For example, a communication click here method shown to be highly effective is the ‘teach back’ method. This involves the health professional, after initially providing verbal information, asking the patient to reiterate the information in their own words. This strategy provides an opportunity to clarify understanding and confirm recall of the patient (DeWalt 2007). A study conducted in a diabetes clinic reported that when the ‘teach back’ strategy was used in consultations, patients were eight times more likely to have better controlled HbA1c levels compared to patients whose health professional

had not used the strategy (Schillinger et al 2003). Health communication training has also been shown to be effective in managing patients with low health literacy. In a randomised trial of health communication training delivered to general practitioners (GPs), those patients under the care of GPs in the intervention group were more likely to undergo colorectal cancer screening than patients treated by GPs who had not received the training (Ferreira 2005). Whilst training and education strategies exist, it is important that health professionals HIF activation are provided with adequate resources and opportunities to assist patients with suboptimal health literacy.

It is an area that will need to be explored further by policy makers and healthcare organisations, particularly given current national health initiatives (see below). Another consideration may be to implement health literacy screening within clinical settings to identify patients with inadequate abilities to seek, understand, and utilise health information. Whilst a range of health literacy measurement tools exist (see second Jordan et al 2010b), they predominantly measure reading comprehension abilities, which do

not represent the breadth of components implied in existing definitions of health literacy. Further empirical evidence demonstrating the validity and reliability of existing measures is also required before considering feasibility at a clinical level (Jordan 2010b). Not surprisingly, health literacy is starting to be addressed at both health policy and program levels in Australia. Both the Health and Hospitals Reform Commission Report and the National Primary Health Care Strategy outline key initiatives relating to health literacy. These include health professionals supporting patients to improve their health literacy skills to navigate the health system, engage in preventive activities, enhance self-management, and change risky lifestyle behaviours. Similar policy and program initiatives are also in development by state governments.