Special Emphasis Notice (SEN): AHRQ Announces Interest in Research on Improving Organizational Health Literacy to Prevent and Manage Chronic Disease

Notice Number: NOT-HS-20-009

Key Dates
Release Date: April 10, 2020

Related Announcements

Issued by
Agency for Healthcare Research and Quality (http://www.ahrq.gov)


Sixty percent of adults in the United States have a chronic condition, such as diabetes, hypertension, or depression, and 40 percent have multiple chronic conditions. In addition, many adults are at risk of developing chronic conditions. People with limited health literacy a third of U.S. adults are at particularly high risk of poor health outcomes from chronic conditions. Organizations frequently address health literacy, a social determinant of health, with targeted interventions. Many, however, have not systematically implemented organizational health literacy strategies. Organizational health literacy is the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and their communities. Examples of organizational health literacy strategies include: training staff at all levels and evaluating their health literacy skills, instituting policies and processes to implement evidence-based approaches such as the Teach-Back Method to confirm patient understanding, and systematically testing written materials with target audiences.

This Special Emphasis Notice (SEN) highlights AHRQ’s interest in receiving applications focusing on primary and other ambulatory care settings that: 1) test approaches to integrating organizational health literacy strategies that make it easier for people, especially those with limited health literacy, to take action to prevent and manage their chronic conditions, including diabetes, and 2) spread and scale previously tested organizational health literacy strategies to settings that serve a high proportion of patients with limited health literacy, and/or socioeconomically disadvantaged people.

AHRQ is interested in applications that address:

  • Which approaches for implementing organizational health literacy strategies, and in which ambulatory settings, are effective in improving prevention and management of chronic diseases for diverse people with limited health literacy
  • How healthcare organizations can best adopt, adapt, implement, and scale and spread health literacy strategies to improve prevention and management of diabetes and other chronic diseases for people with limited health literacy

AHRQ recognizes that health literacy is dynamic and that even people who usually have adequate health literacy face challenges in understanding and navigating the health system, especially when they are sick, tired, or worried. AHRQ therefore seeks applications that integrate health literacy universal precautions (e.g., conducting brown bag medicine reviews with all patients) into organizational operations.

AHRQ is especially interested in studying the effect of the implementation of organizational health literacy strategies on persons with or at risk of chronic conditions, particularly diabetes, with respect to:

  • Reducing racial, ethnic, language, and health literacy disparities
  • People who receive care from safety net providers
  • Meeting the needs of people with multiple chronic conditions
  • Improving healthcare quality (e.g., reducing diagnostic errors), health behaviors (e.g., adherence), patient experiences (e.g., engagement in shared decision-making, ease of communication), service utilization, health outcomes, and health-related quality of life
  • Costs and benefits to organizations and patients

Overall, AHRQ is interested in applications aimed at preventing and managing chronic diseases among people with limited health literacy that study either the integration of organizational health literacy strategies into organizational operations, or the spread and scale of organizational health literacy within and across organizations.

Further Guidance
AHRQ will use standing program announcements for the R01, R03, R18 funding mechanisms to support this research. The funding opportunity announcements for the referenced funding mechanisms can be found at: https://grants.nih.gov/grants/guide/pa-files/PA-18-795.html; https://grants.nih.gov/grants/guide/pa-files/PA-18-794.html; https://grants.nih.gov/grants/guide/pa-files/PA-18-793.html. AHRQ also is interested in supporting the career development of health literacy researchers though our standing K-award grant mechanisms, which are found at https://grants.nih.gov/grants/guide/pa-files/PA-20-067.html and https://grants.nih.gov/grants/guide/pa-files/PA-17-232.html. Applicants should clearly state in the Cover Letter, Project Summary (abstract), and Specific Aims sections of the grant application that they are responding to this particular SEN. Applications responding to this SEN should be submitted on regular application receipt dates and will be reviewed by AHRQ’s standing study sections.


Please direct all inquiries to:

Maya Gerstein
Agency for Healthcare Research and Quality
Center for Evidence and Practice Improvement
Email: Maya.Gerstein@ahrq.hhs.gov