The Horowitz Center promotes a science-based and best practices approach to clear communication and health literacy improvement. The Resources section includes links to information, training, reports, guidelines, and best practices on health literacy, plain language, cultural responsiveness, and related topics. Applying guidelines and best practices ensures consistency and maximizes effectiveness.
The sources are government, academic, and non-profits organizations that provide credible information. The resources are organized to help you Learn, Act, or Legislate. We also have an archive section at the end.
You can find foundational information on health literacy, clear communication, plain language, and cultural competency and humility in this section.
Health Literacy Basics
Agency for Healthcare Research and Quality AHRQ's Health Literacy resources help health care professionals and delivery organizations make information easier to understand and systems easier to navigate.
Centers for Disease Control and Prevention - Health Literacy Find background information, research, and key resources on health literacy in public health and health care.
Health Literacy Resources: Introduction to Health Literacy The Health Sciences and Human Services Library at the University of Maryland Baltimore curates and maintains a wide-ranging collection with articles, videos, government resources and more.
Roundtable on Health Literacy The mission of the Roundtable is to inform, inspire, and activate a wide variety of stakeholders to support the development, implementation, and sharing of evidence-based health literacy practices and policies.
Clear Communication and Plain Language Basics
Clear communication includes a broad set of factors that affect how easily and accurately people understand the information and messages you're trying to share. Clear communication rests on many techniques, including everyday numbers and plain language that help people
- find what they need
- understand what they find
- use what they find to meet their needs
CDC Clear Communication Index
The CDC Index are research-based guidelines to help you evaluate and design public health materials that align with health literacy evidence. You use an online or print worksheet to work through 4 open-ended and 20 yes/no questions. The CDC website has the worksheet, examples and a User's Guide.
Jargon or "insider language" is common in written and spoken health information. Plain language glossaries give everyday-word alternatives to jargon. Check out these useful tools when writing or speaking about health.
- The Just Plain Clear glossary by UnitedHealth Group
- University of Maryland Baltimore's Health Sciences and Human Services curated this list of plain language glossaries and resources
- CDC's Everyday Words for Public Health Communication includes alternatives for common public health jargon. The glossary shows how to rewrite sentences and information chunks so they are short and in everyday words.
Making Data Talk
The NIH National Cancer Institute created these guidelines and examples to help communicators present data in easy-to-understand formats.
Plain Language Videos
This series of brief animated videos uses humor and graphics to show plain language techniques. A caution about the video on bulleted lists: it uses a Western movie skit with simulated guns, bullets, and shooting as a pun on "bullets." The U.S. Citizenship and Immigration Services sponsored the videos.
CDC's Vital Signs series
CDC publishes Vital Signs, plain language summaries of its data, analyses, and policy recommendations so that non-experts can use the information to be informed and take action. Each Vital Signs summary is linked to an MMWR article so that anyone can find the original data and analysis. Vital Signs provides an example of how to simplify complex information and make it easy to read for a wide range of people while also providing detailed information for highly motivated readers.
Using Plain Language for Inclusive Communication
Plain language techniques help you reach as many people as possible because the techniques make information easy-to-understand and use. These resources will help you understand information accessibility challenges and apply plain language and other techniques to increase accessibility.
This page outlines best practices for communicating with and about people with disabilities with examples of some Dos and Don'ts.
United Nations Convention on the Rights of Persons with Disabilities (UN CRPD)
This convening by the UN aimed to change perceptions of people with disabilities and to establish a human rights tool for this population. Articles 9 and 25 of the convening are most relevant to plain language. Article 9 addresses accessibility and makes specific reference to the accessibility of information and communication. Article 25 is about health and includes informed consent which can be hard to truly obtain because of jargon and a lack of plain language.
Self-advocacy and Plain Language
Self-advocacy refers to the right of persons with intellectual and/or developmental disabilities to advocate for their wants and needs, or to be supported in their advocacy. Read The Arc's statement on self-advocacy and leadership for background on the topic. Plain language can enable self-advocates to access services, manage their health, and impact policies surrounding their healthcare. The resources below are a few examples of the facilitating relationship between plain language and self-advocacy.
