Medication Literacy of Refugee and Spanish Speaking Populations in Salt Lake County, Utah: An Initial Assessment



The purpose of this study was to assess the health literacy rate in Spanish speaking and refugee patients at the University of Utah Health Redwood Clinic. The patient’s health literacy rate was assessed by surveying patients as they picked up prescriptions at the pharmacy within the clinic. With the results, are able to generate solutions to better the communication between provider and patients, improve adherence in patients who are non-English speakers, and improve patient understanding of healthcare and medications. In addition, the results of this study will provide more data to help physicians and health care providers understand that health literacy rates need to be addressed. This study will be a stepping-stone for more reviews to come in Salt Lake City, Utah area addressing the health literacy rates in Spanish-speaking and refugee patient communities. It can illustrate ways to close that gap and help providers improve communication with patients. As a result, patients may go home with less confusion and feel more informed about their medications, their follow up, and any paperwork received upon discharge or leaving the clinic.


Our study design is a descriptive study that assesses the health literacy of Spanish-speaking and refugee patients using data from a validated survey provided to them. The name of the survey is called BRIEF Survey for Health Literacy. We will provide data on these specific patients that can be looked at and compared to national studies or statewide studies. The study surveyed both English and non-English speaking patients. The plan was to collect 100 surveys, but only 41 surveys were completed. The patient survey focused on a participant’s ability to answer specific questions that will help determine their health literacy rate. The factors associated with the outcomes include the patients’ ability to understand what the question is asking, being able to read, and their self-confidence.


Out of the 41 surveys, 16 surveys of them classified in the marginal category and 15 fell in the inadequate category. More than half of the patients were below the adequate category of health literacy. Only 24 % of patients fell in the adequate category meaning 10 out of the 41 patients are confident that they understand written directions whether it is for follow-up appointments, medication instructions, or discharge instructions.


Even though there were 41 surveys collected, this is not a large sample size to generalize the health literacy of all non-English speaking patients within the Redwood clinic. It does give us a small glimpse that most of the people that took these surveys health literacy is not adequate and may need help. We concluded that most of the non-English speaking patients at the Redwood clinic fall in the marginal and inadequate categories, meaning more needs to be done so the translation between health care workers and patients is not lost. 

Published in College of Pharmacy, Virtual Poster Session Spring 2020


  1. Very interesting study, Josh. It is interesting that nearly 80% of those you surveyed had either inadequate or marginal health literacy. It is definitely important to ensure that our patients have an adequate understanding of their health and the care they receive. I feel that this is especially true for pharmacy, where even small misunderstandings can have large negative effects. I was also impressed at how many languages you encountered in the surveys you did. I know the sample size may not be adequate to determine a difference, but did you notice if there were differences in health literacy between the different languages you saw, or was it pretty uniform across all languages?

    1. Hey Spencer, great question. Yea I wish our sample size was bigger to have given me a better understanding and to give you a better answer to your question. For the most part just from the data I collected it was pretty uniform across all languages.

  2. Nice to see the results of your project, Josh! What was something you learned while working on your project that you think will help you in your future career?

    1. Hi Dr. Witt! Something that I can take away from this project to my career is to understand the population that I will be working with and make sure that they understand their medications and discharge instructions. Even though they may have been living in the states for years they may have not gotten far in their education and may have trouble understanding what is verbalized or given in writing to them.

  3. Josh, congratulations on a fine project and poster. What important insight you can provide Redwood Clinic based on these results. While I imagined there would be some challenges to health literacy, I don’t think I imagined that such a vast majority of the patients would be of low/moderate literacy. Does the facility already have translators and materials printed in other languages? If so, do you think all of the issue is simply a language issue, or could there be other issues, such as cultural reluctance to ask questions, that might also affect overall health literacy?

    1. The biggest insight I can provide them is to make sure that patients understand the material they are going home with, teach-back method would be great. Maybe with a larger sample size, we could have seen more people in the adequate category. Redwood Clinic does have translators in person and via an IPad, so there are resources that can be used, but I guess the follow-up question to that is how often are these resources being used and is time a factor for them not being used as often. I think up to a point there is some cultural reluctance to ask questions but a lot of times these patients do not know what to ask or are embarrassed to ask for something to be repeated. I feel like the embarrassment to ask for someone to repeat something is just human nature, and is just across the board not taking into consideration people’s nationalities.

  4. Great poster! I was curious to know if you had discussed with your mentor other potential interventions, besides translators and language-specific materials, to help these patients with their health literacy?

    1. No we did not, we feel like having translators works well enough because most people will understand verbal instructions than written ones but I think it just comes down to time and if translators are being used properly.

  5. Hi Josh, interesting project! What do you think are other limitations in our health that need to be addressed to ensure that this patient population is adequately informed of their health conditions, medications, etc.?

    1. I feel like time is the biggest limitation, because providers have like 30 minutes spots to see a patient and that is not enough time to thoroughly go through everything if a patients first language is not English. Most of these patients do not have a high education level so unless they are willing to learn to read and write then I feel like verbal communication with translators is the best. I feel like also having family members in the room may be helpful for patients.

  6. This is a really important finding. Great project.

  7. Hi Josh – so nice that you are highlighting a topic that is so prevalent in our state. It is an issue that deserves much attention, so thank you for addressing this issue and hopefully there will be some strategic ways to help these patients in order to improve their different health issues and overall quality of life.

    1. Thank You! I hope it is a stepping stone for other projects. Also just to remind providers and health care workers that the language barrier and health literacy are factors to think about when helping our patients.

Comments are closed.