Brief Report| Volume 19, ISSUE 2, 104454, February 2023

Implementing a Single-Item Health Literacy Tool for Spanish Speakers

Published:November 10, 2022DOI:


      • Health literacy is a key metric to improve patient health outcomes.
      • Limited English proficiency among primarily Spanish-speaking patients compounds health literacy concerns.
      • The administration of a Spanish single-item literacy tool and the documentation of literacy level is feasible within a primary care clinic visit.
      • The use of the Spanish single-item literacy tool increased the recognition and coding of limited health literacy in the electronic medical record.


      Health literacy assessment among individuals with limited English proficiency can serve as an important metric to improve health outcomes. A quality improvement project was conducted at a community health center in the Southeastern United States for the purpose of assessing the feasibility of integrating a Spanish single-item literacy screening tool into a clinic visit to assess health literacy among Spanish-speaking patient populations. The tool was administered by clinic staff, and the results were documented by providers through diagnostic coding. It was found that a Spanish single-item literacy screening tool can identify individuals with limited health literacy and increase documentation of this factor as a social determinant of health in the electronic medical record.


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      Margarita M. Marmolejo, DNP, FNP-C, is a nurse practitioner at St. Joseph/Candler, Good Samaritan Clinic in Garden City, GA (project location) and Hampton Roads Community Health Center in Portsmouth, VA (current affiliation). She can be contacted at [email protected]


      Laura P. Kimble, PhD, FNP-C, is a clinical professor and assistant dean for clinical advancement at Emory University School of Nursing in Atlanta, GA.


      Caroline Coburn, DNP, ANP-BC is an associate professor at Emory University School of Nursing.


      Nidsa Baker, DNP, ANP-BC, is a nurse practitioner with St. Joseph/Candler, Good Samaritan Clinic.