Introduction of health literacy into the allied dental curriculum: first steps and plans for the future.

In 2003, the U.S. Department of Education's National Center for Education Statistics conducted the National Assessment of Adult Literacy (NAAL). The NAAL reported that over 90 million adults were functionally or marginally illiterate. When these individuals encounter the health care system, they often have difficulties with reading and understanding basic text and, as a result, have difficulty managing their disease or using medications. The purpose of this article is to describe our initial efforts to educate our students concerning health literacy, its consequences, and our assessment. As part of a new segment of the allied health curriculum, second-year dental hygiene students received a lecture concerning the prevalence of poor literacy in America and the possible consequences of poor literacy on their patients' ability to maintain oral health. To provide clinical experience with assessing health literacy, the students were instructed in the administration of a validated medical health literacy tool. This clinical exercise had two functions: 1) to familiarize students with assessing health literacy as part of their clinical experience and 2) to continue to gather preliminary data concerning the level of health literacy of adult patients at Indiana University School of Dentistry using a standardized methodology, the Short Test of Functional Health Literacy in Adults (S-TOFHLA). The results indicated that 13 percent of those assessed had "inadequate" or "marginal" literacy as measured by the S-TOFHLA. As a result, we plan to continue to expand our educational efforts and develop a larger investigation of the prevalence in our dental school population. With these data, we hope to develop effective educational programs and experiences for our students, faculty, and staff to improve their awareness and communication skills and ultimately improve the oral health of our patients.