Introduction: Low health literacy is a significant barrier to chronic disease management and patient safety, leading to poor medication adherence and increased adverse events. These issues are particularly pronounced among people experiencing homelessness, who face disproportionate challenges with uncontrolled hypertension. This study evaluates whether a structured, low-resource counseling tool can improve hypertension health literacy and self-efficacy in this high-risk population. Methods: A pre-test and post-test design was used with twelve adult male residents of the Union Gospel Mission (UGM) Calvert men's shelter in Dallas. Each participant received a one-on-one session using the P.L.A.N. (Problem, Life Impact, Actions, Need for Help) framework, designed to facilitate simple, patient-centered dialogue. Surveys assessing objective hypertension knowledge and subjective self-confidence were completed directly before and after the intervention. The post-survey also measured satisfaction with the tool through dichotomous and open-ended questions. Paired t-tests were used to analyze changes in scores. Results: Use of the P.L.A.N. tool led to significant gains in both domains. Mean knowledge scores increased from 66% to 89.3% (p = 0.0001). Mean confidence scores improved from 65% to 83% (p = 0.0047). Qualitative feedback was unanimously positive with 100% of participants indicating they would reuse the worksheet and that it enhanced their understanding and empowerment. All data was collected at the Dallas UGM Calvert shelter and the sample size was twelve. Conclusions: In conclusion, the P.L.A.N. tool is a promising, resource-efficient intervention for improving health literacy and patient-centered outcomes in underserved populations, directly addressing safety risks linked to low literacy rates. Despite limitations of sample size and single-site design, these results support further research in larger, diverse settings and with longitudinal tracking of clinical outcomes, including sustained medication adherence and blood pressure control. This framework offers a replicable, practical method for empowering vulnerable patients and enhancing patient safety.
Kanna et al. (Tue,) studied this question.