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Section 1: Nature of the Project
Introduction
Though the health care environment is complex and changing, the same goals
remain: provide high quality patient care and improve patient outcomes. The objectives of
Healthy People 2020 include achieving health equality, decreasing and eliminating health
disparities, and improving communication between health care providers and the patients
they serve (Office of Disease Prevention and Health Promotion, 2017). But the problems
surrounding low health literacy in the United States are significant, with research
indicating that only 12% of adults nationwide have proficient health literacy skills
(Kennard, 2016). It is important for patients to be informed on their medical condition
and treatment plan so that they can advocate for their own health care choices. It is also
important for patients to be well informed so that they can properly care for themselves at
home.
The complexity of the acute care hospital setting can be overwhelming for
patients. It is important for the clinical nurse to recognize the complexities during their
hospital admission, often related to medical terminology, treatment plans, and patient care
equipment and devices. This also includes education on the diagnosis and treatment plan,
goals, new medications and potential adverse effects, and follow-up needs. From a patient
perspective, management of health care needs becomes even more challenging when the
complexities of health care are combined with low health literacy. Low health literacy
creates a risk for poorer patient compliance and access to care, which affects patient
outcomes (Hernandez, French, & Parker, 2017). However, clinical nurses practice at the
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bedside where they can recognize when a patient is struggling with low health literacy,
which then provides an opportunity for the registered nurse to intervene early to meet the
patient’s needs and help them to understand their health care plans.
The medical–surgical nurse cares for patients of various ages and diagnoses who
are often dealing with complicated health issues, and they are in a position where they
can recognize patients who are struggling with low health literacy to intervene and
individualize patient education and communication with the patient. Patients with low
health literacy face challenges to their personal health care, as they are often unable to
read and follow discharge instructions or messages on prescription bottles. Medical
jargon used by providers or on written instructions may exacerbate the problem.
Additionally, as technology is used more frequently, patients with low health literacy may
be unable to make an appointment or schedule an outpatient study. Further, patients may
become fearful, shamed, and embarrassed, and they may not ask questions to clarify their
needs. By identifying a patient struggling with lower health literacy, the nurse can
identify the best way to teach the patient, with the intent to maximize understanding of
their health care conditions, medication, plan of care, and follow-up needs. But to
promote patient engagement in their health care plan, nurses need to be knowledgeable on
the topic of health literacy.
Problem Statement
There was no formalized education at the project site provided to medical–
surgical nurses on health literacy. Thus, this doctoral project addressed the need for a
formal educational program for medical–surgical nurses on health literacy. Nurses must
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have the knowledge and understanding of health literacy to improve health literacy for
their medical–surgical patient population. It is necessary to improve nurse’s knowledge of
health literacy, which can be achieved through a formal education program on this topic.
Purpose Statement
The purpose of this project was to increase medical–surgical nurses’ awareness
and knowledge of the importance of health literacy. The practice focus question was: Will
medical–surgical nurses show an improvement in their knowledge of health literacy when
comparing measurement of knowledge preeducation and immediately posteducation? In
this doctoral project, the gap in practice was addressed by providing education to nurses
on health literacy.
Medical–surgical nurses must have the skills to apply health literacy principles to
patient education resources. It is important for the medical–surgical nurse to understand
health literacy; how low health literacy affects follow-up, compliance with the treatment
plan, and ultimately patient outcomes; barriers that patients with greater health literacy
demands face; clues that nurses can look for indicating low health literacy skills; and
know the importance of evaluating the patients learning by using the teach-back
technique. Health literacy refers not only to the abilities of the patients but also to the
nurses who are providing health education, education on new medications, and discharge
instructions. Nurses are on the front-line in the hospital setting, so there is significant
responsibly shared in the bedside nursing team to ensure that the patient understands his
or her diagnosis, treatment plan, and follow-up needs.
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Project Goals and Objectives
Project goals and objectives were developed in accordance with the project
hypothesis that a professional education program would increase medical–surgical nurse’s
knowledge on the topic of health literacy. Future goals include increasing patient
satisfaction scores for the nurse communication domain, medication domain,
understanding of the transition plan, and understanding of the plan of care and follow-up
needs.
Nature of the Doctoral Project
An educational program was provided for medical–surgical nurses on health
literacy and the importance of nurses’ awareness of a patient’s understanding and
comprehension of their health. This professional education was developed using primary
sources of evidence from the literature to improve the nurses’ knowledge and skills
regarding health literacy. The nature of this project was staff education through a formal
education program using PowerPoint and a pre- and post-test approach. The goal was to
educate the nurses to improve their knowledge regarding health literacy and introduce a
health literacy assessment tool.
Quality improvement is important to improve patient care and outcomes, and
nurse leaders are pivotal to hospital quality initiatives. This project included a systematic
plan with a short-term goal of improving nursing knowledge and a long-term goal of
improving patient satisfaction. This educational program was provided for medical–
surgical nurses on
• An overview of health literacy;
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• How low health literacy affects follow-up, compliance with the treatment
plan, and ultimately patient outcomes;
• Barriers that patients with greater health literacy demands face;
• Clues that nurses can look for indicating low health literacy skills;
• The importance of evaluating the patients learning by utilizing the teach-back
technique.
Significance
The significance of the project is a successful implementation of an educational
program for the medical–surgical nurses, which will lead to individualized patient
education through these nurses. This doctoral project holds significance for the nursing
field because it can be applied to other areas of nursing practice to improve nurse
understanding of health literacy and the negative effects of low health literacy, which will
allow for nurses to adapt the care they provide to their patients through individualized
patient education.
Bedside nurses will improve their knowledge base and skill set on health literacy,
which will influence a positive change in practice specific to patient education. Providing
education to the bedside nursing team promotes a respectful and supportive environment
for the patient, focusing on the patient’s individual needs, and providing patient-centered
care. Teaching nurses on how to address low health literacy also benefits patients and
helps reduce health disparities (Cornett, 2017). Medical–surgical nurses can share this
information with colleagues and use what they learn in their interactions with patients and
families. Experienced nurses who act as mentors and preceptors to student nurses,
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orientees, and novice nurses can also translate what they learn in this program and work
with and support their colleagues on this topic.
Summary
Management of health care needs for the hospitalized patient becomes even more
difficult when the complexities of health care is combined with low health literacy, which
affects patient outcomes (Berkman, Sheridan, Donahue, Halpern, & Crotty, 2011). There
was no formalized education at the project site provided to medical–surgical nurses about
the effects of low health literacy. With this doctoral project, the identified nursing practice
gap was addressed through a formal education session on health literacy and the
importance of nurses’ awareness of a patient’s understanding and comprehension of the
patient’s health. The goal was to improve the nurses’ knowledge regarding health literacy,
and the nature of this project is educational. In the next section, the context of the
problem, supporting background, and theoretical approaches to address this practice issue
will be discussed.
Section 2: Background and Context
Introduction
Low health literacy creates risk for patient compliance and can lead to negative
patient outcomes (Geboers et al, 2015). There was no formalized education at the project
site provided to medical–surgical nurses about the effects of limited health literacy. The
purpose of this project was to increase medical–surgical nurses’ awareness and
knowledge of the importance of health literacy. In this section, I will detail the concepts,
models, and theories used in the project. Relevance to nursing practice will also be
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discussed and the local context and relevant background presented. Finally, I will discuss
the role of the doctoral student and project team.
