School of Public Health

Health Literacy Lab

What is the Health Literacy Lab?

Health Literacy Month.jpegHoused in the UNTHSC School of Public Health, we are an interprofessional team of health literacy experts dedicated to improving individual and population health by making health information easy to understand and use. We provide education and services to individuals and organizations who use or communicate health information for themselves, patients, and the public. Evidence-based best practices inform all that we do at UNTHSC’s Health Literacy Lab.

Our lab leader, Dr. Teresa Wagner is an associate professor in the School of Public Health and the School of Health Professions at the University of North Texas Health Science Center. She currently oversees the UNTHSC State Certified Community Health Worker Training Center. Her award-winning research focuses on alleviating health disparities in underserved communities through health literacy.

Dr. Wagner completed her doctoral residency in Health Literacy and the Institute for Healthcare Advancement health literacy certificate program. She’s recognized on state, national, and international levels for her work as a health literacy expert. She’s a registered and licensed dietitian with a doctorate in public health, certified in Public Health, Patient Safety, Lifestyle Medicine, Health Coaching, and as a Community Health Worker Instructor.

Our Mission:

To create, provide, and sustain health literacy education and initiatives in the region to ensure people can access, understand, and use health information by developing current and future healthcare and health literacy workforce.

What do we do?

  • Invest in improved health literacy to help create solutions for healthier communities.
  • Conduct high-quality, innovative funded research, education, and training across multiple disciplines to inform our work, and prepare a future health-literate workforce.
  • Dedicate effort towards health equity and improved outcomes, with an emphasis especially on marginalized and rural communities through health literacy.
  • Build community relationships through outreach and service learning partnering on organizational health literate materials, information, assessment, and programs.
  • Execute collaboration and the integration of public health, population health, medicine, and health equity into consultancy projects.
  • Drive the development & mentorship of the current and future healthcare and health literacy workforce.

What is Health Literacy?

Healthy People 2030 includes two types of health literacy:

Personal health literacy is the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

Organizational health literacy is the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

The HP2030 definitions:

  • Emphasize people’s ability to use health information rather than just understand it.
  • Focus on the ability to make “well-informed” decisions rather than “appropriate” ones.
  • Incorporate a public health perspective.
  • Acknowledge that organizations have a responsibility to address health literacy.

Why is Health Literacy Important?

Having good health literacy skills can help people read, understand, remember, and use information to make decisions about their health. Being health literate also means you can follow your healthcare provider’s treatment or preventive health instructions.  People with low health literacy understand less about their medical conditions and treatments and report a lower health status and quality of life overall. They also are less likely to use preventive care services and have higher rates of hospitalization.

Our Collaborative Work

Organizational Health Literacy – Innovate to Communicate
Our toolkit and various projects demonstrate how healthcare organizations can pursue organizational health literacy (OHL) to make things easier for patients by improving communication and helping patients find their way around, become engaged in their healthcare, and manage their health.

Howe, C.J., Adame, T., Lewis, B., & Wagner, T. (2020). Assessing Organizational Focus on Health Literacy in Hospitals in North Texas. American Journal of Nursing, 120(12), 24-33. Assessing_Organizational_Focus.26.aspx

Wagner, T., Ramirez, C., & Godoy, B. (2021). Covid-19 Rural Health Inequities: Insights from a Real-World Scenario. Journal of Communication in Healthcare.

Wagner, T. & Howe, C. (2019). Addressing Systemic Health Literacy Issues & Patient Safety through a Grassroots Collaborative. Journal of Consumer Health on the Internet. 23(1), 62-69.

Health Literate, Age-Friendly EMS
This project culminated from several years empowering MedStar to reliably provide the four evidence–based elements of high–quality, known as the “4Ms,”to all older adult’s care through their health system practices improving the care (satisfaction & outcomes) provided to meet the needs of older adults.

Wagner, T., Carlson, E., Ebbett, D. & McEntire, L. (2022). Cover Story: Improving EMS Dementia Literacy. EMS World.

Taylor, K. & Wagner, T. (2022). Age Friendly Emergency Medicine Services: Integrating What Matters, Medications, Mobility, and Mentation into Emergency Response. Alzheimer’s & Dementia, 18(59), 1552-1559.

