Research-based Health Literacy Materials and Instruction Guide

This resource provides research-based health literacy materials and instruction guide.

S. R. Levy
S. Rasher
M. Berbaum
L. Bercovitz
J. Mandemach
R. Garreton
Author(s) Organizational Affiliation
National Institute of Child Health and Human Development, Office of Vocational and Adult Education, National Institute for Literacy
Publication Year
Resource Type
Informational Material
Target Audience

These Health Literacy Materials were developed for an adult literacy research study and experimentally tested using a randomized design. While the complete results have not yet been formally published, there were some important findings, which showed that the materials were effective at both improving literacy skills and health knowledge. Because of the current lack of formally published data and statistical analysis, we have reviewed these as instructional materials and not research.

The materials, adapted for beginning ABE and ESOL levels, include 18 sections with topics such as Talking to Health Professionals, Filling Out Medical History Forms, and Following Directions and Dosages for Medications. The teachers guide includes materials for each section with activities and handouts to work on Basic Skills and Vocabulary, Reading Comprehension, ESL Activities and Supplemental Activities.

These instructional materials meet both the need of adults to enhance their literacy skills as well as their need to better navigate the health care system and begin to achieve better health care for themselves and their families. They integrate literacy skills and practice with pertinent health information.  This type of work helps to support a significant public health need given the potential for higher annual healthcare costs and lower long-term health outcomes for adults with lower literacy skills.


In a scientifically-based research environment, use of these materials led to increased

participants’ literacy scores on standardized tests used to validate literacy gains. Equally as important for these adult learners, using these instructional materials significantly increased health literacy and knowledge. The study experimentally tested and worked with 1,946 adults in Illinois programs over a period of 5 years. The National Institute for Literacy, its LINCS Region III Resource Center, and Meg Schofield have expanded and enhanced the usability of the materials for the instructor and learner, created an Instruction Guide to further assist adult educators, and made the free dissemination of this work possible

Required Training


What the experts say

Although the full-scale filed implementation results for the efficacy study of these materials appears to be still unavailable, many health literacy advocates are familiar with Susan Levy’s work and have seen her present on these materials. These materials have great potential for use in improving health literacy among the adults with whom it can and will be used.

Partial results were reported in an article published in Issue 9B of Focus on Basics (2008), which describes the research design and results in some detail. Please see:
Health Literacy Curriculum Works for ABE Students  (P. 33.)

This article indicates that as many as 50 sites in Illinois are using or have used these materials and that important outcomes including gains in health knowledge, behaviors, and beliefs were realized. Also, the literacy gains for students using the health literacy instructional materials were equal or greater than the gains made by the control group, which was given a similarly designed literacy curriculum without the health component. Thus, these materials have been shown, through randomized experimental design, to improve both health knowledge and literacy and language acquisition. This is important for teachers who fear that addressing health in their literacy programs may “take away” from the competencies that their students must gain. Another important finding was that the lowest levels of ABE and ESL instruction improved more in their health knowledge than the other groups. This shows that addressing health with the lower levels of learners can be effective.

If possible, the complete research outcomes should be analyzed and published. It would add strength to the findings and possibly uncover more information.