Concepts, Models, and Theories
Health Literacy Framework
The health literacy framework shows literacy as the foundation of health literacy,
and health literacy as the mediator between an individual person and the context of health
(Nielsen-Bohlman, 2004). Individual context of health varies from person to person but
can include social skills, cognitive abilities, emotions, cultural and religious beliefs, and
physical conditions such as visual or auditory deficits (Nielsen-Bohlman, 2004). Literacy
includes reading, math, writing, and speech skills (Nielsen-Bohlman, 2004). Health
literacy directly affects health-related outcomes and costs, such as compliance to the plan
of care and follow-up needs (see Figure 1).
Figure 1. Health literacy framework. Adapted from Health Literacy: A Prescription to
End Confusion, by L. Nielsen-Bohlman, 2004, p. 33. Washington, DC: National
Academies Press.
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Education System
The education system in America plays a major role in a person’s literacy
development, as kindergarten through 12th grade education is responsible for the
development of literacy and numeracy skills. The number of years of schooling
completed is not a valid indicator of health literacy. The skills gained through education
form the foundation for more complex skills later in adult life, including comprehension
of disease process, understanding of the severity of chronic illness, and the relationship of
comorbidities with the consequences of not following the treatment plan. More
vulnerable populations for poor health literacy include those who did not complete high
school; those who completed high school but did not acquire strong skills; adult
immigrants who did not have access to education or the opportunity to speak, read, or
write in English; and elders who did not have full schooling opportunities
(NielsenBohlman, 2004). The ability to not only read but to comprehend what one is
reading is fundamental, and the intricate and complex health care environment is difficult
to navigate for those with low health literacy (Williams, Muir, & Rosdahl, 2016).
Lewin’s Change Management Theory
When implementing a change within the organization, Lewin’s theory is useful to
understand human behavior in relation to change management and resistance to change.
Lewin’s theory can provide support for nursing leaders during transitions, such as through
this educational project where staff commitment and buy-in will need to be priority to
bring value to this project. Lewin discussed how forces, once identified, could affect the
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change process and provide understanding of a group’s behaviors (Shirey, 2013). Lewin
identified three stages of change:
1. Unfreezing: It is important to provide the rational and background data as to
why health literacy is a topic of interest in the acute care hospital setting. This
phase will promote buy-in from the nurses involved, so that they can open
their minds to gain knowledge through this educational project.
2. Moving: Driving forces will support this phase through the educational
project, as knowledge is shared with the nurses. It will be important to keep
the lines of communication open, provide details as to how the nurses can
assess their patients for poor health literacy skills, and identify strategies to
overcome the barriers.
3. Refreezing: When the nurses involved in the education have used the
knowledge gained through this experience to influence their personal nursing
practice at the bedside. This will improve the care of the patient at the bedside,
which will ultimately improve patient outcomes and patient satisfaction.
(Shirey, 2013)
Definitions of Terms
Health literacy intervention: Nursing interventions and processes designed to
mitigate the effects of low health literacy on patient–nurse communication and patient
education (Stiles, 2011).
Health literacy: Health literacy is defined as “the degree to which individuals
have the capacity to obtain, process and understand basic health information and services
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needed to make appropriate health decisions” (Stiles, 2011, p. 35). Health literacy is not
independent of general literacy.
Limited (or low/poor) health literacy: A health literacy skill level that is lower
then what is necessary to obtain, process, and understand basic health information to
make appropriate health related decisions (Stiles, 2011).
Numeracy skills: Health literacy includes numeracy skills, sometimes referred to
as math skills or number skills. Being numerate means understanding numbers and
mathematical concepts and having the ability to apply these numeracy skills to solve
problems (Zimmerman, Woolf, & Haley, 2014).
Patient education: Patient education is defined as “the process of influencing
patient behavior and producing changes in knowledge, attitudes, and skills necessary to
maintain or improve health” (American Academy of Family Physicians, 2000, para. 1).
Patient education is essential to improving compliance and health maintenance, which
improves outcomes.
Rapid Estimate of Adult Literacy in Medicine (REALM-SF): This is a 7-item word
recognition test that nurses can use to perform a quick assessment of a patient’s health
literacy level. The tool was validated for use in 2007 and is recommended by the Agency
for Healthcare Research and Quality (AHRQ; see Appendix A.)
Successful functioning: Also referred to as functional health literacy, successful
functioning encompasses the ability for an individual to control their health and health
actions and determinants, identify patterns of behavior, and reflect critically on their
functioning to promote self-care and self-management of their health (Stiles, 2011).
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Clarifying the Characteristics
Defining characteristics of health literacy include reading and numeracy skills,
comprehension, successful functioning, and the capacity to use information to make
personal health care decisions (Rowlands, Shaw, Jaswal, Smith, & Harpham, 2015).
Health literacy includes numeracy skills, used in calculating glucose levels, weights,
measuring medications, understanding nutrition labels, and calculating the financial
pieces of health care such as co-pays and deductibles. Successful functioning
encompasses the ability of an individual to control their health and health actions and
determinants, identify patterns of behavior, and reflect critically on their functioning to
promote self-care and self-management of their health. A person with functional health
literacy is one who is empowered to act on their health care needs, regardless of
circumstances, using their advanced cognitive and social skills (Rowlands et al., 2015).
A person’s educational status may not indicate his or her reading level or ability,
as deficiencies may be masked out of fear or embarrassment (Ganesh, 2017). Education
level has the potential to impact an individual’s skills, including reading, math, and
literacy which contributes directly to a person’s health status. This is because attaining
these skills contributes to more active communication with the person’s health care team.
A two-way conversation can occur, where the individual can be their own advocate,
participate actively in their care, and ask any necessary clarifying questions. In turn, the
patient benefits from their ability to understand and comprehend their own health needs:
they can follow-instructions for follow-up care, read medication labels to take
medications as prescribed, and navigate the health care system to make appointments
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(Zimmerman, Woolf, & Haley, 2014). Those with low health literacy struggle with these
basic tasks, which leads to increased hospital stays, readmissions, decreased preventive
care and an overall poorer health status (Zimmerman, Woolf, & Haley, 2014).
There are many tools available for clinicians to measure health literacy levels,
including the REALM-SF, Newest Vital Sign, and the Test of Functional Health Literacy.
The REALM-SF, the tool chosen for this project, is a 7-item word recognition test to
provide clinicians with a valid quick assessment of patient health literacy. This
measurement tool is a word recognition test which has been field-tested and validated in
diverse research settings, and studies have found excellent agreement with the 66-item
REALM instrument in terms of grade-level assignments (Arozullah et al, 2007). The
REALM-SF can be administered in a short period of time, less than 2 minutes, which
makes it the ideal tool for the acute care medical–surgical setting (Ganesh, 2017).
Relevance to Nursing Practice
Because health literacy is a critical component of health care in America, nurses
need to be able to recognize the need to adjust their patient education plan based on
patients’ needs and literacy level. Nurses need to identify and challenge the barriers that
present to the situation. In the hospital setting, nurses are the main source of information
for patients and families. Nurses must understand health literacy to be able to assess for
health literacy limitations and intervene appropriately, to ensure understanding of any
education provided to the patient and family during the hospital stay.
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Local Background and Context
The project site is in a large community hospital in a Northeastern city. The
setting will be the adult health medical–surgical units, which include: a 51-bed medical–
surgical unit with remote telemetry capabilities, 18-bed medical–surgical unit, and 15-bed
orthopedic unit with medical–surgical overflow. Typical age of patients is adults, over age
18, but this site has a large geriatric population over age 55. Typical diagnoses for the site
include, but are not limited to: diabetes, congestive heart failure, urinary tract infection,
pancreatitis, mental status change, abdominal pain, fever, cellulitis, drug overdose,
cancer, alcohol withdrawal, pneumonia, status post-surgical interventions, chronic
obstructive pulmonary lung disease, fractures needing repair, etc. The average nurse to
patient ratio is 5:1. Clinical members of the nursing team include: registered nurses,
nursing assistants, unit clerk/coordinator, assistant nurse manager, nurse manager, nurse
case manager, and social worker. Hospital readmissions are an area of opportunity for the
project setting. Patient satisfaction is another area of opportunity for the project setting.