Taylor, K., Partain, D., McEntire, L., & Wagner, T. (2022). Age Friendly Emergency Medicine Services. EMS World.

Digital and Personal Health Literacy
Our digital and personal literacy projects and programs help individuals find, evaluate, and use information and includes digital media platforms which involves a combination of technical and cognitive abilities.

Wagner, T., Blevins, D., Lopez, J. & Liu, J. (2018). Health literacy for an aging population: Evaluating online tools for the homebound over age 65. Journal of Consumer Health on the Internet, 22(4), 371-381.

Wagner, T., Lindstat, C., Jeon, Y. & Mackert, M. (2016). Implantable medical device website efficacy in informing consumers weighing benefits/risks of healthcare options. Journal of Health Communication, 21, 121-126.

Wagner, T. (2019) Incorporating Health Literacy into English as a Second Language Classes.
Journal of Health Literacy and Practice, 3(3), S37-S41.

WebLit Legit
WebLitLegit is a toolkit that helps people recognize science-based information from opinion, identify credible sources, question why the information is being presented, and analyze if it sounds too good to be true.

Wagner, T., Adame, T., Lewis, B., & Howe, C.J. (2022). Is your WebLitLegit? Discerning credible health information on the internet. Journal of Health Literacy and Practice.

What About Mom?
An innovative, easy-to-use app for new mothers and their families to identify possible warning signs and symptoms after birth that might need immediate attention.

Wagner, T., Stark, M. & Raines-Milenkov, A. (2020). What About Mom? Health Literacy and Maternal Mortality. Journal of Consumer Health on the Internet, 24(1), 50-61.

Wagner, T., Thompson, E., Gadson, A., Stark, M., Bush, K. & Raines-Milenkov, A. Postpartum Education and Health Literacy: New Mom’s Perspectives. (2020). Journal of Consumer Health on the Internet. 24(4), 346-35.

Cassidy Faught III, Carol Howe, Amy Raines-Milenkov & Teresa Wagner. (2022). What About Mom? Teen: Usability of a Postpartum App for Teen Mothers, Journal of Consumer Health on the Internet, 26:3, 283-292. DOI:

Being health literate will:

Help you find healthcare and use health services.
Help you seek and do preventive care for yourself.
Allow you to make your own decisions about your health and healthcare.
Help you understand how to improve your health, and
Allow you to be more comfortable talking to your healthcare providers.

Preferred By Nine Out Of Ten

The Agency for Healthcare Research & Quality states, “9 out of 10 Americans may lack the knowledge and skills needed to manage their health and prevent disease.”

Low health literacy is estimated to cost the U.S. economy up to $236 billion every year.
– Vernon, J., et al. (2007). Health Literacy: Implications for National Health Policy. University of Connecticut.

Health Information Resources

Organizational Health Literacy Toolkit

Health Literacy Toolkit​

The toolkit includes:

A lesson plan
Power point presentation
Demonstration videos
Role-play scenarios
A Kahoot game
Communication observation forms
Self-learning modules
A participant and trainer evaluation

Click on the underlined words below to access the resources!

Innovate to Communicate Lesson Plan

Use this lesson plan for a 90-minute workshop. You can also break up the lesson plan into parts for shorter sessions.

Innovate to Communicate Power Point

Use the PowerPoint to guide you through the Innovate to Communicate Workshop. All aspects of the workshop are embedded within the PowerPoint e.g. videos and role play scenarios.

Adult Medicine Review Video

Participants watch and learn aspects of a medicine review.

Adult Medicine Review Role Play Scenario

Participants practice teaching about medicines using these role playing scenarios .

Pediatric Teach Back Video

Participants watch and learn how to use simple language, chunk information, and check for comprehension using teach back

Pediatric Teach Back Role Play Scenario

Participants practice using simple language, chunking information, and checking for comprehension with these teach back role playing scenarios.

AHRQ Health Literacy Universal Precautions Communication Tools

Participants can use the self-assessment form and observation form during the role play scenarios to introduce quality improvement tools into health literacy initiatives.

Innovate to Communicate Kahoot Game

Use the Kahoot Game to reinforce lessons learned

Evaluation of Innovate to Communicate

Please use these evaluation forms at the end of the Innovate to Communicate Workshop. There are two evaluations: 1) trainer evaluation and 2) attendee evaluation