Evaluation of the "Literacy Gap in Health Among Target Population (LIGHT)" in Inner Sydney General Practices

Project Short Title
LiGHT Evaluation

Project Number

Project Status

Chief Investigators
Mark Harris

Other investigators
Dr Jane Lloyd, Chandni Joshi, Dr Nighat Faruqi

Project coordinator
Chandni Joshi


Health literacy may be understood from two perspectives; as a health asset which patients need to develop in order to have an active role in their health care, or as a risk factor for health professionals to manage through more effective communication and methods such as ‘teach-back’. Health literacy may be defined as ‘The degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions’. Health literacy has been directly and indirectly linked to poorer health outcomes, whether this may be from poor understanding of health information (verbal and written), or from the relationship between low health literacy and other socio-economic determinants of health. Low health literacy is associated with less engagement in healthy lifestyles and with poorer knowledge about chronic disease and limited self-management skills.The 2006 Adult Literacy and Life Skills Survey found that 60% of Australians had low health literacy. This percentage was found to be higher among those from low socioeconomic backgrounds. The LIGHT project specifically targets patients with low health literacy, which often correlates with social disadvantage. Through improving health literacy levels, patients will be able to make more informed lifestyle choices, and will have the tools to better access the health services which they require. 

Research questions

1.         What is the impact of LIGHT on the quality of preventive care received by patients in primary health care, including referral to appropriate services?

2.         What is the impact of LIGHT on changes in behavioral and physiological risk factors of patients attending these practices?

Design and methods

Design and methods

Training of GPs,practice nurses and allied health professionals on communication techniques for patients with low health literacy.

Training on care navigation and implementation of 5As framework for practice nurses and allied health professionals.

Patient screening for low health literacy

GP and practice nurse survey at baseline and six months follow up to determine knowledge, skills, confidence and stated use of preventive guidelines, assessment and tailored management and referral

Practice assessment survey at baseline and follow up

Telephone interviews of low health literacy patients on risk factors for chronic diseases and risk behaviours, referral and attendance for lifestyle modification services and their communication with their primary health care providers.

Social network analysis to determine the referral patterns of GPs, practice nurses and allied health professionals to lifestyle modification services.