Mission Statement
This DNP project will align with the organizations philosophy of continual
performance improvements. This professional education will be developed to improve the
nurse’s knowledge base and skill set on the topic of health literacy, which will result in
better patient education and improved patient outcomes.
Role of the DNP Student
I am nurse manager of two of the three medical surgical units in the hospital. One
of the expectations of nurse management is to drive and promote positive patient
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outcomes through process improvement and quality improvement. Education of nursing
staff about health literacy is a quality improvement intervention, which promotes positive
patient outcomes. Overall, for this doctoral project I assumed all responsibilities. I
planned, implemented, and analyzed this education program.
Planning involved establishing program goal and objectives, the development of
the educational curriculum as well as the pre and post-assessment tools. Through an
extensive literature review and analysis, best practices were sought to add into the
education curriculum. Sources of evidence included: research articles, peer-reviewed
journals, scholarly articles on health literacy, and review articles. The strategy was to
obtain evidence through a literature review of PubMed and EBSCOhost databases within
the library using keywords: health literacy, addressing health literacy, assessing health
literacy in the hospital setting, nurse education, nurse understanding of health literacy,
patient education. Key words were used to broaden the scope of the literature search and
relevant articles will be reviewed. This literature was reviewed thoroughly.
An educational program using PowerPoint that addresses health literacy was
developed and implemented. The target audience included all medical–surgical nurses.
Participants were given a pre-test and a post-test on their understanding of health literacy.
Nurses were also provided the opportunity to attend a post-education assessment to
address any follow-up needs.
The project objectives included the following:
1. Develop and implement a web-based educational program using PowerPoint
that addresses health literacy.
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2. Educate medical–surgical nurses on health literacy, using the PowerPoint
3. Introduce and educate medical–surgical nurses on the health literacy
assessment tool, REALM-SF.
4. Measure the effectiveness of the education program in a convenience sample
of a population of RNs at project site
Role of the Project Team
The project team included medical–surgical nursing management for 6E, 6PW,
and 5PW, as well as the clinical outcomes managers for the three areas. Stakeholders
identified but not directly involved include the director of nursing, director of research,
and vice president of clinical services, as their support and expertise brought value to this
project.
I assumed all responsibilities as leader of the project team. We met to discuss the
project concepts, background, and theory, identified need, and established objectives.
Once the educational program was formalized and finalized, it was added to the agenda
of the Institutional Review Board (IRB) at the project site. Approval was gained from
both the Walden IRB and the project site’s IRB.
Summary
In summary, this doctoral project was designed to educate the medical–surgical
nurses on health literacy. In this section, I detailed the concepts, models, and theories
used in the project. Relevance to nursing practice was discussed and the local context and
relevant background presented. Finally, I discussed the role of the doctoral student and
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project team. In the next section, the practice problem, sources of evidence, and analysis
methods will be discussed.
Section 3: Collection and Analysis of Evidence
Introduction
This project addressed low health literacy that affects patient outcomes (Geboers
et al, 2015) by providing education at the project site to medical–surgical nurses about the
effects of low health literacy. In addition, nurses at the project site do not assess patients
for literacy level. The purpose of this project was to increase medical surgical nurses’
awareness and knowledge of the importance of health literacy and to introduce a health
literacy assessment tool to be used on the medical–surgical units. In this section I will
present the practice-focused question and plan for collection and analysis of data.
Practice-Focused Question
The practice focus question was: Will medical–surgical nurses show an
improvement in their knowledge of health literacy when comparing measurement of
knowledge preeducation and immediately posteducation? In this doctoral project, the gap
in practice was addressed by providing education to nurses on health literacy. The goal
was to improve the nurses’ knowledge regarding health literacy and promote the
REALM-SF tool to assess patients’ literacy levels and allow for individualized education
(AHRQ, 2017). I hypothesized that a formalized educational program on health literacy
and the importance of nurse’s awareness of a patient’s understanding and comprehension
of their health through a validated health literacy screening tool will provide medical–
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surgical nurses with knowledge that they can put into their practice immediately at the
bedside to improve patient education and patient outcomes.
Practice-Focused Questions
This project helped explore the understanding of medical–surgical nurses and
addressed the following questions:
1. What is the nurses’ understanding of health literacy?
2. To what extent do medical–surgical registered nurses have health literacy
knowledge?
3. What is their understanding of the barriers and challenges patients in the acute
care setting face when attempting to manage their health?
4. Will education on health literacy in the medical–surgical patient population
improve bedside nurses understanding of health literacy?
Limited or Low Health Literacy
The health care system is rapidly changing, which can be overwhelming to
patients in the acute care setting. As seen in the goals of Healthy People 2020, there is
national effort to address health literacy and ensure that all individuals have access to and
understanding of accurate health information, promoting overall health (Bauer, 2010).
Two thirds of U.S. adults over age 60 have inadequate health literacy skills, according to
the National Assessment of Adult Literacy Survey (Whittaker, Tom, Bivens, &
KleinSchwart, 2016). Additionally, research has shown that only 12% of adults
nationwide have proficient health literacy skills (Kennard, 2016).
Low health literacy is associated with:
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• Poor patient–clinician relationship, linked to feelings of fear and
embarrassment, individuals with low health literacy tend to ask fewer
questions when with clinicians (Carollo, 2015).
• Limited knowledge about medications, which results in decreased adherence
to medication regimen and consequently adverse drug reactions and
emergency room visits (Whittaker, Tom, Bivens, & Klein-Schwart, 2016);
• Limited knowledge of preventive health services, which results in decreased
access to health care (Carollo, 2015; Van Schalk et al., 2016);
• Poorly managed chronic illnesses (Carollo, 2015);
• Higher incidence of hospital admissions and readmissions (Stiles, 2011);
• Higher incidences of morbidity and mortality (Stiles, 2011).
Challenges and Barriers
It is important for health care professionals to recognize that health literacy is
complicated and creates barriers to self-management of chronic diseases (Collins, Currie,
Bakken, Vawdrey, & Stone, 2012). Health literacy is comprised of numerical literacy, oral
literacy, print literacy (the ability to read print), as well as cultural and conceptual
awareness of health, all of which can cause the patient to feel overwhelmed (Collins et
al., 2012). The patient with low health literacy is often does not understand their health
care needs, from their discharge instructions to their prescriptions to their follow-up
needs. When the complexity of health care is combined with low health literacy, patients
struggle to manage their health care needs, which leads to poor outcomes such as hospital
readmissions. It is important to note that “even well educated people with strong reading
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and writing skills may have trouble comprehending a medical form or doctor’s
instructions regarding a drug or procedure” (Nielsen-Bohlman, 2004, para. 2).
Assessing the Patient’s Health Literacy Level
In the hospital setting, nurses are the main source of information for patients and
families; therefore, nurses may be the best solution to this nationwide health literacy
crisis. Medical–surgical nurses play a major role during the patient’s hospital stay, always
promoting effective communication to meet the patient’s needs. Nurses have the
responsibility to provide patient education while promoting patient well-being, patient
centered care, and positive outcomes (Carollo, 2015).
Without the proper assessment of a patient’s health literacy level, there is the risk
that nurses may overestimate a patient’s health literacy level and provide patients with
overly complex health information. Nurses must understand health literacy to be able to
assess for health literacy limitations and intervene to ensure understanding of any
education provided to the patient and family during the hospital stay (Chesser, Woods,
Smothers, & Rogers, 2016). Nurses need to be able to recognize the need to adjust their
patient education plan based on patients’ needs and literacy level. The REALM-SF tool is
a validated paper-based health literacy-screening tool and is the chosen health literacy
tool for this project (AHRQ, 2017).
