Health Literacy Universal Precautions Toolkit

Study Description and Methods

Health literacy represents the ability to understand and use health-related information and includes a person’s ability to read, write, and understand verbal communications related to health. Research suggests that difficulty understanding health information is linked to limited health knowledge, poor self-care behavior (e.g., managing medications), and negative clinical outcomes (e.g., higher mortality rates and greater use of emergency department care).

Although some patients are more likely to have limited health literacy skills – for example, elderly patients – nearly everyone struggles with health information and navigating the healthcare system. The good news is that providers can do a great deal to make things easier for their patients. The Health Literacy Universal Precautions Toolkit was developed to guide primary care practices in making simple changes to their office environments and strategies for communicating with patients that can improve comprehension of health information among patients of all health literacy levels.

As part of this demonstration project, 12 primary care practices will be selected to implement a subset of the tools included in the Toolkit. Practices will implement four tools over a 6-month period, collecting data about their office environments and healthcare processes during the month prior to and the month following implementation. The research team will make two site visits to each participating practice, during which qualitative interviews addressing the implementation process will be conducted. The data practices collect and the information they provide as part of the qualitative interviews will allow the research team to refine and improve the Toolkit at the conclusion of the project.

Specific Aims and Objectives

The specific aims of this project are to:

  1. To learn about the experiences of practices implementing the Toolkit, including what changes they are able to make and what challenges they face.
  2. To revise the Toolkit based on the experience of and input provided by participating practices.


This project is currently collecting data.

Collaborating Institutions

The AAFP National Research Network is collaborating with the University of Colorado, School of Medicine, and the State Networks of Colorado Ambulatory Practices & Partners USA (SNOCAP-USA) to conduct this study.

Contact Information

For additional information about this study, please contact:

Natty Mabachi
Research Project Manager
AAFP National Research Network
1-800-274-2237, x3173

This project was funded by a grant from the Agency for Healthcare Research and Quality.