Providers’ Perspectives on Patient Health Literacy in the Rural Deep South



Health Literacy, Primary Care, Rural, Social networks, Healthcare advocates, Health providers


Introduction: Alabama is a largely rural state and is ranked 48th in health outcomes among all states in 2020. Although health literacy is essential to improve patient outcomes, health literacy assessments are not routinely incorporated into the medical setting. The purpose of this study is to explore perspectives on health literacy from primary care providers in the rural deep South and the use of health literacy assessments.  These assessments help providers evaluate their understanding of their patients’ literacy levels and their adapting methods to foster the best health outcomes for their patients.

Participants: The study population consisted of twelve healthcare professionals serving patients from five rural communities in Alabama. These healthcare professionals included eight (67%) physicians and four (33%) nurse practitioners.

Results: Many providers in this study reported not having a formal method of assessing patients’ health literacy status. Instead, most used their judgment or surrogate methods (e.g., reading office brochures) to determine patients’ ability to perceive the information presented to them and use it to manage their health.

Conclusions: Healthcare providers must consider assessing health literacy simply and uniformly. For example, using newer health literacy measures that are valid and easy to use could provide helpful information about patients’ ability to comprehend and use health information. Additionally, social support networks and/or health care advocates should be considered as an intervention to address health illiteracy.

Keywords: Health literacy; Primary Care; Rural; Social networks; Healthcare Advocates; Health Providers


Author Biographies

  • JoAnn S. Oliver, PhD, RN, CNE, FAAN, The University of Alabama

    Professor, Capstone College of Nursing

  • Rebecca S. Allen, PhD, ABPP, The University of Alabama

    Professor and Director-Alabama Research Institute on Aging, Department of Psychology, College of Arts and Sciences

  • Brittney T. Anderson, MD , Anderson Family Care –Demopolis, AL

    Primary care physician

  • Richard V. Crowley, BS, MBA, The University of South Carolina School of Medicine - Greenville

    Medical student at University of South Carolina.

  • G. Sujitha Peramsetty, BS, Saint Louis University School of Medicine, St. Louis, MO

    Medical Student at Saint Louis University School of Medicine.

  • Pamela Payne-Foster, MD, MPH, The University of Alabama

    Professor of Community and Rural Medicine and Institute for Rural Health Research