Understanding and improving health literacy have become important goals in health communication. Research has shown that limited health literacy is associated with poor health outcomes and that it is more prevalent in culturally and linguistically diverse populations. The goals of this study are to describe English-speaking (ES) and Spanish-speaking (SS) diabetic patients’ perceptions of sources of health information, to identify the actions patients report taking in seeking that information, and to test reading comprehension of medical information among SS patients.

Data for this study were based on semi-structured interviews, life-story narratives, and a reading comprehension test with diabetic patients (43 native ES patients and 22 native SS patients with limited English proficiency) collected at a bilingual clinic and at an English-speaking clinic in the Midwestern United States (Indianapolis, Indiana). The results showed that the three approaches to the assessment of health literacy revealed disparities in access and use of sources of information as well as disparities in reading comprehension of health information. In view of the results, we argue that understanding and assessing health literacy, particularly in the case of ethnic minorities, requires complementary approaches of study. Emphasis should be placed on addressing the disparities SS patients face. Interventions should aim at maximizing the role of oral sources of information, training patients to use a wider variety of sources, and designing linguistically and culturally appropriate sources of health information for patients with limited English proficiency.

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