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  1. Ennis, Katherine PT, DPT
  2. Hawthorne, Kelly PT, DPT, MPT, GCS
  3. Frownfelter, Donna PT, DPT, MA, CCS, RRT, FCCP


Background: Patient education is the physical therapist's key in guiding patients to a healthier future. When considering patient education, it is important to note that barriers such as limited health literacy can alter the effectiveness of teaching strategies. Health literacy is the ability to comprehend health information and use that information to make informed decisions about one's health and medical care, thus giving individuals the knowledge and skills to optimally function and navigate in the health care environment. While millions of Americans have marginalized literacy skills, older adults aged 65 years and older represent the largest group with compromised general literacy skills in the United States, which significantly contribute to limited health literacy skills. Limited health literacy can have negative consequences on health outcomes due to a lack of knowledge of healthy lifestyle choices, preventative services, disease etiology and management, being able to locate and access appropriate health care services, and carrying out self-care tasks. In addition, limited health literacy increases the risk of hospitalization, the overall cost of health care, and mortality rates.


Purpose: This article includes (1) the definition of health literacy, (2) the prevalence and consequences of limited health literacy, (3) signs of limited health literacy, (4) health literacy screening and assessment tools, (5) intervention strategies, and (6) implications for physical therapist education.


Methods: PubMed, MEDLINE, CINAHL, and EBSCOHost were searched for articles published from 1990 to 2010 with the descriptors: health literacy, older adults, patient education, functional health literacy, health literacy outcomes, health literacy assessment, and health literacy interventions.


Conclusion: Limited health literacy affects millions of Americans and plays a significant role in reduced health outcomes for patients. Through patient education and targeted intervention strategies, physical therapists can assist patients in overcoming limitations and enhancing the quality of their health and medical care.