Major Assignment 2:  Health Literacy Assessment

Course Objectives:      #2, 5, 6

Course Evaluation:      100 points (25% of course grade)

Due Date:                    Week 4


  • Complete Week 4 content PRIOR to completing this assignment.
  • Review the assignment grading rubric (at the end of this document) before beginning work on this assignment.
  • Review assignment details (below) for guidelines/point allocations.
  • Explore Osborne Table of Contents for other chapters that might interest you.
  • Contact your instructor if you have any questions.

Submission Requirements:

  • Use your last name in the file title (Smith MA_2)
  • Save your paper as a single Word document to your desktop and then upload it to the assignment link located in the week 5 folder.  
  • Appropriate formatting
    • Elements of APA format to focus on for Major Assignments are:

12-point Times New Roman font

Double line spacing, except for instances in which you can appropriately convey the information with bullet points (single space those)

Title Page

Page numbers, upper right corner
Margins, 1 inch on all sides
Headings, use appropriate levels
In-text citations
Reference page

  • If your assignment requires interviewing an individual, this is considered personal communication and is listed as an in-text citation only.  You will not include the personal communication on the reference page.  Document the communication, in your paper, in question/answer format using numerals or bullet points.
    • Refer to Purdue Online Writing Lab for specifics on required formatting:

Assignment Part 1:  Institution Assessment (10%)

  • Research whether your institution creates their own health promotion and educational materials for patient education OR if these materials are provided by an outside source such as Krames or within the EHR such as Epic or Cerner.  Describe your findings.  Please specify which option you are writing about in your paper.

Option A:  If your institution creates their own educational materials, then contact and conduct a brief interview (telephone or email is acceptable) with a person in the department of your institution who creates and reviews health promotion and/or educational materials for patient education.  In this section of your paper, report in detail what you learned.  Ask the following questions and provide the interviewee’s responses in this section of your paper:

  1. Who (individuals or professional groups) has input into creating patient education (brochures, instructions for follow up care, or disease education) materials?
    1. health promotion and educational materials?
  • Who evaluates documents for health literacy reading levels and readability?
    • Is there a process for the review of existing health promotion and educational materials?

Option B:  If your institution uses educational materials provided by an outside source, find the person at your institution who can answer the following questions:

  1. What is the process for health promotion and educational materials?
  2. How does the outside source evaluate their documents for health literacy reading levels and readability?
  3. How often does the outside source update their materials?
  • After you have conducted the interview, describe what YOUR thoughts are regarding your institution’s process? 
    • Is the process adequate?  If not, what would you recommend to improve the process?

Option C:  If you are unable to find a person or department in your institution to complete either Option A or B, or you are not currently working in healthcare, then describe in detail the following:

  1. Based on your readings for this assignment, who could be responsible for writing and reviewing health promotion materials in an institution.
  2. Who would address the readability of the documents?  Describe in detail what the process would be.
  3. What are the benefits of assigning this responsibility to someone or a committee?
  4. What are the potential difficulties that arise if no one addresses readability of documents and health literacy of clients?
  5. Who should be responsible for assessing individual patient’s health literacy (not the documents) when they are admitted to the hospital?

Option C is not an alternative for lack of preparation or running behind with the assignment.  It is meant to substitute if you truly cannot identify a person or department that creates and reviews educational materials for your institution.

Assignment Part 2: Assess an adult for health literacy using a literacy assessment tool (20%)

  • Choose an adult who is NOT a health professional.  In your description of your interviewee, include the person’s age, educational level, career, family life, etc.  Consider interviewing an elderly person, or someone from a different culture.
  • Read Osborne (pages 11-12) for a discussion of health literacy assessment instruments.  Many of the instruments Osborne mentions are copyright protected or require a fee for use.  For this reason, you will use ONE of the three tools below. Included you will find a tool for use in Spanish speaking people if that suits your needs.  Use one of the following tools:
    • Rapid Estimate of Adult Literacy in Medicine—Short Form (REALM-SF)
    • Short Assessment of Health Literacy – SAHL – English, Spanish
    • Short Assessment of Health Literacy for Spanish Adults (SAHLSA-50)
      • The 3 tools listed above are located at

    • NVS – Newest Vital Sign Tool/Test
  • Use one of the above tools to conduct an assessment test of your selected client’s literacy level.
  • Answer the following questions:
    • Describe the tool you used to assess your client’s reading level and discuss why you chose that tool.
    • What are the results of the health literacy assessment?  Describe in detail.
    • What are the possible drawbacks to the assessment tool you chose?  Did you complete any additional assessment considering this information?
    • Describe the level of comfort in your health literacy assessment for your interviewee and yourself.  Reflect on what might be some sources of discomfort in assessing people for their health literacy. 
    • What did you learn overall from this activity of assessing health literacy?

Part 3: Assess a document for health literacy principles (30%)

  • Choose a patient HEALTH PROMOTION education pamphlet or document in use in your health care setting. If you are not currently working in healthcare, find a document online about a health promotion topic that interests you. These should not be scholarly journal articles.  Try to select a document that you suspect lacks some of the principles of health literacy to make your assignment experience richer and more detailed.  Be sure to identify the pamphlet you are using for this portion of the assignment.  

  • Utilize the SMOG or FRY grade level assessment tool (  or ) to determine readability level of your document.  Describe the process and the results.

  • Assess the document for design appropriateness (Osborne, Ch. 9) and for plain language (Osborne, Ch.28) and other concepts outlined in those chapters relative to health literacy.  Please look at the multiple aspects considered with design and plain language in the chapters.  Also, please discuss design appropriateness and plain language aspects in separate paragraphs and identify the chapter for each of them.  It should be clear that you understand which aspects are considered design and which aspects are considered plain language.

  • Select one additional Osborne chapter & assess how your document meets or does not meet suggestions for health literacy outlined in that chapter.  Again, please specify the chapter and put this information in a separate paragraph.

Part 4: Implementation & Evaluation Ideas (30%)

  • Reflect on your experience using a new paragraph for each of the following:
    • Have you used the health promotion/education document you assessed in your nursing practice? 
    • If you are not currently in practice, do you think this document would be useful in practice?  why?
    • What were your impressions and experiences using the document prior to the assessment? 
    • Did you believe the document was appropriate and easy to understand?
    • Has your viewpoint changed? If so, how?
  • Explain what changes you believe are needed to make the document more useful to patients. 
    • What specifically would you recommend?
    • Select another additional chapter from the Osborne text (your choice) to use in your analysis of your new ideas. (Include reference to specific chapter). 
  • Summarize your experiences and/or plans to include evaluation of patient understanding of health education as a routine aspect of your nursing practice.

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