Prevention/Care Management, 2008

American Medical Association/AMA Foundation

March 2008

The American Medical Association (AMA) and the AMA Foundation used AHRQ's Evidence Report No. 87, Literacy and Health Outcomes, to develop an updated curriculum for the AMA's Health Literacy Train-the-Trainer Program. The program trains teams of physicians to recognize and respond to limited health literacy in their practices with an eye toward building a nationwide force of trainers who, in turn, pass their skills on to other trainers.

Joanne Schwartzberg, MD, Director of Aging and Community Health at AMA and a leading authority on health literacy, says that "the [evidence] report was the seminal work that led to the health literacy interventions that we are now including in our training."

Following the release of the Literacy and Health Outcomes Evidence Report, Schwartzberg noted that an increased number of investigators began targeted research on health literacy interventions. This led to a significant increase in the number of publications on health literacy interventions, particularly relating to chronic conditions such as congestive heart failure and diabetes. "I don't think this would have happened without the AHRQ report. It was the groundwork around which many other positive developments came about," Schwartzberg emphasizes.

Early indications suggest that AMA's updated train-the-trainer program is leading to positive changes in behavior throughout physicians' offices. For example, in a follow-up questionnaire completed by program participants, more than 70 percent reported having made changes within 4 to 10 months after taking part in the program. These changes in their clinical practice were aimed at reducing problems related to health literacy.

"In terms of Rogers' Diffusion of Innovation theory," Schwartzberg explains, "We're now at the point where we're moving from the early adopters of these health literacy interventions to the early majority. We started with 11 teams. Now we have 29 trained teams around the country who have trained approximately 30,000 others in health literacy, including physicians from major organizations such as Kaiser Permanente, Aetna, United HealthCare, the American College of Physicians, and the National Patient Safety Foundation, among others."

In addition, the impact of AHRQ's evidence-based report has also reached academic institutions. Based in part on the scientific foundation from AHRQ's report, the AMA Foundation's curricular materials have now been incorporated in approximately 10 medical school educational programs.

Impact Case Study Identifier: COE 08-05
AHRQ Product: Evidence Report
Topic(s): Health Literacy, Value-based Health Care
Scope: National

Literacy and Health Outcomes, Summary. Evidence Report/Technology: No. 87. January 2004. AHRQ Publication No. 04-E007-2: Agency for Healthcare Research and Quality Rockville, MD. http://www.ahrq.gov/clinic/tp/littp.htm

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