Creating a novel digital intervention to bridge the organizational and personal health literacy gap by teaching the way patients learn: a process and application study

Low literacy is on the rise in the USA and is one of the independent predictors of poor health outcomes. While much written health information is now adapted to lower reading levels, more needs to be done to address the gap between material content and target consumers comprehension ability which often is more complex than simple reading level adjustments. This paper describes the process of developing a culturally, context and literacy-aligned intervention that promotes and supports preventive lifestyle behaviors among low-income Latino women (Latinas). Focus group discussions and key-informant interviews were conducted to identify needs, barriers and beliefs of low-income Latinas regarding obesity, healthy eating and physical activity. A simple literacy-aligned, culturally-appropriate and socio-economically acceptable (LACASA) framework and intervention were then created through an academic-community partnership: medical professionals and students, community health workers and researchers. The curriculum - which included minimal and easy-to-read written material and power point presentations - was piloted and revised before being launched. The resulting lifestyle curriculum for high-risk low-income Latinas was well-received and was a good fit for the priority population. Creating a program using the LACASA approach requires an interdisciplinary team to invest time working with key members of the priority population and a commitment to adjusting materials to the groups literacy level and its cultural and economic realities. Programs created to serve low-income individuals with limited literacy cannot rely on pre-created curricula. Instead, these must be re-evaluated and adjusted to address both content core principles and specific contexts of the priority population.