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Projects: Center for Health Literacy

The Horowitz Center participates in and leads a variety of research and service projects. 

Research Projects

HealthyMe/MiSalud Smartphone Application: Identifying Mechanisms to Engage African Americans and Hispanics in Personal Health Libraries

Principal Investigator: Dr. Cynthia Baur
Sponsor: National Library of Medicine, NIH, R01LM013039-01
Term: 9/18/18 - 5/31/22

The purpose of this project is to refine and evaluate a smartphone application with personal health goals, personal and family health histories, disease prevention and health promotion and other primary and secondary prevention information resources. The intended users are adult African Americans and Latinos with limited health literacy, including limited health information seeking. 

Making Numbers Meaningful: Promoting Evidence-based Communication of Numbers in Health

Principal Investigator: Dr. Jessica S. Ancker, Weill Cornell Medicine, New York-Presbyterian  
Sponsor: National Library of Medicine, NIH, R01LM012964 
Term: 9/01/18 - 8/31/22

Dr. Cynthia Baur serves as an Expert Panel member for this project to collect and integrate current evidence on communicating numbers to patients (including risks, laboratory results, medication instructions, and other numbers) and create and evaluate a web-based resource to guide developers and writers of patient education materials. 

Enhancing the Health of Rural Maryland: Testing Multiple Nutrition Education Delivery Methods

Principal Investigator: Dr. Virginia Brown, UMD Extension  
Sponsor:  Maryland Agricultural Education and Rural Development Assistance Fund/Rural Maryland Prosperity Investment Fund
Term:  9/04/18 - 6/30/19

Dr. Cynthia Baur served as a consultant on clear communication criteria for health messages. The project revised and tested multiple delivery options to Maryland residents for a healthy eating with diabetes educational program.  

Perinatal and Oral Health Survey of Maryland

Principal Investigator: Dr. Alice Horowitz
Sponsor: STMD-Maryland Department of Health and Mental Hygiene
Term: 8/1/15 - 7/31/19

The purpose of this project was to reduce the prevalence of oral disease in both pregnant women and infants through education and improved access to oral health care. Oral health is an essential component of promoting and maintaining overall health during pregnancy and throughout life. To accomplish this, Dr. Horowitz and her team conducted surveys with pregnant women to determine the barriers and facilitators of getting medical and dental care during pregnancy. In addition, they heard the opinions of relevant health care providers to gain their views regarding similar barriers and facilitators. Ultimately, Dr. Horowitz and her team developed a model that can be used in Maryland and beyond that helps ensure pregnant women get dental care prior to delivery and their children remain caries free.


Principal Investigator: Dr. Ernest Carter, Prince George’s County, Maryland Health Department 
Sponsor: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC)
Term: 9/01/18 - 8/31/23

PreventionLink is a multi-county program addressing Southern Maryland’s need for higher quality public health programs. The Horowitz Center for Health Literacy helped the Prince George’s County Health Department learn about health literacy and chronic disease issues as the county builds a primary care network for chronic care patients in Southern Maryland. The chronic disease conditions are diabetes, high blood pressure, and high cholesterol. 

The overall project will focus on patients who use a high level of healthcare services. In Years 1-3 of the project, Center staff spoke with individuals who have enrolled, completed, or left the National Diabetes Prevention Program. The objective was to learn about and address barriers to completing the program. The Center also developed patient materials that addressed health literacy for diabetes. 

Service Projects

Vision: Maryland will be a place where it is easy to find and use information and services for health and well-being.

Mission: Promoting health literacy in Maryland through educating a coalition of community leaders & mobilizing them into action within their jurisdictions.

HLM is a statewide and free membership coalition that brings together people and organizations to work on improving health literacy. HLM works with any interested organization, such as healthcare providers, government agencies, and community-based organizations, to improve access to and use of good health information and offer opportunities to use such information to improve health outcomes. Join the coalition by signing up for our email list!

Read our past newsletters here.


In April 2018, the Horowitz Center for Health Literacy hosted a Health Literacy Huddle, bringing together organizations interested in being a part of a newly-reinstated statewide health literacy coalition. 

In 2019, Health Literacy Maryland convened 4 times across the state, in Charles, Allegany, Baltimore, and Wicomico Counties.

In 2020, staff from the Horowitz Center visited each county local health improvement coalition (LHIC) in Maryland to learn about each county's priorities and health literacy activities.

This lead to a health literacy technical assistance project for the LHICs, which concluded in August 2020 and transitioned to capacity, data, and community engagement technical assistance. 

Beta-test the new Health Literacy Maryland directory map!

Once you've had a chance to click around, share your thoughts through this quick, 3-question form. Thanks in advance!

The Horowitz Center partnered with the Nebraska Association of Local Health Directors to offer the Health Literacy Champion Toolkit. The toolkit is for local health department staff to assess health literacy capacity, develop an action plan, and commit to implementing the plan. State health departments and other organizations may also find the toolkit a valuable assessment and planning tool, although some of their organizational functions may differ.

The Health Literacy Champion Process has 5 steps:

  1. Review the Toolkit background document.
  2. Health Literacy Check-Up: assess health literate policies and procedures in the department.
  3. Health Literacy Action Plan: develop SMART goals and an action plan.
  4. Health Literacy Pledge: commit to implementing the plan.
  5. Action Plan Implementation: implement the plan.