REALM-SF
The REALM is commonly used in the clinical setting, serving as a screening tool
for clinicians to provide a reading grade estimate for the patient tested (AHRQ, 2017).
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The REALM-SF, presented and validated by the AHRQ in 2007, is a shorted version of
the REALM. This 7-item word recognition test (Appendix B), which can be administered
in under 2 minute, will provide nurses with a valid and quick assessment of the patient’s
health literacy (AHRQ, 2017).
Administration of the tool. The nurse will perform this literacy assessment using
the REALM-SF tool upon admission onto the medical–surgical unit. The nurse will then
write a progress note titled, “Health Literacy Assessment” in the electronic medical
record documenting the assessment and the patients score.
To begin, the nurse will explain to the patient the purpose of the tool and the
instructions using scripting, “I want to make sure that I explain things in a way that is
easy for you to understand. Will you help me by reading some words for me? Let’s start at
the top of this list, and please read each word out loud. If you don’t recognize a word, you
can say pass and move on to the next word”. The nurse will then give the word list to the
patient. If the patient takes more than 5 seconds on a word, say, “pass” and move to the
next word. The nurse will hold on to the scoring sheet, it is not to be visible to the patient
(AHRQ, 2017).
Scoring. Once the assessment is complete, the nurse will tally up the score by
counting how many words the patient pronounced correctly. The score will range from 0
through 7 and this will signify a grade range (AHRQ, 2017).
• Limited health literacy is defined as subjects that score at or below a
6thgrade reading level (score = 0 to 3). A score of 0 indicates 3rd grade and
below (AHRQ, 2017). This patient will not be able to read most low-literacy
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materials. It will be important for the nurse to provide oral instructions,
materials with illustrations, audio, or video (AHRQ, 2017). A score of 1-3
indicated a fourth- to sixth-grade reading level (AHRQ, 2017). This patient
will need low-literacy, easy to read materials. This patient may not be able to
read prescription labels.
• Marginal health literacy is defined as subjects that score at the 7th- to
8thgrade reading level (score = 4-6). This patient may struggle with most
patient education materials, so it is recommended that low-literacy easy-to-
read materials be used (AHRQ, 2017).
• Adequate health literacy is defined as a score at or above a 9th grade reading
level (score = 7; AHRQ, 2017). This patient will be able to read most patient
education materials.
Sources of Evidence
Health literacy is a relatively new health topic within the literature, with the
landmark report from the Institute of Medicine titled Health Literacy: A prescription to
End Confusion that came out in 2004 (Nielsen-Bohlman, 2004). The authors of this report
found that nearly half of all Americans, estimated at 90 million people, struggle with
limited health literacy causing difficulty understanding and comprehending health
information and health needs (Nielsen-Bohlman, 2004). Since this landmark report in
2004, many more studies have been done on the topic of health literacy, validating the
need to improve the nation’s health literacy and clinicians focus on this important topic.
Speros (2005) presented a concept analysis on health literacy, concluding that that the
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nurse must secure the ability to assess their patient’s health literacy level as patients with
low health literacy levels are more likely to misunderstand health care instructions and
also more likely to be non-compliant with their plan of care as they have much difficulty
navigating the health care system. Health education and effective nurse-patient
communication is vital to empower patients to take control of their health (Speros, 2005).
Patient education. Badarudeen, & Sabharwal (2010) discussed the opportunity to
enhance patient education material, to ensure that chosen patient education tools are
matched to the needs of the individual. These authors recognized behavioral patterns that
are linked to poor health literacy, including incorrectly or incompletely filled out intake
forms, non-compliance with medical appointments and medications. Enhanced
patientcentered, individualized communication both verbally, such as through follow-up
phone calls, and written, such as through enhanced readability materials no higher than
5th grade reading level, can promote positive patient outcomes (Badarudeen, &
Sabharwal, 2010). Medical jargon needs to be avoided and the text within the written
material needs to be simplified, as the material will only be useful to the patient if
presented in a way that the patient can understand (Badarudeen, & Sabharwal, 2010).
Porter, Estabrooks, Noel, Bailey, Zoellner and Chen (2016) conclude that the
teach back method is a highly recommended technique for the nurse in the role of teacher
to use to ensure that the patient understood the education provided. When using this
strategy, the nurse would ask the patient to repeat instructions back to them, or to recall
the key components using their own words. The patient would then teach the nurse what
they just learnt, to ensure understanding. Similarly Ballard and Hill (2016) stated that,
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“implementing the fundamentals of universal precautions and the teach-back method are
effective deterrents to the negative outcomes associated with low health literacy” (p.
232).
Relationship Between Education and Health
Zimmerman, Woolf, and Haley (2014) linked the impact of education to the
ability for a patient to navigate through the health care system. A systematic review of
health literacy found that those with low health literacy levels also struggled with low
health-related knowledge and comprehension, such as the inability to interpret health
messages on discharge instructions or messages on the labels of prescription medications
(Zimmerman, Woolf, & Haley, 2014). Additionally, these authors found that adults with
higher levels of education are less likely to engage in risky behaviors, such as smoking,
and more likely to share healthy behavior, such as exercise. Therefore, those with higher
education are more likely to be advocates of their own health, which promote better
patient outcomes (Zimmerman, Woolf, & Haley, 2014). It is unfortunate that the
percentage of adults in the United States is small, as according to the CDC (2016), only
12 percent of U.S. adults had proficient health literacy and only 9% scored in the highest
numeracy levels. Adults age 50 and older are more likely to have poor health literacy then
those under age 50 (Geboers et al, 2015). In those with poor health literacy, the rate of
poor adherence to the plan of care, treatment plan, or medication regimen is as high as
47% (Geboers et al, 2015).
Health Literacy Knowledge and Experience Survey (HL-KES)
The HL-KES tool was used to collect data for this project, as a pre and
postimplementation knowledge assessment. The HL-KES was developed by Dr.
24
Catherine Cormier and used to examine the health literacy knowledge and experience of
registered nurses in Georgia (Cormier, 2006). The original survey consisted of five
content areas: basic health literacy facts, health literacy screenings, guidelines for written
materials, and an evaluation of health literacy interventions, totaling 38 questions
(Cormier, 2006). On The Health Literacy Knowledge and Experience Survey – Short
Form survey (HL-SF12), there are 12 general-knowledge questions regarding health
literacy (Mullan et al, 2017). These questions explore individual nurse awareness and use
of techniques for communicating with patients with low health literacy, including an
assessment of barriers. The pre-implementation assessment was given to the nurses
before the education is provided. The post-implementation knowledge assessment was
given to the nurses immediately after the educational intervention.
While the education program was available to all medical–surgical nurses, nurses
were asked to voluntarily participate in the project to maintain ethical standards. The
project did not begin until approval was received from both Walden’s IRB and the project
site’s IRB.
Analysis and Synthesis
The Health Literacy Knowledge and Experience Survey for Registered Nurses
was the tool used as a pre-test and post-test. The pre-implementation assessment was
given to the nurses before the education was provided to provide a baseline level of the
knowledge of the nurse. The post-implementation knowledge assessment was given to the
nurses immediately after the educational intervention.
25
The raw data was entered into Microsoft Excel to create a spreadsheet for
analysis. SPSS version 25 was the statistical analysis software of choice. There was no
identifying data collected to protect the participants. The data entered was double checked
to ensure for accuracy. The data was analyzed in its entirety for trends. If trends were
found leaning towards inaccurate responses or questions showing large portion of
incorrect responses, this allowed for a gap analysis to be performed.
