title: Health literacy in the "oral exchange": an important element of patient-provider communication.
abstract: OBJECTIVE
  Oral communication between health care providers and patients--the "oral exchange"--greatly impacts patient health outcomes; however, only recently have health literacy inquiries been incorporated into this field. This review examines the intersection between oral and aural literacy and the oral exchange.
  
  
  METHODS
  A systematic literature search was carried out. Papers published in English since 2003 that specifically examine oral/aural literacy and oral patient-provider communication were included.
  
  
  RESULTS
  The search yielded 999 articles, 12 of which were included in this review. Three tools have been developed to measure either patient or provider oral/aural literacy. There is a discrepancy between patient and provider oral/aural literacy levels, and high literacy demand is associated with reduced patient learning. Low patient oral/aural literacy is associated with poor health outcomes. Two interventions have been developed to reduce literacy demand.
  
  
  CONCLUSIONS
  This review demonstrates the critical role of oral and aural literacy in the oral exchange, the importance of reducing literacy demand, and the need for future research in this field.
  
  
  CONCLUSIONS
  Recommendations include the use of plain language and teach-back by providers, as well as incorporation of awareness of oral and aural literacy into community programs and health care provider education and training.
authors.affiliation: Harvard School of Public Health, Social and Behavioral Sciences, Boston, USA. Electronic address: ssn567@mail.harvard.edu.
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Nouri
authors.affiliation: Harvard School of Public Health, Social and Behavioral Sciences, Boston, USA.
authors.forename: Rima E
authors.initials: RE
authors.lastname: Rudd
mesh_terms: D003142:Communication; D032882:Comprehension; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D007802:Language; D011369:Professional-Patient Relations
keywords: Health communication; Health literacy; Oral and aural literacy; Oral exchange; Patient–provider communication; Speaking and listening skills