Urban Partnerships to Address Health Literacy in High Need Populations

  • Abiola Keller Marquette University
  • Amy Vuyk Curative Care Network, Milwaukee, Wl
  • Joshua Knox Marquette University
Keywords: HEAL program, health education, community-academic collaboration


Low health literacy disproportionately affects racial and ethnic minority communities and lower-income socioeconomic groups. To address this critical determinant of health inequity, two nonprofit organizations, Repairers of the Breach, a day shelter for individuals experiencing homelessness, and Bread of Healing a neighborhood-based clinic serving individuals with low incomes, partnered with researchers at Marquette University to implement and evaluate an evidence-supported health literacy program. The partnership delivered the curriculum in seven one-hour sessions over seven weeks. The program attendees were predominantly African American men and women from 19–73 years old. Most participants had formal education ranging from elementary school to some college. Forty individuals attended at least one class and 14 attendees completed 4 or more classes. Program completers demonstrated gains in confidence and topic knowledge. Most interviewees reported a personal/family need for the program, acceptability of the group format, and the ability to learn the skills they needed for self-care. The project used a successful collaboration between community-based organizations serving vulnerable populations and an urban academic institution to demonstrate the necessity, feasibility, acceptability, and effectiveness of formal health literacy education in adults with low incomes or who are experiencing homelessness. Urban and metropolitan serving institutions can work in partnership with community to address low health literacy in high need populations.

Author Biographies

Abiola Keller, Marquette University

Abiola O. Keller, PA-C, MPH, PhD is an Assistant Professor in the College of Nursing at Marquette University. Her research focuses on depression, medication adherence, and chronic disease self-management with particular interests in health disparities. In particular, her work emphasizes partnering with community agencies and using Community Engaged Research methodologies to address self and symptom management.

Abiola O. Keller
College of Nursing
Marquette University
Clark Hall 363
PO Box 1881
Milwaukee WI 53201-1881
Telephone: 414-288-8569
Email: Abiola.keller@marquette.edu

Amy Vuyk, Curative Care Network, Milwaukee, Wl

Amy Vuyk, MS, CCC-SLP is a pediatric speech language pathologist at Curative Care Network in Mílwaukee, Wl. Amy earned a B.S. in Education from the University of Wisconsin-Madison in 1993. She completed an MS in Speech and Language Pathology at Marquette University in 1995.

Amy Vuyk
Curative Care Network
Telephone: 414-526-8575
Email: amymaulbetsch@gmail.com

Joshua Knox, Marquette University

Joshua Knox, PA-C, MA is a Clinical Associate Professor in the Department of Physician Assistant Studies at Marquette Univerisity and Associate Director of the Marquette University Emergency Medicine Post-graduate Physician Assistant Program. His areas of clinical expertise and research interests include gastroenterology, hematology/oncology, emergency medicine, public health, and health literacy.

Joshua Knox
Department of Physician Assistant Studies
Marquette University
1700 West Wells Street
Milwaukee WI 53233
Telephone: 414-288-8483
Email: joshua.knox@marquette.edu


Arozullah, A. M., Yarnold, P. R., Bennett, C. L., Soltysik, R. C., Wolf, M. S., Ferreira, R. M., . . . Davis, T. (2007). Development and validation of a short-form, rapid estimate of adult literacy in medicine. Med Care, 45(11), 1026-1033. https://doi.org/10.1097/MLR.0b013e3180616c1b

Bekhet, A. K., Zauszniewski, J. A., & Matel-Anderson, D. M. (2012). Resourcefulness training intervention: assessing critical parameters from relocated older adults' perspectives. Issues Ment Health Nurs, 33(7), 430-435. https://doi.org/10.3109/01612840.2012.664802

Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J., & Crotty, K. (2011). Low health literacy and health outcomes: an updated systematic review. Ann Intern Med, 155(2), 97-107. https://doi.org/10.7326/0003-4819-155-2-201107190-00005

Centers for Disease Control and Prevention. (June 29, 2018). Health Literacy. Retrieved from https://www.cdc.gov/healthliteracy/gettraining.html

Centers for Disease Control and Prevention. (March 11, 2019). Program Performance and Evaluation Office (PPEO)-Program Evaluation. Retrieved from https://www.cdc.gov/eval/index.htm

Dennis, S., Williams, A., Taggart, J., Newall, A., Denney-Wilson, E., Zwar, N., . . . Harris, M. F. (2012). Which providers can bridge the health literacy gap in lifestyle risk factor modification education?: A systematic review and narrative synthesis. BMC Fam Pract, 13, 44. https://doi.org/10.1186/1471-2296-13-44

Griffey, R. T., Kennedy, S. K., D'Agostino McGowan, L., Goodman, M., & Kaphingst, K. A. (2014). Is low health literacy associated with increased emergency department utilization and recidivism? Acad Emerg Med, 21(10), 1109-1115. https://doi.org/10.1111/acem.12476

Kutner, M., Greenberg, E., Jin, Y., & Paulsen, C. (2006). The health literacy of America’s adults: Results from the 2003 National Assessment of Adult Literacy. Retrieved from http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483

Literacy for Life. (2016). About Literacy for Life. Retrieved from https://literacyforlife.org/about/

Literacy for Life. (2016). HEAL Program. Retrieved from https://literacyforlife.org/programs/

McDonald, J. H. (2014). Handbook of Biological Statistics (3rd ed. Vol. 2018). Baltimore, Maryland: Sparky House Publishing.

Mellor, J., & Uselton, E. (2016). HEAL Program Evaluation Report, 2014-2015. Retrieved from

Milwaukee Health Department. MKE Elevate: A community health improvement plan. Retrieved from https://city.milwaukee.gov/health/MKE-Elevate.htm#.W_NwSehKhPY

Office of Disease Prevention and Health Promotion. (2019). Health Communication and Health Information Technology. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/health-communication-and-health-information-technology/objectives

Ratzan, S., & Parker, R. (2000). Introduction. Retrieved from Bethesda, MD:

Taggart, J., Williams, A., Dennis, S., Newall, A., Shortus, T., Zwar, N., . . . Harris, M. F. (2012).

A systematic review of interventions in primary care to improve health literacy for chronic disease behavioral risk factors. BMC Fam Pract, 13, 49. https://doi.org/10.1186/1471-2296-13-49

U.S. Department of Health and Human Services. (2010). National action plan to improve health literacy. Retrieved from https://health.gov/communication/initiatives/health-literacy-action-plan.asp