Nurse practitioners' knowledge, experience, and intention to use health literacy strategies in practice

Low health literacy is found in at least 90 million Americans and is related to poorer health outcomes across populations. The impact of low health literacy is significant in patient-provider encounters with effects on the entire health care delivery system. This study is an investigation of nurse practitioners' (NPs) knowledge, experience, and intention to use health literacy strategies in practice. A descriptive correlational design was used with the Theory of Planned Behavior as framework. NPs who work in an outpatient setting were recruited from the attendees at a national NP conference (n = 456). Participants were administered three self-report instruments: Health Literacy Knowledge and Experience Survey, Parts I and II, and the Health Literacy Strategies Behavioral Intention Questionnaire. Participant demographic data was also collected.;Overall knowledge of health literacy and health literacy strategies was found to be low in the sample of 456 NPs. NPs demonstrated knowledge about the consequences of low health literacy, as well as the need to provide literacy-appropriate patient education. Screening patients for low health literacy and evaluating patient education materials were found to be areas of knowledge deficit.;Experience with health literacy strategies revealed that most NP participants used written patient education materials with few participants evaluating the reading level of these materials. Alternate formats for patient education, such as audiotapes, videotapes, or computer software, were rarely incorporated.;The intention to use health literacy strategies in practice was found to be strong. Associations between demographics, knowledge, experience, and intention were explored. Statistically significant differences were found in mean experience scores between NP level of educational preparation and NP practice settings.;The findings of this investigation offer implications for enhancing NP curriculum and for continuing education opportunities. Increasing NPs' knowledge of health literacy and encouraging the use of health literacy strategies has the potential to guide clinical practice that will support improved patient outcomes.