Health Literacy and Communication in Stroke Prevention, Management, and Recovery: A Scientific Statement From the American Heart Association

Health literacy is a critical component of high-quality stroke care. Across the continuum from prevention through recovery, health literacy is strongly associated with functional outcomes and stroke-related morbidity. Despite its importance, it is often overlooked, leaving patients and caregivers overwhelmed by communication demands that exceed their capacity. These mismatches are especially pronounced among individuals with stroke-related cognitive or language impairments, limited English proficiency, socioeconomic disadvantage, or limited digital literacy. This scientific statement synthesizes current evidence on the role of health literacy and communication within stroke systems of care and identifies nurse-led opportunities to advance equity and patient-centered outcomes while recognizing this as a shared interprofessional responsibility. Nurse-led interventions, including teach-back-based education, dyadic psychoeducational programs, and tailored digital support, have demonstrated improvements in stroke knowledge, self-efficacy, quality of life, and caregiver preparedness. However, the literature is marked by methodological heterogeneity. Many studies are underpowered and infrequently use validated health literacy or communication measures. Future directions include standardized assessment of health literacy; literacy-sensitive, nurse-led, and interprofessional care models; workforce training in plain-language and culturally responsive communication; and organizational health literacy principles. Emerging technologies, including telehealth and artificial intelligence, offer promise for improving communication and personalization but require rigorous evaluation to minimize bias and ensure equity and usability.