptimal care transitions for patients admitted with cardiovascular conditions can contribute to readmission and other adverse health outcomes. The Vanderbilt Inpatient Cohort Study (VICS) research will enhance understanding of how health literacy and other patient factors affect the quality of care transitions and outcomes after hospitalization. 



Children who become overweight by age 2 years have significantly greater risks of long-term health problems, and children in low-income communities, where rates of low adult literacy are highest, are at increased risk of developing obesity. The objective of the GreenLight Intervention Study is to assess the effectiveness of a low-literacy, primary-care intervention on the reduction of early childhood obesity.