Pre and post intervention data was analyzed for comparison and t-tests were used.
The null hypothesis was that the pre and post intervention assessment results will be the
same. The alternative hypothesis was that the results will be significantly different,
showing that the education program had a positive impact.
Summary
In summary, low health literacy levels puts the patient at greater risk for poorer
compliance and poorer access to care, which leads to poorer patient outcomes. Because
there was no formalized education at the project site provided to medical–surgical nurses
about the effects of limited or low health literacy, this was recognized an opportunity for
an educational project. The purpose of this project is to increase medical surgical nurses’
awareness and knowledge of the importance of health literacy, and to introduce the
REALM-SF. In this section the practice-focused question and my plan for collection and
analysis of data was presented.
26
Section 4: Findings and Recommendations
Introduction
The problem addressed in this study is two-fold: first, the average patient
struggles with low health literacy, and second, nurses are not educated on this topic so
they are not able to individualize care for these patients. Patients with low health literacy
are often ill informed regarding their health care needs such as their discharge
instructions, prescriptions, and follow-up needs. When the complexity of health care is
combined with low health literacy, patients struggle to manage their health care needs,
which lead to outcomes such as hospital readmissions.
Medical–surgical nurses at a major hospital in the Northeast region are not
proficient in the topic of health literacy regarding the effects of low health literacy in their
patient population. Medical–surgical nurses play a major role during the patient’s hospital
stay in terms of communicating to meet the patient’s needs. Nurses have the
responsibility to provide patient education while promoting patient well-being, patient
centered care, and positive outcomes (Carollo, 2015).
The purpose of this project was to increase medical–surgical nurses’ awareness
and knowledge of the importance of health literacy and to introduce the REALM-SF tool
to assess a patient’s literacy level and subsequently allow a nurse to better individualize
the education provided to the patient. The practice-focus question was: Will medical–
surgical nurses show an improvement in their knowledge of health literacy when
comparing measurement of knowledge preeducation and immediately posteducation?
27
Findings and Implications
Nurses are on the front-line in the hospital setting, so there is significant
responsibly shared in the bedside nursing team to ensure that patients understand their
diagnosis, treatment plan, and follow-up needs. Poor health literacy leads to an increase
in hospital admissions, poor compliance with the treatment plan and medication regimen,
and higher mortality rates (Kennard, 2016). Much evidence was obtained from the
literature in support of developing a comprehensive curriculum to ensure registered
nurses’ understanding of health literacy and the effects of poor health literacy on patient
outcomes. Sources of evidence included peer-reviewed journals with scholarly articles on
health literacy, government websites, and review articles.
The developed staff education module from this project is Health Literacy: What
do Medical–Surgical Nurses Need to Know? This module includes:
• An overview of health literacy;
• How low health literacy affects follow-up, compliance with the treatment
plan, and ultimately patient outcomes;
• Barriers that patients with greater health literacy demands face;
• Assessing health literacy level, using the REALM-SF tool;
• Scores and grade equivalents for the REALM-SF, including recommendations
to individualize patient education based on these scores;
• The importance of evaluating the patients learning by using the teach-back
technique.
28
• Tips and reminders on patient education techniques and strategies to ensure
optimal patient outcomes.
Health Literacy Knowledge and Experience Survey
The HL-SF12 for registered nurses tool was used to collect data for this project as
a pre- and post-implementation knowledge assessment. On this survey there were 12
general-knowledge questions regarding health literacy, which helped explored individual
nurse awareness and use of techniques for communicating with patients with low health
literacy, including an assessment of barriers. The preimplementation assessment was
given to the nurses before the education was provided. The postimplementation
knowledge assessment was given to the nurses immediately after the educational
intervention. See Table 1 for pre- and post-test results per question.
Table 1
Health Literacy Knowledge and Experience Survey Results
Correct on
pretest
Correct on
posttest
Q1: Low health literacy levels are most prevalent among which of the
following age groups?
42
97
Q2: Low health literacy levels are common among:
90
100
Q3: The research on health literacy indicates that:
58
90
Q4: The best predictor of health care status is:
26
90
Q5: Patients with low health literacy skills:
74
97
Q6: The most effective way for a nurse to determine how well a patient with
low health literacy understands Health care information is to:
90
100
Q7: The recommended reading level for written health care information is:
48
93
Q8: After providing written health care information to a patient he states,
“Let me take this information home to read.” This may be a clue to the
nurse that the patient:
84
97
Q9: An individual with functional health literacy will be able to:
61
97
Q10: What is the strongest advantage of conducting health literacy
screenings? Health Literacy screenings:
64
97
Q11: Which of the following statements, made by the nurse, would be the
best approach to initiating a health literacy screening with a patient?
93
100
29
Discussion
Thirty-one medical surgical nurses participated in this education session. The
mean pre-test score was 67.71%, with a standard deviation of 15.124. The mean post-test
score was 96.6%, with a standard deviation of 6.606. This is an increase of 28.6 points
from pre-test to post-test. To test the hypothesis that the pre-test and post-test resilience
means were equal, a dependent samples t-test was performed. Prior to conducting this
analysis, the assumption of normally distributed difference scores were examined. The
null hypothesis was that the pre and post intervention assessment results would be the
same. The alternative hypothesis was that the results would be significantly different,
showing that the education program had a positive impact. A two-tailed paired samples t
test revealed that the nurses scored better on the post-test (M = 96.6, SD = 6.606)
compared to the pre-test (M = 67.71, SD = 15.124), t = -10.761, p = 0.000. All
participates showed a significant increase in their scores from pre-test to post-test, which
signifies that this education program was successful. Please see table 2 for a comparison
of pre-test and post test scores.
Table 2
Overall Raw Test Scores
Participant
Pre-test score
Post-test score
Variance
A
83
100
+17
B
67
92
+25
C
25
92
+67
D
67
100
+33
E
58
92
+34
F
67
100
+33
G
75
100
+25
30
H
75
100
+25
I
67
100
+33
J
75
100
+25
K
75
100
+25
L
50
92
+42
M
83
100
+17
N
75
92
+17
O
83
100
+17
P
83
92
+9
Q
83
92
+9
R
58
100
+42
S
50
100
+50
T
75
100
+25
U
58
100
+42
V
25
100
+75
W
50
67
+17
X
75
100
+25
Y
67
100
+33
Z
75
92
+17
AA
83
100
+17
BB
75
100
+25
CC
75
100
+25
Recommendations
The analysis and synthesis of the data gathered during this project hold the
promise of further recommendations on the topic of health literacy projects moving
forward. The results of this analysis show that there is a significant gap in medical–
surgical nurse’s knowledge of health literacy. Future research is needed to support these
findings in other areas of bedside nursing, such as on the telemetry, maternity, and
stepdown nursing units. Additional recommendations would include a breakdown of
nurses by generation, and focusing in on their individual generational needs. Furthermore,
essential to this topic is the long-term result of individualize patient education, based on
31
health literacy needs, on patient outcomes, including hospital readmissions, compliance
with follow-up care and the treatment plan, and morbidity and mortality.
Life-long learning in the nursing field is a dynamic and continuous process for
nurses in all specialties, as learning encompasses a person’s professional lives as well as
their personal lives. Continuous education, such as through this education module, is
imperative for nurses to remain aware and up-to-date on new research, advancements in
the health care field, and evidenced-based practices. It is through educational
opportunities that nurses are able to gain knowledge that will influence their nursing
practice and build upon their clinical skill sets. Based on the findings of this project,
nurses found the educational module beneficial; the nurses’ knowledge gap was closed
post-education.
