Academic journal article American Journal of Pharmaceutical Education

An Interactive, Multifaceted Approach to Enhancing Pharmacy Students' Health Literacy Knowledge and Confidence

Academic journal article American Journal of Pharmaceutical Education

An Interactive, Multifaceted Approach to Enhancing Pharmacy Students' Health Literacy Knowledge and Confidence

Article excerpt

Objective. To implement and evaluate the effectiveness of an interactive health literacy program by measuring pharmacy students' knowledge and confidence.

Design. A health literacy module consisting of a lecture and workshop was incorporated into a self-care course for first-year pharmacy students. Active-learning activities included practicing health literacy tools, discussing faculty-created video vignettes, and improving readability of patient education monographs. A non-validated survey assessed knowledge and confidence before and after training. Assessment. Fifty-three students (88%) completed a pre-training survey, and 60 (100%) completed a post-training survey. Students' confidence improved in six of seven areas (p<.001). Students' knowledge significantly improved in three of 14 areas (p<.01) pertaining to the average American reading level, high-risk age groups, and correlation of late prescription refills to low health literacy. Although knowledge increased in other areas, the improvements were not significant.

Conclusion. An interactive, multifaceted health literacy training program significantly improved pharmacy students' knowledge and confidence in recognizing and being able to assist patients with low health literacy.

Keywords: health literacy, health literacy education, active learning, video


Approximately 90 million adults in the United States, or 36% of the population, have low health literacy. (1) Health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information to make appropriate health decisions. Low health literacy contributes to poor health outcomes as well as increased mortality and health care costs. (2) Factors that may contribute to low health literacy include older age (>65 years), low income, lower education level, and race/ethnicity, with 41% of Hispanics and 24% of African-Americans having below basic health literacy. (2,3) One manifestation of this issue is that the average adult American reads at an eighth-grade level, while health-related patient information is often written at a 12th-grade reading level, which may lead to patients having difficulty in understanding or following health care advice. (4)

Pharmacists are one of the most accessible health care providers and should be readily equipped to assess and address patients' health literacy issues. Pharmacists need to ensure patients are well informed about their medications and disease states including prevention strategies in order to empower them to make the right decisions on their health care. (5)

The American Association of Colleges of Pharmacy (AACP) Center for the Advancement of Pharmacy Education (CAPE) 2013 Educational Outcomes advised schools of pharmacy in Domain 3.5 to teach students to recognize social determinants of health to diminish health disparities and inequities in access to quality care. (6) A suggested example of an activity to meet this domain is to provide instruction on health literacy assessment and modify communication strategies to meet patients' needs. (6) The Accreditation Council for Pharmacy Education (ACPE) has adopted the CAPE Educational Outcomes, requiring that doctor of pharmacy (PharmD) curricula address, among other areas, patient health literacy. (7) Additionally, the Institute of Medicine (IOM), American Medical Association (AMA), and the American Pharmacists Association (APhA) have called for the integration of health literacy education and competencies within all health professional curricula. (1,8,9)

Several models of health literacy training for pharmacy students have been described in the literature. (10-14) Devraj and colleagues incorporated six health literacy sessions in a required third-year health promotion course. (10) The sessions used active-learning exercises such as administering health literacy assessments, identifying signs of low health literacy, conducting mock patient counseling sessions, rating the readability of drug information, analyzing information in drug advertisements, and writing patient education materials. …

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