RESEARCH ARTICLE The health literate health

Full list of author information is available at the end of the articleBackground The issue of health literacy has gained increased attention ever since the U.S. Department of Education issued a re-port in 1993 that showed a significant portion of the coun-try’s adult population may have too limited literacy skills to comprehend written information needed for dealing with daily activities including health care [1]. Early research on health literacy included the development of instruments to adequately assess individuals ’ health literacy level [2,3], analyses of the effects of low health literacy on disease knowledge, health behaviors, and other health outcomes [4], and interventions to mitigate those adverse effects e.g. [4,5]. By and large, research suggests that improving indi-vidual health literacy may not only produce better health outcomes [6,7] but also decrease health care costs [8-10], thereby saving resources to improve health at a population level. Recently, efforts have shifted to develop short and group-specific instruments to assess health literacy [11-14