Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Elizabeth Tovar

Clinical Mentor

Dr. Cynthia Cooke

Committee Member

Dr. Lynne Jensen

Committee Member

Dr. Jo Singleton


Purpose: The purpose of this study is to assess health literacy knowledge and practices among ambulatory care providers who care for patients with type 2 diabetes.

Methods: Healthcare professionals who provide diabetes care and education were invited to participate in a health literacy education session with a pre and post-intervention knowledge survey. A retrospective chart review was conducted to evaluate health literacy practices in three PCP and three endocrinology offices. An evaluation of health literacy practices was used to compare PCP and endocrinology practices and determine if health literacy practices correlated to controlled hemoglobin a1c values.

Results: Healthcare professionals are knowledgeable of health literacy. Gaps in knowledge were identified through the pre and post-intervention surveys. It was also identified that endocrinology offices were more likely to provide verbal or written education, but had fewer patients with controlled hemoglobin a1c levels compared to primary care offices. The retrospective chart review revealed that healthcare providers are not assessing patient education preference and are not using formal health literacy tools.

Conclusions: Healthcare professionals are knowledgeable about health literacy, and verbalized appreciation and the value they found in the health literacy education provided. It was also identified that health literacy is currently not being evaluated by health care professionals in primary care and endocrinology offices in a large healthcare system. Since there is little evidence to support improved outcomes when literacy is assessed use of formal tools to assess health literacy is not recommended. Instead, the recommendation is for all ambulatory staff to be educated about health literacy and to adopt universal health literacy precautions.