Strengths and Limitations of the Project
The strength of this project was that it provided clear and focused education,
tailored to the needs of the medical–surgical nurse and focused on the medical–surgical
patient population. The nurses who participated gained essential, evidenced-based
knowledge, which will influence their nursing practice; to help them individualize the
way they provide patient education. This will improve clinical practice at the bedside,
allowing the nurse to provide high quality, safe patient care, which will ultimately
improve patient outcomes.
The goal of this project was to improve the nurses’ knowledge regarding health
literacy and promote the use of the REALM-SF tool to assess the patient’s literacy level,
to allow for individualized education. The chosen tool was an identified strength of this
32
project, as this tool was proven and validated by the AHRQ (2017), and this short-form
version is the perfect choice for a busy acute care setting. The REALM-SF is both
efficient and effective, and the results bring immediate value to the nurse performing the
assessment.
One limitation was that, while this education program was available to all
medical–surgical nurses, nurses were asked to voluntarily participate in the project.
Because of this, not all medical surgical nurses participated and thus missed out on the
opportunity to expand their knowledge on health literacy. It would benefit the
organization to offer this educational module on health literacy to all medical–surgical
nurses, as a Health Stream educational module. This education module offers portability
and ease in transitioning the program to a self-learning module, which will save time and
also be cost-effective for the organization.
Summary
Health literacy is defined as “the degree to which individuals have the capacity to
obtain, process and understand basic health information and services needed to make
appropriate health decisions” (Young & Weinert, 2013, p. 70). Because health literacy is a
critical component of health care in America, nurses need to be able to recognize the need
to adjust their patient education plan based on patients’ needs and literacy level. Nurses
need to identify and challenge the barriers that present to the situation. In the hospital
setting, nurses are the main source of information for patients and families. Nurses must
have an understanding of health literacy to be able to assess for health literacy limitations
and intervene appropriately, to ensure understanding of any education provided to the
33
patient and family during the hospital stay (Sand-Jecklin, Murray, Summers, & Watson,
2010). In this doctoral project, the gap in practice was identified and then addressed by
providing education to nurses on health literacy.
Section 5: Dissemination Plan
Introduction
Dissemination of this doctoral project serves to advance the nursing practice and
improve patient outcomes at the practicum site. The initial audience for this project was
the medical–surgical nurses at one of three hospital campuses in the network. This nurse
education has helped to increase the medical–surgical nurses’ knowledge of the
importance of health literacy and to introduce the REALM-SF tool, which can be used to
assess a patient’s literacy level and better individualize the education provided to the
patient. The goal was to improve nurses’ clinical knowledge base and skill set in this area,
and through analysis of the results this project was successful.
Providing education on this topic to the bedside nursing team promotes a
respectful and supportive environment for the patient, focusing on the patient’s individual
needs and providing patient-centered care. Educating nurses on health literacy benefits
patients and reduces health disparities (Cornett, 2017). By improving their knowledge on
health literacy, medical–surgical nurses can share this information with colleagues—
especially those who act as mentors and preceptors—and apply their knowledge in
interactions with patients and families.
34
There is also additional opportunity to disseminate this educational module out
network-wide to the rest of the organizations bedside nurses through the staff selflearning
educational forum. This education will help to further facilitate and guide change in
nursing practice. In addition, a train-the-trainer approach can be used at each individual
unit level. The unit-based practice councils can then disseminate the education to the
remaining nurses on the unit with plans to evaluate the effectiveness of this education for
continuous improvement opportunities.
There is also opportunity to disseminate this project in venues supportive of the
broader nursing profession. Because health literacy is a complex topic, this education is
valuable for nurses in a variety of roles and settings across the care continuum, including
community and public health, and ambulatory settings. Providing education on this topic
to nurses across the care continuum will further promote better patient environments.
Taking this topic to professional nursing conferences or through written publications in
nursing journals will allow this education to reach a variety of nurse leaders who then can
disseminate this education into their organizations.
Analysis of Self
My Philosophy of Nursing
The health care environment has the same goals even though it is always
changing: provide high quality patient care and improve patient outcomes. The nursing
profession is unique because through philosophy, theory, and research, the nursing
discipline’s body of knowledge has grown. This body of knowledge has made the nursing
profession the discipline that it is today: health-oriented and person-centered, with a focus
35
on improving patient outcomes through evidenced-based practice. As a result of this
doctoral program, I now have the ability to not only think like a nurse but also to now
think like a scholar with evidence-based practice to introduce the REALM-SF as a tool in
measuring health literacy.
Nursing Career
My professional nursing career, to this point, has been overwhelmingly satisfying.
I feel that I was meant to be a part of this growing profession. When I worked at the
bedside as a telemetry nurse, I started with only a diploma in nursing. I quickly realized
that I had a strong desire to continue my education. Theorists who guided my bedside
practice include Florence Nightingale, Dorthea Orem, and Jean Watson. I focused on
caring for the patient as a person and caring for the family and loved ones at the bedside
as my patient too. I supported the patient’s basic needs while promoting education and
self-care. I spent personal time with my patient, waiting for and hoping for a caring
moment.
As I recognized my love for learning and the value I brought to my organization, I
joined shared governance at the hospital where I worked. I also went back to school for
my BSN. The knowledge gained through my BSN program helped to solidify many of the
concepts I had already practiced every day, as an understanding of philosophy improved.
But it was learning about Patricia Benner’s novice to expert theory that helped me realize
my desire to go into nursing leadership. I started with cross-training to the role of house
supervisor, then I went on to precept new nurses. I also volunteered as a capstone
preceptor for senior nursing students. Each step forward in my career built upon the
36
previous one, and the knowledge I gained through this process was satisfying. I soon
decided that I wanted more, and I went back to school again for my MSN/MHA.
The next step in my career was house supervisor, and then shortly after, the role of
nurse manager. In both of these leadership roles, I continued to link theory and
philosophy to my every day responsibilities. No matter how difficult the day, I always
focus on doing the right thing for the patient, meeting their needs, and ensuring high
quality care and outcomes. I recognize the opportunity to grow my team. Together, with
my nursing team, we are working on various quality improvement initiatives on our units.
We are also working on their personal professional development.
Current Role
In my current role, I am nurse manager of two medical–surgical units, one is a
busy 51-bed general medical–surgical unit with remote telemetry capabilities, and the
other a smaller yet just as busy 24-bed medical–surgical unit. My personal philosophy of
nursing focuses in on the basics of care, as I believe that caring remains the core of
nursing. Just as Nightingale “delved into the most basic needs of human beings and all
aspects of the environment,” I share the belief that, with my nursing team, we need to
focus on caring for the patient as a whole person: body, mind, and spirit (Dossey, 2010,
p. 14). I start every morning making patient rounds, and I work hard with my team of
assistant nurse manager to ensure that we personally check in with all patients every day.
Although I enjoy this time at the bedside, I recognize the importance of my presence and
leadership for my nursing team. I never hesitate to jump into hands-on patient care if that
is what the patient needs.
37
Hildegard Peplau stressed the importance of a nurse–patient relationship; she also
promoted the importance of “professionalizing nursing” (Callaway, 2002, p.23). In my
role as nurse manager, I am responsible for a team of nurses from all generations who
share various nursing experiences that range from novice to expert. I often lead my team,
reminding them that nursing on our unit needs to be more than just completing tasks, as it
is the connection with the patient that is important for both patient satisfaction and nurse
satisfaction. Peplau has taught me that relationships with my direct reports need to be
built on trust, and need to be a priority. I make sure to dedicate time meeting with all of
my team personally, in one-on-one meetings throughout the year, where we discuss their
professional development. Just as Peplau was first an educator, I feel the same in the
nurse manager role. I am ultimately responsible for my team of nurses, to educate and
guide them, and to ensure they provide high quality, safe care to our patients.
