Health & Science Literacy

The topic of Health and Science Literacy has become increasingly important in recent years, as biomedical and scientific fields have advanced to include such promises as “personalized medicine” or more targeted treatments for complicated diseases. 

The Georgetown University CERSI convened an Interest Group in Health and Science Literacy to critically examine the issues relevant to health and science literacy, especially with relationship to issues of minority health and health disparities.

Among other activities, the Interest Group conducted a needs assessment and developed a framework for high-priority research and education.

The Interest Group has defined the following regulatory science questions as areas of unmet need in health and science literacy research:

  1. How and how well are health care providers and patients informed and educated about risks and benefits of medical products?
  2. How do patients/providers obtain and use information about the risks and benefits of medical products? Which methods are most effective, and which sources do patients/providers trust?
  3. What is the role of social media as a trusted source of information about medical products?
  4. What is the relationship of health literacy proficiency to health outcomes?
  5. What is the impact of low health literacy on research participants involved in clinical trials?
  6. What communication strategies effectively reach and convey information to underrepresented populations about risks and benefits of medical products? How are those messages crafted? 

The Interest Group awarded two pilot research projects to address some of these questions. In addition to questions of health and science literacy, the pilot projects focused on underrepresented patient populations (i.e., racial or ethnic subgroups, or those from low socioeconomic status, low education, non-English or non-native English speaking, or children).

Results from these research efforts will be presented at a public CERSI-sponsored event in 2015. Date and location are to be determined.


The Georgetown University Interest Group in Health and Science Literacy compiled a bibliography of scientific literature or relevant reports.

Due to the timeliness and rigor and in approach of relevant published systematic reviews, we did not reproduce these efforts. Together these sources include studies that address the questions outlined above as well as other issues identified by the Interest Group as relevant for study, such as: 1) the relationship of literacy proficiency to health outcomes; 2) the impact of low literacy on research participants involved in clinical trials; and 3) the role of social media as a source of health information.

A separate search was conducted to identify specific sources of information examining use of and attitudes about generic drugs among minority groups.

The bibliography is organized into the following categories:

  • Systematic Reviews 
  • U.S. Federal Agency Reports
  • Articles about the impact of FDA communication strategies
  • Articles examining attitudes among minority groups about generic drugs
Systematic Reviews
  1. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Viera A, Crotty K, Holland A, Brasure M, Lohr KN, Harden E, Tant E, Wallace I, Viswanathan M. 2011. Health Literacy Interventions and Outcomes: An Updated Systematic Review. Agency for Healthcare Research and Quality Evidence Report Technology Assessment No. 199. Rockville, MD.
  2. Sheridan SL, Halpern DJ, Viera AJ, Berkman ND, Donahue KE, and Crotty K. 2011. Interventions for Individuals with Low Health Literacy: A Systematic Review. Journal of Health Communication: International Perspectives. 16:sup3, 30-54.
  3. Keller DL, Wright J, Pace HA. 2008. Impact of health literacy on health outcomes in ambulatory care patients: A systematic review. The Annals of Pharmacotherapy. Vol. 42, 1272-1281.
  4. Shrank W, Avorn J, Rolon C, and Shekelle P. 2007. Medication Safety: Effect of Content and Format of Prescription Drug Labels on Readability, Understanding, and Medication Use: A Systematic Review. The Annals of Pharmacotherapy. Vol. 41, 783-801.
  5. Zorn M, Allen MP, Horowitz AM. 2004. Understanding Health Literacy and Its Barriers. Current Bibliographies in Medicine 2004-1. National Library of Medicine. Bethesda, MD.
  6. Morris LA and Halperin JA. 1979. Effects of written drug information on patient knowledge and compliance: A literature review. American Journal of Public Health. Vol. 69, No. 1, 47-52.
U.S. Federal Agency Reports
  1. HHS. 2010. National Action Plan to Improve Health Literacy. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Washington, DC.
  2. HHS. 2013. The National Culturally and Linguistically Appropriate Service (CLAS) Standards in Health and Health Care. Washington, DC.
  3. FDA. 2009. Strategic Plan for Risk Communication. U.S. Department of Health and Human Services, Food and Drug Administration.
Articles Examining Results of FDA Communication Strategies
  1. Taylor R, Lemtouni S, Weiss K, Pergolizzi JV. 2012. Pain management in the elderly: An FDA safe use initiative expert panel’s view on preventable harm associated with NSAID therapy. Current Gerontology and Geriatrics Research. Vol. 2012, 9 pages.
  2. Wolf MS, Davis TC, Shrank WH, Neuberger M. 2006. A critical review of FDA-approved medication guides. Patient Education and Counseling. Vol. 62, 316-322.
Articles Examining Attitudes About Generic Drugs Among Minority Groups
  1. Omojasola A, Gor B, Jones L. 2013. Perceptions of generic drug discount programs among low-income women: A qualitative study. Women’s Health Issues. Vol. 23, No. 1, e55-e60.
  2. Omojasola A, Hernandez M, Sansgiry S, Jones L. 2012. Perception of generic prescription drugs and utilization of generic drug discount programs. Ethnic and Disease. Vol. 22, No. 4, 479-485.
  3. Sewell K, Andreae S, Luke E, Safford MM. 2012. Perceptions of and barriers to use of generic medications in a rural African American population, Alabama, 2011. Preventing Chronic Disease. Vol. 9, 1-8.
  4. Hassali MAA, Shafie AA, Jamshed S, Ibrahim MIM, Awaisu A. 2009. Consumers’ views on generic medicines: A review of the literature. International Journal of Pharmacy Practice. Vol. 17, 79-88.
  5. Huang ES, Brown SES, Thakur N, Carlisle L, Foley E, Ewigman B, Meltzer DO. 2009. Racial/ethnic differences in concerns about current and future medications among patients with Type 2 Diabetes. Diabetes Care. Vol. 32, No. 2, 311-316.
  6. Shrank WH, Cadarette SM, Cox E, Fischer MA, Mehta J, Brookhard AM, Avorn J, Choudhry NK. 2009. Is there a relationship between patient beliefs or communication about generic drugs and medication utilization? Medical Care. Vol. 47, No. 3, 319-325.
  7. Shrank WH, Cox E, Fischer MA, Mehta J, Choudhry NK. 2009. Patients’ perceptions of generic medications. Health Affairs. Vol. 28, No. 2, 546-556.
  8. Turner BJ, Hollenbeak C, Weiner MG, Have TT, Roberts C. 2009. Barriers to adherence and hypertension control in a racially diverse representative sample of elderly primary care patients. Pharmacoepidemiology and Drug Safety. Vol. 18, 672-681.
  9. Iosifescu A, Halm EA, McGinn T, Siu AL, Federman AD. 2008. Beliefs about generic drugs among elderly adults in hospital-based primary care practices. Patient Education and Counseling. Vol. 73, 377-383.
  10. Valles JA, Barreiro M, Cereza G, Ferro JJ, Martinez MJ, Escriba JM, Iglesias B, Cucurull E, Barcelo E, Generic Drug Study Group. 2003. A prospective multicenter study of the effect of patient education on acceptability of generic prescribing in general practice. Health Policy. Vol. 65, 269-275.