Health literacy has traditionally been defined as the “ability of the individual to access, understand, and use health-related information and services to make appropriate health decisions” (U.S. Department of Health and Human Services, 2000, p. 11-9). To successfully perform and incorporate skills and behaviors recommended by health care providers, clients must be able to understand written, pictorial, and verbal communications to navigate the complex health system and make health-promoting choices. Research has shown, however, that people with limited health literacy—especially those with chronic conditions such as diabetes—have inadequate knowledge of illness prevention and management and lower self-reported health status (Baker, Parker, Williams, & Clark, 1998; Baker et al., 2002). National and international assessments of adults’ ability to use health information suggest an incongruence between people’s skills and the demands of health systems. Nearly half of all Americans, or 90 million people, have difficulty understanding and...

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