Faculty Scholarly Dissemination Grants


Effectiveness of the Teach Back method in improving health literacy in a primary care practice


Allied Health Sciences


College of Health Professions


Medicine and Health Sciences


Background/Research Question Both the 2009 and 2012 Community Health Needs Assessment for Muskegon, Oceana, and Newaygo Counties, MI identified low levels of health literacy as an underlying issue experienced among all residents, regardless of income. Both community residents and health care providers identified health literacy as a barrier, specifically noting a general lack of understanding of risk and benefit for medical options and the inability of the public to make informed decisions regarding their care. As a result of the 2009 report, a multi-faceted intervention grounded in the principles of community-based action research was developed to combat the low levels of health literacy experienced by the residents of Muskegon County. Methods Phase I of the research arm of the intervention was a comprehensive assessment of a primary care office that functions under the Patient-Centered Medical Home model, utilizing a series of assessments to identify potential barriers in provider-patient communication. Due to wide discrepancies observed among all office personnel, from front desk staff to discharge personnel, the Teach Back method was adopted by the practice in Phase II of the intervention. Approximately 10% of the practice population (n=865), 18 years of age or older, regardless of gender, race/ethnicity, or income, were surveyed using a researcher-developed survey, March-May 2013. The 13 question survey was developed based on a comprehensive literature review of both health literacy and the Teach Back method. Respondents were asked to answer the questions on a Likert scale never, sometimes, usually, always, and not applicable. Utilizing Health Literacy Champions, the Teach Back method was implemented in the practice starting in June 2013 with a post-intervention survey being completed 6 months post implementation; the same 13 question survey was given to approximately 10% of the practice population (n=806). Pre-post survey differences were analyzed via a chi-square test with significant set at the 0.05 level. Results Post-intervention survey respondents were more likely to state that they were always asked if they understood the health/medical condition being described (57.5% vs. 62.9%, p-value=0.002); always asked to describe follow-up instructions (43.5% vs. 51.1%, p-value=0.000); always asked to repeat back in their own words information or instructions they were given (15.5% vs. 24.7%, p-value=0.000); always asked if they would have any problems doing what was needed to take care of their illness/health condition (52.4% vs. 61.5%, p-value=0.000); and always felt that the provider understood any difficulties they might have in following the treatment plan (60.7 vs. 69.6%, p-value=0.000) when compared with pre-intervention survey respondents. Conclusions/Implications Phase II of this intervention demonstrated that the Teach Back method was effective in increasing patient s understanding of their illness. The research also demonstrated the ability to implement the Teach Back method in a provider practice that sees over 10,000 patients a year. The responses indicate a greater understanding of risk and benefit for medical options and a greater ability of the patient s to make informed decisions regarding their care. Plans are currently underway to implement the Teach Back method in all practices in Muskegon County, MI.

Conference Name

6th Annual Health Literacy Research Conference

Conference Location

Bethesda, Maryland

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