New York Occupational Therapy Program Promotes Health Literacy with AHRQ’s Toolkit

May 2020

An online teaching module based on the AHRQ Health Literacy Universal Precautions Toolkit helped to improve the knowledge and understanding of health literacy concepts among master’s-level occupational therapy (OT) students at Touro College in New York. After using the module, nearly all students (92 percent) said they were “extremely likely” or “likely” to recommend health literacy as part of the school’s OT curriculum.

An estimated one-third of U.S. adults have limited health literacy, as measured by their ability to understand health information from written sources. Limits on health literacy increase as adults age, reaching 61 percent for those between the ages of 65 and 75, and rising to 70 percent for adults over age 75. Low health literacy is associated with poorer health outcomes and inappropriate use of health services, an AHRQ-funded literature review found. However, people of all ages, races , and ethnicities can have limited health literacy, even those who normally read well but are sick, tired, or frightened.

That’s why experts recommend using health literacy universal precautions, which means treating everyone as if they were at risk of limited health literacy. Training on these precautions can help students be better prepared to provide high-quality care.

To support this kind of training, Virginia Koenig, O.D.T., and Touro College’s academic fieldwork coordinator, used the AHRQ Health Literacy Precautions Toolkit as the basis to create a 6-week online module.

Making health literacy a more “student-friendly” topic also filled a void about an important aspect of patient care, according to Tziona E. Hoffman, who is one of two master’s-level OT students who worked with Dr. Koenig in creating the module.

Hoffman noted that she had a very limited understanding of health literacy before she began the project. Once she learned more, Hoffman said she “realized that it applied to everything [and] wanted to learn more about it.”

Working with Dr. Koenig and fellow OT student Tzipora Rosen, Hoffman conducted a literature review and helped prepare the module, based on the AHRQ toolkit, for online use. The students recruited 15 master’s-level students to complete the module. It included PowerPoint lectures, learning assessments, and sample activities.

Students could complete the module at their own pace but were required to complete it and take quizzes in sequential order. Amazon gift cards were used as an incentive to complete a pre- and post-course survey.

After completing the activity, students showed statistically significant improvements in their ability to apply health literacy universal precautions concepts and to use AHRQ’s toolkit in academic and clinical settings, Dr. Koenig said. Students also demonstrated confidence in working with patients with limited literacy.

Hoffman says she already sees the value of her health literacy training in her work with the New York City Department of Education. The terminology usually used in OT can be difficult for parents or children to understand, she said. Due to her work on the AHRQ-based module, “I see myself promoting health literacy and trying to educate and set an example.”