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Public Policy and Administration


Gregory Dixon


Low health literacy is a problem the U.S. faces and, like health care itself, is a complex issue stemming from patient demographics and the healthcare providers being very diverse. Tools have been developed to mitigate the risks of low health literacy, however, without formal policy. The purpose of this qualitative case study was to explore and compare commonalities in health literacy best practices of organizations that are recognized as leaders in health literacy and are addressing low health literacy in their communities. By comparing the organizations' abilities to implement standards of plain language and health literacy tools/guidelines, best practice and policy recommendations could be made to various organizations regardless of level (local, state, federal, or nonprofit). The theoretical framework was based on the Evans and Stoddart framework of determinants of health and the health behavioral theories. The conceptual framework was based on health literacy best practices and policy. The research questions focused on how organizations implement health literacy tools/guidelines, the impact of health literacy best practices on policy development and addressing health literacy through formal policy. The qualitative multiple case study used open-ended interview questions via telephone conferencing, with 13 participants from health literacy organizations. The analysis was done by coding and bracketing the responses manually and with NVivo software. Results indicate that health literacy policy development and involvement exists but it is not derived from the health literacy best practices. The implications for positive social change for this study impacts the patient (individual), community, organization, and society through best practices and recommendations for policy development.