tive approaches to reducing the negative effects of limited health literacy. To accomplish this, these organizations should:

  • Engage consumers in the development of health communications and infuse insights gained from them into health messages.

  • Explore creative approaches to communicate health information using printed and electronic materials and media in appropriate and clear language. Messages must be appropriately translated and interpreted for diverse audiences.

  • Establish methods for creating health information content in appropriate and clear language using relevant translations of health information.

  • Include cultural and linguistic competency as an essential measure of quality of care.

Recommendation 6-2 The Department of Health and Human Services should fund research to define the needed health literacy tasks and skills for each of the priority areas for improvement in health care quality. Funding priorities should include participatory research which engages the intended populations.

Recommendation 6-3 Health iteracy assessment should be a part of healthcare information systems and quality data collection. Public and private accreditation bodies, including Medicare, the National Committee for Quality Assurance, and the Joint Commission on Accreditation of Healthcare Organizations should clearly incorporate health literacy into their accreditation standards.

Recommendation 6-4 The Department of Health and Human Services should take the lead in developing uniform standards for addressing health literacy in research applications. This includes addressing the appropriateness of research design and methods and the match among the readability of instruments, the literacy level, and the cultural and linguistic needs of study participants. In order to achieve meaningful research outcomes in all fields:

  • Investigators should involve patients (or subjects) in the research process to ensure that methods and instrumentation are valid and reliable and in a language easily understood.

  • The National Institutes of Health should collaborate with appropriate federal agencies and institutional review boards to formulate the policies and criteria to ensure that appropriate consideration of literacy is an integral part of the approval of research involving human subjects.

  • The National Institutes of Health should take literacy levels into account when considering informed consent in human subjects research. Institutional Review Boards should meet existing standards related to the readability of informed consent documents.

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