Improving verbal communication for oncology patients who self-identify as having low/marginal health literacy.

177 Background: Within our academic oncology institute, patient’s health-related social needs (HRSN) are identified through the new patient intake questionnaire (NPIQ). 28% (n=2787) of patients who completed the NPIQ (n=9836) reported low/marginal health literacy (HL). While reviewing the HRSN data, it was discovered that there was no formal process to support patients who reported having low/marginal HL. While printed and online health materials use standard reading levels, verbal communications are not individualized to patients’ literacy needs. As an integral member of the interdisciplinary team, Oncology Nurse Navigators (ONNs) communicate vital and complex health information with patients throughout the cancer continuum. This quality improvement project explored the impact ONNs could have with patients who self-identify as having low/marginal HL. Methods: To assess ONN HL knowledge and communication strategies for patients with low/marginal HL, a survey was conducted in March 2024. Findings revealed a HL knowledge gap across all disease programs. For project manageability, our team piloted HL interventions to the sarcoma disease group where 33% of patients (n=223) responded to the NPIQ as having low/marginal HL. Two-part intervention included: 1) creation of a HL training and tools for ONNs (e.g., teach-back method; scripting; reference materials) and 2) development of Epic Smartphrase acknowledging training and tools were utilized. Results: To understand ONNs knowledge of where to find patient HL score in Epic, we conducted a survey (n=69; response rate=43%). 94% of ONNs reported not knowing where to access HL information. The first intervention was training-based. ONN trainings (n=2) were held from 3/12/2024 to 5/14/2024. At baseline, 0% of ONNs (n=4) used HL tools, as they were not in existence. At first reassessment, 75% of ONNs reported using the HL tools to communicate with patients. Part two of the intervention (in-progress) is the creation of a Smartphrase to document when ONNs altered patient communication. Data on Smartphrase usage are forthcoming. Conclusions: Providing HL training and tools to ONNs equips them to 1) identify patients who have low/marginal HL, and 2) conduct conversations with patients at an appropriate literacy level.