Improving health literacy in patients with chronic conditions: A call to action.

Knowledge and education is foundational to an individual receiving care, and health literacy is the ability of patients to understand and act on health information. Cardiovascular disease and diabetes are complex conditions that require active participation on the part of the patient. Lack of understanding on the condition and participation in self-care behaviors limits the effectiveness of treatment. An effective model is needed to better understand how patients with cardiovascular disease and diabetes acquire the knowledge and skills necessary to manage their health. In working together, the authors have created multiple programs that have been delivered at medical offices and corporations, resulting in a model for building functional and critical health literacy skills. This model is a progression that begins with health literacy, including the knowledge and understanding of the condition. Functional literacy includes numeracy, which is the ability to understand and manipulate numbers, and navigation, which is an understanding of what to do with the information. Finally, critical health literacy includes communication skills, including knowing what questions to ask and what information to share, and decision making, which can include shared decision making. These five levels of health literacy form a progression in the ability of the patient to become an active participant in their care, and inform the healthcare provider on effective educational methods.