- Autistic Self-Advocacy Network provides many easy reading and plain language policy toolkits on topics such as the Americans with Disabilities Act and Medicaid
- The Maryland Department of Health (MDH) Developmental Disabilities Administration (DDA) lists Maryland-specific self-advocacy resources including plain language interpretations of the DDA's processes and assistance with completing paperwork
Culturally Respectful and Responsive Care
The U.S. Department of Health and Human Services Office of Minority Health states that health disparities and inequities can be traced in part to a lack of care that respects and responds to people's cultures. Public health and medicine are also cultures in the sense that professionals are trained in the acceptable ways of thinking, communicating, and acting in their roles. Culture includes all aspects of daily life, from what we eat, how we dress, the words we use, and the ideas and topics we consider acceptable.
Guidelines and best practices for culturally respectful and responsive care help us self-reflect as well as learn how to interact with others so that we have productive conversations and interactions. The resources in this section are just the tip of what's available as you consider how to make your own practices and those of your organization culturally respectful and responsive.
Think Cultural Health
U.S. Department of Health and Human Services, Office of Minority Health
National Standards on Culturally and Linguistically Appropriate Services (CLAS)
U.S. Department of Health and Human Services (HHS) Office of Minority Health
This section includes resources to help you put health literacy concepts and techniques into action. The Voter's Guide, for example, not only shows how to use clear communication methods to simplify complicated health policy issues but also helps people and communities build their critical health literacy skills by becoming informed voters and advocates.
Healthy People 2030 defines organizational health literacy as "the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others." Check out the resources below for organizational health literacy best practices.
- Building Health Literate Organizations: A Guidebook to Achieving Organizational Change - This guidebook is based on the 10 Attributes of a Health Literate Health Care Organization and helps healthcare organizations engage in organizational change to become health literate. (Source: Abrams, Kurtz-Rossi, Riffenburgh, and Savage 2014)
- Health Literacy Universal Precautions Toolkit (2nd ed.) - Primary care practices can use this toolkit to help reduce the complexity of health care, increase patient understanding of health information, and enhance support for patients of all health literacy levels. (Source: Agency for Healthcare Research and Quality 2015)
The Rural Health Information Hub (RHIhub) has released an evidence based toolkit on Rural Health Literacy. This toolkit highlights different models and programs to address health literacy in rural communities. Communities may implement health literacy models focused on personal or organizational improvement, or adapt a model to meet the specific needs of rural
residents. The toolkit was developed in collaboration with the NORC Walsh Center for Rural Health Analysis. RHIhub interviewed Horowitz Center Director Dr. Cynthia Baur and the Center is featured in the guide.
Read More on Rural Health
“A New Era of Health Literacy? Expanded Definitions, Digital Influences, and Rural Inequities”
Feb 2, 2022 – Published in The Rural Monitor
In an article published in The Rural Monitor, Dr. Baur commented on digital health information and potential barriers to patient access. Dr. Baur noted that public health and healthcare organization leaders are the changemakers for improving health literacy. The article explored both personal and organizational health literacy, as well as the role of digital health literacy in rural health inequities.
- Always Use Teach-Back! - This toolkit helps healthcare providers learn to use teach-back to support patients and families throughout the care continuum. (Source: UnityPoint Health n.d.)
- Health literacy trainings - Build your health literacy foundation with these free online courses. (Source: Centers for Disease Control and Prevention)
For more resources, check out the AHRQ's Health Literacy page.
Health literacy-specific laws, policies, and regulations are not very common, but health literacy issues appear in many types of laws and regulations, such as those about insurance, medicines, and health information readability. Laws, policies, and regulations about plain language, for example, or patient-centeredness or "patient friendly" care can be openings to advance health literacy practices. This section provides examples of health literacy-related laws, policies, and regulations that can inspire future action.
