Communication with low health literate patients

Importance of strengthening health literacy

Almost half of the European population has inadequate health literacy. Older people are particularly affected as modern healthcare demands more and more self-management, often utilising ICT-based systems Find more information here. It is important to strengthen health literacy capacities of older people as this will enable them to remain active and healthy and to participate more in society. When communicating with people who have low health literacy skills, the first important step is to identify what the individual health literacy gap is and to respond accordingly.

How to communicate with people who have low health literacy skills?

  • Use simple language, talk slowly and prioritise information. Prioritisation is needed because research shows that persons with lower levels of health literacy are focusing longer on non-relevant information in texts (Michael Mackert et al. Understanding Health Literacy Measurement through eye tracking. Journal of Health Communication 2013)
  • Use teach-back method: This e.g. implies to encourage questions, to summarise what you hear the patient is answering and to ask if the summary is all right.
  • Repeat health-related messages and use means of follow-up, e.g. follow-up calls during a certain period of time.
  • Before using health related documents, it is essential to test them in the target population in order to make sure that these documents are comprehensible for older adults with low health literacy.
  • Depending on a person’s needs, apply multiple channels of communication and use innovative media like photonovels, films, graphs, drawings. They can reduce comprehension problems in older adults with low health literacy. (For more information on this aspect, please refer to the section on health communication).

Health literacy capacities of older adults can be improved by informing them in ways which are considered useful and affirming and enhance skills and self-confidence to make decisions about their own health. Healthcare workers and healthcare organisations can contribute by tailored communication on health issues Find more information here.


Adili, F., Higgins, I., Koch, T. (2013) Older women and chronic illness: Transitioning and learning to live with diabetes. Action Research 2013 11(2): 142–156. DOI: 10.1177/1476750313477157

Bonevski, B., Randell, M., Paul, C., Chapman, K., Twyman, L., Bryant, J., Brozek, I., Hughes, C. (2014). Reaching the hard-to reach: a systematic review of strategies for improving health and medical research with socially disadvantaged groups. BMC Medical Research Methodology 2014 (14) 42

Koops van ‘t Jagt; Hoeks; Jansen; de Winter; Reijneveld (in press), Comprehensibility of Health Related Documents for Older Adults with Different Levels of Health Literacy: A Systematic Review. Journal of Health Communication.