This document provides guidance on developing effective patient education handouts. It emphasizes the importance of understanding your audience and their health literacy level in order to communicate key health messages clearly. Guidelines are provided on establishing a clear purpose, addressing specific behaviors, using plain language at a 5th grade reading level, incorporating culturally sensitive content, and employing a logical genre with purposeful images to maximize patient learning. References are included to help assess readability, search for appropriate images, and apply principles of multimedia learning.

1. HTH 378
Carolyn Schubert
schubecf@jmu.edu

2. Learning Objectives
• Understand the issue of health literacy in order to synthesize and prioritize
nutrition information
• Evaluate the context of your patient population in order to develop an
appropriate message
• Apply multimedia learning principles in order to maximize patient learning
from the genre of patient education handouts

3. Your Patient Handout
• What worked well?
• What was difficult?
• Where did you find your
information?
• How did you decide on
what content to include?
• How did you determine
the layout?

4. Purpose
Audience Genre
Situation

5. Health Literacy Facts
• US health care costs:
$106-$238 billion
annually1
• 12% of US population is
health literate1
• Vulnerable populations:
• Over 65 years old
• Non-white racial groups
• Less than high school
education
• Non-native English2

6. Health Literacy for Providers3
• Help people find info and services
• Communicate about health and healthcare
• Process what people are explicitly and implicitly asking
• Understand how to provide useful info and services
• Decide which info and services work best for different
situations and people so they can act

7. Purpose
• Content
• Clear Purpose
• Use Evidence-Based Guidelines
• Behavior Focus
• 1-2 main themes
• Specific examples of desired behavior
• Written Word
• Repeat Keywords/Key Concepts
Elements from the
Developing and
Assessing Nutrition
Education Handouts
(DANEH) Checklist

8. Clarifying Purpose4
Unclear Purpose
• This material will help you stay
healthy
Clear Purpose
• This material will help you
understand what prediabetes is and
how you can manage it with diet
and exercise.

9. Addressing Behavior4
Clear Purpose
• Start by doing at least 10 minutes
of physical activity at least 3 times a
week. For example, you could walk
the dog, take a walk at lunch, get
off the bus one stop early and walk,
or use the stairs instead of taking
the elevator
Unclear Purpose
• Engage in moderate exercise
regularly

10. Purpose Activity
In your patient education handout,
• How many themes did are addressed?
• How does it address behavior or social influences?
• What words or concepts are repeated?

11. Audience
• Content
• Promotes relevant health
issues for target audience
• Cultural Sensitivity
• Organization & Readability
• 5th grade reading level
• Written Word
• Simple, common words
• Positive messages
• Active, conversational tone

12. Audience-Tailored Messages
• Obesity in Adults
• Hispanic Americans: 78.8%
• African Americans: 76.7%
• Whites: 66.7%
• Asian Americans: 11.6%
NIDDK, 2012
Issues to Address
• Food Access (Desert)
• Cost
• Drug Access Differences
• Help Seeking Culture

13. Readability5
Clear
• Chronic diseases—those that go on
for a long time and often don’t go
away completely—are among the
most common and costly health
problems, and we often know how
to prevent them
Unclear
• Chronic diseases and conditions—
such as heart disease, stroke,
cancer, diabetes, obesity, and
arthritis—are among the most
common, costly, and preventable
of all health problems

14. How to Assess Readability
• CDC’s Everday Words for Public Health
Communication5
• Microsoft Word > Options > Spelling & Grammar >
Readability Statistics
• Flesch-Kincaid Grade Level

15. Audience Activity
In your patient education handout,
• What is the readability grade level?
Find 1-2 research articles about your audience and health
disparities or health literacy issues

16. Genre
• Organization and Readability
• Logical order, most important
message first
• Short paragraphs
• Space around headings & text
• Text blocks are left-justified
• Bullets, numbers, and tables
• Several informative headings
• Easy to read font
• Important text bolded or
underlined
• Purposeful and relevant images

17. Purposeful and Relevant Images
• People learn better6
• from words and pictures
• when printed words and graphics are placed near each
other
• when graphics and narration are presented simultaneously

18. Purposeful and Relevant Images
• Resources
• Public Health Image Library
http://phil.cdc.gov/phil/home.asp
• Creative Commons Search
https://search.creativecommons.org/
• Google Image (Advanced)

19. Genre Activity
In your patient education handout,
• Review structure of headings, paragraph length, font
• Review your image(s)
• What is the relationship between between the text and image?
• If you don’t have an image, search for an image to reinforce
your message for improved learning

20. References
1. Health Literacy. National Network of Libraries of Medicine website.
http://nnlm.gov/outreach/consumer/hlthlit.html#Prevalence_of_Low_Health_Literacy. Accessed February 19, 2016.
2. U.S. Department of Health and Human Services. National Action Plan to Improve Health Literacy.
http://health.gov/communication/hlactionplan/pdf/Health_Literacy_Action_Plan.pdf. Published 2010. Accessed
February 19, 2016.
3. Learn about Health Literacy. Center for Disease Control and Prevention website.
http://www.cdc.gov/healthliteracy/learn/. Last updated September 30, 2015. Accessed February 19, 2016.
4. The Patient Education Materials Assessment Tool (PEMAT) and Users Guide. Agency for Healthcare Research and Quality
website. http://www.ahrq.gov/sites/default/files/publications/files/pemat_guide.pdf. Last updated August 2014.
Accessed February 12, 2016.
5. Everyday Words for Public Health Communication. Center for Disease Control and Prevention website.
http://www.cdc.gov/other/pdf/everydaywordsforpublichealthcommunication_final_11-5-15.pdf. Posted October
2015. Accessed February 20, 2016.
6. Mayer R. Research-based principles for multimedia learning. Harvard Initiative for Learning and Teaching website.
http://hilt.harvard.edu/files/hilt/files/mayerslides.pdf. Posted May 5, 2014. Accessed February 15, 2016.