As stated by Rega, Telaretti, Alvaro, and Kangasniemi, (2017), “In the course of
their clinical practice, nurses need to know how to act, but theoretical knowledge can
provide arguments about why they should act” (p.74). Philosophy has guided the nursing
practice through nursing theory. Nursing research laid the foundation for the science of
nursing. A mixture of practical, philosophical, and theoretical knowledge is needed
“because evidence-based practice alone cannot explain phenomena that are exclusive to
nursing” (Rega, Telaretti, Alvaro, & Kangasniemi, 2017, p.71). Subsequently, individual
nurses rely on philosophy and theory. Nurses reflect on philosophical concepts, their
personal beliefs and values, and then relate the theoretical concepts to their own personal
practice.
38
Why Health Literacy?
When thinking about what I wanted to focus on for my doctoral project, I thought
long and hard on my experience at the bedside as a medical–surgical and telemetry nurse.
I thought about my patients that I cared for as a primary nurse, and I thought about the
patient population that I care for now, as nurse manager of two busy medical surgical
units. Our patients are sick, navigating through co-morbidities and life-changing events,
and they’re scared of the unknown, and often the complexity of the acute care hospital
setting can be overwhelming for the patient. In addition, patient education in the acute
care setting can be a challenge for the bedside nurse who juggles a multitude of priorities
throughout the workday. The patient education piece is important because patients need to
be informed on their medical conditions and treatment plans so that they can advocate for
their own health care choices. It is also vital for patients to be well informed so that they
can properly care for themselves at home. Well-educated patients are better able to
manage their own health care needs and facilitate their own plan of care. Patient-nurse
communication is a vital key element of patient education, but I thought, how much does
the patient really understand and is the nurse taking the time to recognize that the patient
doesn’t understand? It is important for the clinical nurse to recognize the complexities
during the hospital admission, often related to medical terminology, treatment plans, and
patient care equipment and devices. This also includes education on the diagnosis and
treatment plan, goals, new medications and potential adverse effects, and follow-up
needs. From a patient perspective, management of health care needs becomes even more
challenging when the complexities of health care are combined with limited or low health
39
literacy levels. And this is where I recognized there was opportunity for improvement.
This doctoral project addressed the topic of health literacy. Low health literacy puts the
patient at greater risk for poorer compliance and poorer access to care, which leads to
poorer patient outcomes.
As the project developer, the many hours invested in this practicum experience
allowed me to witness the many challenges that the bedside nurse confronts daily when
providing patient education throughout the patient’s hospital stay as well as at the time of
discharge. On a busy medical floor, time is of the essence, so I knew immediately that I
needed to find an assessment tool that was efficient and valuable to the nurse. Numerous
hours were spent scouring the literature and the Internet for a tool that would strengthen
this important initiative, and when I came across the REALM-SF I knew that this tool
was exactly what I was looking for. This process in itself reinforced my commitment to
this project, as now I understood the value in a project developer, who is patient and
persistent, yet determined to explore the literature in an effort to develop an innovative
strategy to overcome a gap in clinical practice.
Challenges
The biggest challenge for me through this process was certain nurse’s blatant
display of resistance to change. While the majority of nurses who attended this program
were open to the education provided to them and excited about the opportunity to learn
something new, there were a select few who challenged the process. Two nurses, in
separate sessions, interrupted the education with complaints about an additional
assessment being time-consuming and demanding, rather than absorbing the information
40
discussed and looking at this as a learning opportunity for them. One nurse in particular
was so challenging that she was disruptive to the group. During this doctorial experience,
I have learned strategies to address barriers to resistance to change, and through patience,
perseverance, and effective communication, this challenge was overcome. This program
taught me the importance of always staying true to the reason why we are here in this
place, for the better of society as we promote positive social change. My doctoral
instructors, facilitators, and mentors have taught me to inspire and engage nurses, even in
times of uncertainty and resistance, and these efforts ran true during this experience.
Hopes for the Future
My long-term career goals are two-fold. First, I want to continue my growth as a
nurse scholar and nurse leader, transforming and advancing the nursing profession. It is
important to me to share my knowledge on the topic of health literacy with continued
hope to promote positive change of bedside nursing practice. My hope for the future is
that this project has helped to improve nursing practice at the bedside surrounding the
context of patient education. My hope is that, thorough individualizing patient education
based on the patients’ health literacy needs that patient outcomes will improve in the
long-term. I also hope to continue to research on this topic, as its value to improving
patient outcomes is vast. Second, I want to continue to influence nursing practice and the
future of nursing, from novice nurses new to this great profession to the overall care
continuum. Completion of this doctorial journey provides me not only with knowledge
and expertise, but with professional respect that will help allow me to further influence
this great profession.
41
Summary
As a result of this educational module, nurses will be better equipped to
understand their patients’ health literacy level. Nurses will then be able to individualize
their patient education based on their patient’s personal needs. When discussing the topic
of health literacy, it is important to note the contributing factors and the potential
implications for nursing practice and social change as a result of this doctorial project.
Nurses need to see the value in this education provided to them, and they need to make
the personal decision to alter the way that they practice. The goal is that nurses will assess
their patient’s literacy level using the REALM-SF, so that the nurses can then intervene
according to the results of this assessment and provide the patient with education that
they will be able to understand and comprehend.
42
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Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
45
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
46
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
47
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
48
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
49
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
50
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
51
14(1), 614-623. doi:10.1186/s12913-014-0614-1
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
52
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
53
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
54
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
55
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
56
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
57
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
58
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
59
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
60
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
61
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
62
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
63
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
64
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
65
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
66
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
67
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
68
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
69
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
70
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
71
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
72
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
73
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
74
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
75
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
76
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
77
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
78
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
79
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
80
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
81
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
82
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
83
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
84
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
85
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
86
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
87
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
88
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
89
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
90
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
91
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
92
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
93
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
94
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
95
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
96
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
97
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
98
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
99
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
100
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
101
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
102
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
103
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
104
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
105
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
106
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
107
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
108
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
109
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
110
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
111
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
112
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
113
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
114
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
115
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
116
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
117
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
118
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
119
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
120
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
121
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
122
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
123
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
124
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
125
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
126
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
127
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
128
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
129
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
130
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
131
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
132
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
133
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
134
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
135
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
136
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
137
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
138
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
139
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
140
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
141
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
142
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
143
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
144
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
145
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
146
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
147
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
148
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
149
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
150
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
151
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
152
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
153
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
154
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
155
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
156
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
157
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
158
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
159
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
160
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
161
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
162
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
163
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
164
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
165
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
166
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
167
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
168
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
169
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
170
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
171
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
172
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
173
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
174
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
175
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
176
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
177
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
178
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
U.S. Department of Health and Human Services. (2008). America’s health literacy: Why
we need accessible health information. Retrieved from
https://health.gov/communication/literacy/issuebrief/
van Schaik, T. M., Jorstad, H. T., Peters, R. G., Tijssen, J. G., Essink-Bot, M. L., Fransen,
M. P., & Twickler, T. B. (2017). Cardiovascular disease risk and secondary
179
prevention of cardiovascular disease among patients with low health literacy.
Netherlands Heart Journal, 25(7-8), 446-454.
Williams, A. M., Muir, K. W., & Rosdahl, J. A. (2016). Readability of patient education
materials in ophthalmology: A single-institution study and systematic review.
BMC Ophthalmology, 16133. doi:10.1186/s12886-016-0315-0
Whittaker, C. F., Tom, S. E., Bivens, A., & Klein-Schwartz, W. (2017). Evaluation of an
educational intervention on knowledge and awareness of medication safety in
older adults with low health literacy. American Journal of Health Education,
48(2), 100-107.
