Impacting navigation of the health care system through health literacy intervention program- a pilot study with homeless families in transitional supportive housing

Homeless women with children in transitional housing programs are at risk for inadequate and inappropriate navigation of the health care system. Effective intervention programs to enhance navigational skills are needed to improve health outcomes and decrease health care costs. Health literacy has emerged as an essential yet complex component in impacting health outcomes. This descriptive study had two objectives: to pilot a health literacy based intervention program to impact navigational skills and to measure the residents' health care utilization before and after the intervention. Twenty-two women living in a Midwest urban transitional housing program participated. The quantitative study compared participants' reported health care usage at two points in time: one month before intervention program and three months after completion of intervention. Paasche-Orlow and Wolf's theoretical framework, Causal Pathways Linking Health Literacy to Health Outcomes, describes the cognitive and psychosocial health literacy skills which are necessary for successful health care navigation. The Health Literacy Study Circles+: Skills for Health Care Access and Navigation provided evidence-based curriculum for the intervention's design which focused on three health literacy skills: problem-solving; patient- provider communication; and self-care capacity. Descriptive analysis revealed a change in navigation skills toward more positive health behaviors. The pre/post intervention survey responses indicated an increase in participants' use of regular health care provider and a shift toward improved self-perception of personal health and satisfaction with health care provider. Study limitations include small sample size and brief pre/post time frame. Replication of research is needed to establish effectiveness.