Provider Trainings to Improve Health Literacy

This approach focuses on training healthcare professionals to increase their skills, with the overall goal of improving organizational health literacy. Provider trainings build organizational health literacy by supporting healthcare professionals in learning clear communication strategies and incorporating these techniques into patient care. Two promising strategies that rural communities are using include the train-the-trainer approach and incorporating cultural competency.

Train-the-Trainer Approach

Train-the-trainer is an approach to training leaders and subject matter experts in specific concepts and skills, so they can then effectively train others in the organization or community to use those concepts and skills.

Programs that use a train-the-trainer approach to increase organizational health literacy can customize trainings so that they support health literacy awareness among staff. Trainings can also be developed to help create organizational goals and initiatives around health literacy. Having organizational goals tied to health literacy is a key attribute of a health literate organization. Incorporating universal precautions techniques, such as increasing understanding for all patients regardless of their health literacy level, into train-the-trainer approaches may enhance both personal and organizational health literacy.

Cultural Competency Workforce Training

This training approach seeks to build the cultural competency skills of healthcare providers. Cultural competency in healthcare means that an organization or healthcare setting acknowledges people's values, beliefs, and behaviors and adapts healthcare services and communication to meet cultural and linguistic needs. Using culturally competent approaches can improve how an individual understands health information, cares for individual and family health, and makes decisions. Culturally competent care is foundational for reducing health disparities and improving health equity.

When interacting with rural populations, it is important to consider the role of cultural and ethnic customs. Learning the patients' needs and being respectful of their cultural background can aid in decision-making and overall treatment plans. This may include gathering an understanding of a patient's health beliefs, health customs, ethnic and religious beliefs, and dietary customs.

For more information about integrating cultural competency into rural programs, see the Rural Services Integration Toolkit and for additional rural program examples that incorporate cultural competency, see the Rural Monitor and Rural Project Examples: Culture and cultural competency.

Examples of Programs Using Provider Trainings to Improve Organizational Health Literacy

• Western New York healthcare organizations are participating in the Health Literacy Call to Action Health Literacy Trainer program funded by the Health Foundation for Western and Central New York. Virtual training sessions are designed to offer resources and materials that can be customized to meet an organization's needs.
• Messengers for Health strives to improve the health and well-being of rural residents living on the Crow Indian Reservation and other areas in Montana. By incorporating the cultural strengths of the community and heritage, they work to improve the health literacy of tribal community members living within this region.
• REACH Healthcare Foundation works in rural communities to address health disparities by improving health coverage and access to care. One REACH-funded project involved developing a framework to increase cultural competency in Kansas. Results highlight the importance of rural culture as it relates to seeking, accessing, and providing effective healthcare. Findings suggest that characteristics of rural culture should be considered when implementing programs to improve cultural competency and ultimately healthcare access.
• St. Charles Madras is a Critical Access Hospital in Jefferson County, Oregon, that is implementing workforce trainings to improve cultural competency of its staff. With funding from the Oregon Office of Rural Health, they created a project to get patient feedback on how to improve cultural competency in care and are using this feedback to design workforce training in the hospital.
• The North Dakota Rural Health Association, the University of North Dakota (UND) Center for Rural Health, and the UND Department of Family and Community Medicine developed a health literacy project for health profession students and resident physicians called the Targeted Rural Health Education (TRHE) Project. Through TRHE, health professionals learn how to write a plain-language article with public health data that is understandable for rural communities and can be published in a rural newspaper. The program is also featured in Rural Health Models & Innovations.

Program Clearinghouse Examples

• Doña Ana County Health and Human Services is developing a health literacy curriculum for community health workers, which includes a module that uses a train-the-trainer approach.

Implementation Considerations

Provider trainings are focused on improving health literacy at the organizational level, improving communication between providers and their patients, and utilizing culturally competent strategies to improve overall health outcomes for all patients. Trainings can also help build relationships within the community between healthcare professionals and patients.

Implementing cultural competency training for healthcare providers and other staff in organizations involves careful attention to resources for ongoing training and reflection. There is an increasing number of resources that organizations can use to train their workforce on cultural competency principles, including National Standards for Culturally and Linguistically Appropriate Services (CLAS).

Organizations should consider the potential need and importance of hiring and retaining staff that share cultural values and speak the same language as community members. Providing language-concordant services and translation services can help engage community members in their care. For example, employing translators from the community and ensuring that translation services are available for all patient visits are also essential. Organizations may consider partnering with other organizations to share translation services in areas where these resources are harder to find.

Resources to Learn More

Address Language Differences
Document
An excerpt from the Health Literacy Universal Precautions Toolkit providing activities that address language and sensory differences among patients in healthcare settings who need language assistance services such as translators and written material in preferred languages.
Organization(s): Agency for Healthcare Research and Quality (AHRQ)
Date: 9/2020

Cultural Sensitivity and Health Literacy: A Provider's Guide to Offering Culturally and Linguistically Sensitive Care
Document
Offers tips and strategies to help healthcare providers and their organizations become culturally competent and linguistically sensitive when caring for patients of diverse cultural beliefs and practices and/or with limited health literacy and other communication needs.
Organization(s): Superior Health Plan
Date: 2019

Culture and Communication
Website
Offers trainings from a variety of sources for healthcare providers, public health professionals, and health profession students on the provision of culturally and linguistically appropriate services for diverse populations to improve health equity.
Organization(s): Centers for Disease Control and Prevention (CDC)

Culture, Language, and Health Literacy
Website
Provides resources supporting effective health communication to help healthcare providers acknowledge and address the health literacy, language, and culture of diverse populations and communities.
Organization(s): Health Resources and Services Administration (HRSA)

Principles of Community Engagement
Document
Provides public health professionals, healthcare providers, researchers, and community-based leaders a science-based practical guide for developing a community engagement plan that works collaboratively with the community and other groups on public health projects.
Organization(s): National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC)
Date: 6/2011