Young, D. & Weinert, C. (2013). Improving health literacy with inmates. Corrections
Today, (5), 70.
Zimmerman, E., Woolfe, S., & Haley, A. (2014). Understanding the relationship between
education and health. Agency for Health care Research and Quality. Retrieved
from https://www.ahrq.gov/professionals/education/curriculum-
tools/populationhealth/zimmerman.html
American Academy of Family Physicians. (2017). Core educational guidelines. American
Family Physician, 62(7),1712-1714. Retrieved from
https://www.aafp.org/afp/2000/1001/p1712.html
Agency for Healthcare Research and Quality. (2017). Health literacy measurement tools.
Retrieved from https://www.ahrq.gov/professionals/quality-patient-
safety/qualityresources/tools/literacy/index.html#rapid
180
Arozullah, A., Yarnold, P., Bennett, C., Soltysick, R., Wolf, M., Ferreira, R., . . . Davis, T.
(2007). Development and validation of a short-form, rapid estimate of adult
literacy in medicine. Medical Care, 45(11),1026-1033.
doi:10.1097/mlr.0b013e3180616c1b
Badarudeen, S., & Sabharwal, S. (2010). Assessing readability of patient education
materials: current role in Orthopaedics. Clincial Orthopaedics and Related
Research, 468(10), 2572-2580. doi:10.1007/s11999-010-1380-y
Ballard, D., & Hill, J. F. (2016). The nurse’s role in health literacy of patients with cancer.
Clinical Journal of Oncology Nursing, 20(3), 232-234.
Bauer, C. (2010). The national plan to improve health literacy. Retrieved from
http://www.nationaloralhealthconference.com/docs/presentations/2010/Cynthia%
20Bauer%20-
%20National%20Plans%20to%20Improve%20Health%20Literacy.pdf
Berkman, N., Sheridan, S., Donahue, K., Halpern, D., & Crotty, K. (2011). Low health
literacy and health outcomes: am updated systematic review. Ann Intern
Medicine, 155(2), 97-107. doi:10.7326/0003-4819-155-2-201107190-00005.
Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York,
NY: Springer.
Carollo, S. (2015). Low health literacy in older women: The influence of patient–
clinician relationships. Geriatric Nursing, 36(Supplement), S38-S42.
doi:10.1016/j.gerinurse.2015.02.017
181
Centers for Disease Control and Prevention. (2018). Understanding literacy and
numeracy. Retrieved from
https://www.cdc.gov/healthliteracy/learn/understandingliteracy.html
Chesser, A., Woods, N. K., Smothers, K., Rogers, N. (2016). Health literacy and older
adults: a systematic review. Gerontology and Geriatric Medicine, 2.
doi:10.1177/2333721416630492
Collins, S., Currie, L., Bakken, S., Vawdrey, D., & Stone, P. (2012). Health literacy
screening instruments for eHealth applications: A systematic review. Journal of
Biomedical Informatics, 45(3), 598-607. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371171/
Cormier, C. M. (2006). Health literacy: The knowledge and experiences of senior level
baccalaureate nursing students (Doctoral dissertation). Retrieved from
https://digitalcommons.lsu.edu/gradschool_dissertations/4027
Cornett, S. (2009). Assessing and addressing health literacy. OJIN: The Online Journal of
Issues in Nursing, 14(3). doi:10.3912/OJIN.Vol14No03Man02
Dossey, B. M. (2010). Holistic nursing: From Florence Nightingale’s historical legacy to
21st-century global nursing. Alternative Therapies in Health and Medicine, 16(5), 14-16.
Ganesh, A. (2017). Application of health literacy tools to understand the status of health
literacy. Social Work Chronicle, 6(1), 70-89. Retrieved from
http://www.publishingindia.com/swc/42/596/2017/
182
Geboers, B., Brainard, J. S., Loke, Y. K., Jensen, C. J., Salter, C., Reijneveld, S. A., & de
Winter, A. (2015). The association of health literacy with adherence in older
adults, and its role in interventions: a systematic meta-review. BMC Public
Health, 15, 903. doi:10.1186/s12889-015-2251-y
Hernandez, L., French, M., & Parker, R. (2017). Roundtable on health literacy: Issues and
impact. Studies in Health Technology and Informatics, 240, 169-185. Retrieved
from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?
direct=true&db=mnh&AN=28972517&site=eds-live&scope=site
Ingram, R. R. (2018). Creating a “win-win” outcomes for patient with low health literacy:
a nursing case study. MedSurg Nursing, 27(2), 132-134.
Isaacs, S., Ploeg, J., & Tompkins, C. (2009). How can Rorty help nursing science in the
development of a philosophical “foundation”? Nursing Philosophy, 10(2), 81-90.
doi:10.111/j.1466-769x.2008.00364
Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing Education
Perspectives (National League for Nursing), 37(2), 118-119. doi:10.5480/14-1350
Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., & Smylie, J.
(2014). Health literacy: health professionals’ understandings and their perceptions of
barriers that Indigenous patients encounter. BMC Health Services Research,
14(1), 614-623. doi:10.1186/s12913-014-0614-1
183
Mullan, J., Burns, P., Weston, K., McLennan, P., Rich, W., Crowther, S., . . . Osborne, R.
(2017). Health literacy amongst health professional university students: a study
using the health literacy questionnaire. Education Sciences, 7, 54.
doi:10.3390/educsci7020054
Nielsen-Bohlman, L. (2004). Health literacy: A prescription to end confusion.
Washington, DC: National Academies Press.
O’Connell, A., & Fry-Bowers, E. (2011). Knowledge and perceptions of health literacy
among nursing professionals. Journal of Health Communication, 16(3), 295-
307.doi:10.1080/10810730.2011.604389
Office of Disease Prevention and Health Promotion. (2017). Disparities. Retrieved from
https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Disparities
Porter, K., Estabrooks, P., Noel, L., Bailey, A., Zoellner, J., & Chen, Y. (2016). Using
teach-back to understand participant behavioral self-monitoring skills across
health literacy level and behavioral condition. Journal of Nutrition Education and
Behavior, 48(1), 20-26. doi:10.1016/j.jneb.2015.08.012
Rega, M., Telaretti, F., Alvaro, R., & Kangasniemi, M. (2017). Philosophical and
theoretical content of the nursing discipline in academic education: A critical
interpretive synthesis. Nurse Education Today, 577(4), 74-81.
doi:10.1016/j.nedt.2017.07.001
Rowlands, G., Shaw, A., Jaswal, S., Smith, S., & Harpham, T. (2015). Health literacy and
the social determinants of health: a qualitative model from adult learners. Health
184
Promotional International, 32(1), 130-138. Retrieved from
https://academic.oup.com/heapro/article/32/1/130/2950953
Sand-Jecklin, K., Murray, B., Summers, B., & Watson, J. (2010). Educating nursing
students about health literacy: from the classroom to the patient bedside. Online
Journal of Issues in Nursing, 15(3), 1. doi:10.3912/OJIN.Vol15No03PPT02
Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72. Retrieved from
https://journals.lww.com/jonajournal/Abstract/2013/02000/Lewin_s_Theory_of_P
lanned_Change_as_a_Strategic.5.aspx
Stiles, E. (2011). Promoting health literacy in patients with diabetes. Nursing Standard,
26(8), 35-40.
Speros, C. (2005). Health literacy: Concept analysis. Journal of Advanced Nurs, 50(6),
633-640. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15926968
Toronto, C. E. (2016). Health literacy competencies for registered nurses: An e-Delphi
study. Journal of Continuing Education in Nursing, 47(12), 558-565.
doi:10.3928/00220124-20161115-09
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