Targeted Virtual Health Literacy Education for Community Health Workers: An Evidenced-Based Quality Improvement...

Background: Low or limited health literacy is a significant problem in the United States as one in three adults in the United States has inadequate health literacy. Low or limited health literacy contributes to poorer health outcomes for patients and increases costs to the consumer and health care system. Strategies that health care professionals can utilize to overcome these barriers include Health Literacy Universal Precautions, Teach Back, and using simple language. Objective: Standardized health literacy training was inconsistent for community health workers (CHWs) resulting in CHWs having difficulty communicating health-related information to the vulnerable populations they serve who often have low to limited health literacy. A contributing factor is the lack of standardized health literacy training, for nonlicensed health care workers. The aim of this study was to evaluate the CHWs' knowledge about health literacy and self-efficacy after targeted health literacy training. Methods: A pre-test, teaching intervention, and posttest were administered by the principal investigator using the Health Literacy Knowledge and Experience Survey (HLKES-2) to measure the CHW's knowledge and self-efficacy by comparing pre- and postdata results. Five virtual 2.5-hour targeted health literacy training courses were conducted by the primary investigator over a 4-month period. The participants (n = 50) were a sample of CHWs across several regions of the state of Pennsylvania. Results: There was a statistically significant difference between both the pre- and posttest scores of the HLKES-2 after the training (p < 0.0001) in the CHW's health literacy knowledge and a statistically significant change (p < 0.03) in their self-efficacy. Demographics revealed statistically significant changes (p < 0.003) that the higher the education (i.e., secondary education or higher) the better the scores on the HLKES-2 survey. Conclusions: Confident, knowledgeable health care workers can enhance health outcomes for patients with low health literacy in many settings. The combined use of education and technology within standardized, targeted health literacy training can promote support of CHWs. Implications for Nursing: Nursing holds a key role in supporting the education of CHWs. This quality improvement study showed a positive correlation between the targeted health literacy training participation and higher knowledge levels and self-efficacy of the CHWs.