Organizations can download the toolkit materials and complete them on their own at no cost, or talk with Center staff about fee-based help. Organizations that want the Center to certify their pledge and be recognized on the website will submit their materials for Center review and approval. The review fee is $50 per application. If you have trouble with these forms, please email us. For more information, please email the Center at

Read how Ohio's health departments are using the toolkit.

PHAB Accreditation and Health Literacy in Maryland

The Center is developing a Health Literacy Training Hub to support health literacy training that aligns with PHAB standards. We are contacting Maryland local health departments to understand how health department staff are trained in health literacy. We are also collating a database of evidence-based health literacy training resources to aid in program development. 

County Health Literacy Strategic Plans

For counties interested in full integration of health literacy, the Center is working with multiple local health departments on health literacy strategic plans. 

This involves:

  • Discussing county-specific strengths, gaps, and opportunities
  • Consulting on PHAB accreditation applications and post-approval, implementation
  • Providing education and professional development
  • Creating health literacy guidelines 

All efforts contribute to Maryland becoming a health literate state. 

If your organization or health department is interested in partnering with the Center on health literacy strategic planning, email with subject line “County Health Literacy Plan.”


The Horowitz Center partnered with UnitedHealth Group (UHG) to add behavioral health terms to UHG’s Just Plain Clear Glossary, a plain language glossary of health insurance and health care terms that consumers, health care providers, and insurance companies use. The glossary - available now in English, Spanish, and Portuguese - aims to help patients and health consumers make informed decisions about their health.

The Center and UHG updated the glossary based on terms that patients frequently search for. The Center’s role was to identify the terms, specifically relating to behavioral health, and create a plain language definition for each term. The terms and definitions underwent an internal UHG review process and translation before the term was added to the glossary.


The glossary project targets two groups.

  • Doctors, insurance companies, and other healthcare professionals
  • Patients and health consumers

Healthcare professionals can use the glossary to learn plain language and communicate with patients in a way that they will understand. Professionals may be used to medical jargon, and the glossary provides alternate terms and plain language definitions of each term. 

Patients can use the glossary if their provider gives them information using terms they don’t understand. If they also have take-home documents that use terms they don’t understand, the glossary can help to clarify. 


The Center provided UHG with plain language definitions for more than 40 complex terms. The UHG editors and staff reviewed our recommendations and added these terms to the glossary.

Below are a few of the many Center-suggested terms that UHG added to the glossary:


Health literacy is an integral component of Mobile Integrated Healthcare (MIH) programs that aim to reduce the number of 911 calls and emergency department visits from people who frequently use these services. In an MIH program, community paramedics conduct home visits to assess, treat, and refer patients to appropriate services. During these visits, the exchange of health information can empower clients to be informed and take charge of their health.

A visit typically involves:

  • Reviewing clients’ medical history
  • Conducting home safety assessments
  • Evaluating social support networks
  • Reviewing vital signs 
  • Conducting medication review and reconciliation
  • Providing appropriate referrals to services

Highlighting Prince George’s County MIH Program

The Prince George’s County MIH program, based in the Prince George's County Fire/EMS Department, has collaborated with the Horowitz Center to develop an informational binder for their clients to record and store health information. Each binder includes the following:

  • Logs for blood pressure, blood sugar, pain, weight
  • Medication trackers and lists
  • Client goals and notes 

Evaluation Efforts

The Center worked on a pilot study with the Prince George’s MIH Team to determine the usefulness of the binders. The evaluation focused on the following areas: 

  • Doctor-patient communication
  • Health information-seeking behaviors
  • Medication management
  • Healthcare system navigation

The results from this study can help improve the services provided by the MIH team and, ultimately, the health literacy of clients.

The Horowitz Center hosted its first Health Literacy Huddle: A dialogue on health literacy in Maryland on April 25, 2018. At the Huddle, the Center's team presented information it had collected on health literacy activities, assets, gaps, and opportunities at the county and state levels. Various Maryland health organizations, departments, and officials were interviewed for the final analysis. On the 25th, professionals from across Maryland convened to discuss the Center's findings and forge new networks. The event was photographed and filmed. The presentation and supporting materials can be found below.

The Huddle Presentation included key findings on health literacy from the county and state levels.

Supporting Materials

Statewide findings:

Aggregated countywide findings:

Provider Outreach/Educational Activities

Community Outreach/Educational Programs

Community Health Literacy

We are developing a model for community health literacy that reflects the interaction of people, organizations, and context, including culture. 

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Local Health Improvement Coalitions

We see local health improvement coalitions (LHICs) as integral on-the-ground partners for population health improvement, and have been involved in the effort to improve and support Maryland LHICs since 2018.

Our COVID-19 Activities and Presentations

Throughout the pandemic, the Center has contributed to conversations around COVID-19, health literacy, and risk communication. Check out what we've been up to! 

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Oral Health and Health Literacy

Our work contributes to improving oral health and health literacy. 

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Environmental Health Literacy

We are committed to examining health literacy issues and applying health literacy insights in a wide range of public health contexts. Read on to learn how health literacy and environmental health sciences intersect in the emerging area of study of "environmental health literacy." 

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Voices of Health Literacy

Voices of Health Literacy is the Center's multimedia project to feature UMD students, faculty, and staff perspectives on and experiences with health information, communication, and services. 

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