In Maryland, where the Horowitz Center is based, the Consumer Health Information Hub law establishes plain language as the standard for health, insurance, safety, and social services public information and directs the Horowitz Center to promote guidelines, best practices and tools for health literacy-responsive organizations.
DC Law to Establish a Health Literacy Council
The Health Literacy Council Establishment Act of 2017 establishes a council to "improve the health literacy and knowledge of mental health for District residents." Under this law, the Mayor is required to collaborate with the Council on advancing health literacy education in D.C's public education system and workforce programs. (Adopted but funds not available to implement)
The resolution details concerns about retroactive emergency room policies that discriminate against patients, including those with lower health literacy. The resolution calls for a study of the problems and recommendations for action or legislation from the committee.
The law calls for web-based technology to link providers, beneficiaries, and health plans to address deficiencies in medical literacy and demonstrate that personal responsibility is enhanced by technology.
The state may include educational strategies to increase health literacy for Oklahoma Medicaid Program participants in a primary care program.
LegiScan is a legislation tracking device. You can search for health literacy-related legislation here.
In this section, you'll find past resources created by the Center that are no longer being updated.
Health Literacy & Equity Chronicles for Health & Well-Being
Our blog has a new home! Check it out here: blog.umd.edu/healthliteracy
This blog explored the intersection between health literacy and health equity as essential factors in a healthy society.
April 1, 2019 - Dr. Cynthia Baur - Health Literacy and Equity Principles Can Bring True Reform to US Healthcare
April 8, 2019 - Dr. Boris Lushniak - Health Literacy is the Heartbeat of Public Health
April 15, 2019 - Dr. Stephen Thomas - Health Equity, Health Literacy and the Ethical Imperative to Coalesce
April 19, 2019 - Dr. Sandra Quinn - Health Equity Depends on Clear Communication
April 26, 2019 - Dr. Dushanka Kleinman - Health Literacy Contributes to Achieving Health and Well-being Healthy People 2030 Goals
May 6, 2019 - Dr. Alice Horowitz - Putting the Mouth Back in the Body is Health Literacy Work
Created by the Maryland Department of Health, Office of Minority Health and Health Disparities and The Horowitz Center for Health Literacy, this document is a guide on teaching cultural competence and health literacy to health professionals and students. The document was created in March of 2013 and has not been updated since.
- Feb 11: Always Use Teach-Back webinar from the Institute for Healthcare Advancement
- Oct 19-21: Integrated Health Literacy Research / Practice / Policy Virtual Conference
- Oct 27: Webinar: Ethical Challenges for Public Health Practice When Working for Federal Agencies
- Mar 26: Health Literacy Maryland meeting in White Plains, Maryland (Charles County)
- April 27: Maryland Day
- June 17: Health Literacy Maryland meeting in Cumberland, Maryland (Allegany County)
- June 20: Practicing Clear Communication Techniques*
- Sept 16: Health Literacy Maryland meeting in Cockeysville, Maryland (Baltimore County)
- Oct 10-11: Health Literacy in Action Conference in College Park, Maryland
- Nov 14: Practicing Clear Communication Techniques*
- Dec 12: Health Literacy Maryland meeting in Salisbury, Maryland (Wicomico County)
*Only for UMD Extension faculty and staff. If you're interested in a training like this, contact us: firstname.lastname@example.org
Dr. Devlon Jackson presents on communication inequalities in communities of color experiencing psychological distress.
- Apr 25: Presentation - Health Literacy Huddle
- Apr 3: Presentation - Public Health Research Day
- Sept 6: Webinar - Principles of Plain Language
- Oct 4: Speaker Series - Emerging Voices of Health Literacy Research, Catherine Maybury, MPH
- Oct 10: Webinar - Clear Communication Index
- Oct 25 - 26: Health Literacy in Action Conference
- Dec 12: Speaker Series - Emerging Voices of Health Literacy Research, Devlon Jackson, PhD