Esteem HealthCHW Certification Training
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Module 3: CHW SkillsLesson 3.1 · 8 sections · ~30 min

Health Education Skills

Learning Objectives
  • Define health literacy and explain why it matters for making good health choices.
  • Describe the three ways CHWs teach health: simpler words, teach-back, and Ask Me 3.
  • List California's legal requirements for hospitals and health plans to offer language support.
  • Identify best practices for linguistically accessible healthcare for diverse communities.
  • Recall strategies to improve health literacy among patients.

Teaching is core CHW work

One of the main responsibilities of CHWs is teaching people about taking care of their health. Sometimes it's hard to understand what's going on when you're sick — and going to the doctor can be confusing.

CHWs help bridge the gap between what providers say and what patients actually understand. This lesson explores strategies for teaching patients about health, using good communication, and making sure everyone understands — no matter what language they speak or culture they're from.

What health literacy means

The World Health Organization (WHO) says health education is about giving people chances to learn how to be healthy. It's not just giving information — it's helping people feel motivated and confident to take care of their own health.

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Health Literacy
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How well someone can find, understand, and use information to make choices about their health. It helps people stay healthy and manage illnesses.
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Note
Even people who are great at reading and research can struggle with health information — especially when dealing with a new diagnosis or multiple conditions. Literacy and health literacy aren't the same thing.

The role of CHWs in health education

CHWs help patients stay healthy by guiding them toward good habits, helping them understand their medical conditions, and making sure they can communicate effectively with their healthcare team. CHWs provide resources, pass on advice from medical professionals, and coach patients on effective communication with providers.

Three core methods

Three approaches CHWs use to develop health education competencies:

  • Simplifying language
  • The teach-back method
  • Ask Me 3™

The three methods

Simplify your language — Instead of… / Use…

Benign
Not cancer
Lesion
Wound or sore
Oral
By mouth
Avoid
Stay away from
Hazardous
Not safe
Adequate
Enough
An exact amount
"Drink 6 glasses of water each day"
Routinely
Exact times: every day, every other day, once a week
Intake
What you eat or drink
Risk
Chances
Reflection Prompts

How did the patient's understanding of his condition change after using the Ask Me 3 questions?

What's one situation in your life — your own healthcare, or someone you care for — where these three questions could help?

Tip
Whichever method you use, follow up with patients after their appointment. Did they get their questions answered? If they're still uncertain, troubleshoot how to communicate better next time. That's where most of the value of CHW health education actually happens.
Knowledge Check

A CHW finishes explaining a medication schedule and wants to confirm the patient understood. Using the teach-back method, what should the CHW do?

AAsk the patient, "Does that make sense?" and move on if they nod.
BAsk the patient to explain, in their own words, what they need to do.
CHand the patient a printed handout and ask them to read it later.
DQuiz the patient with rapid yes-or-no questions to test their memory.
Knowledge Check — Matching

Match each Ask Me 3™ question to the patient need it helps address.

Terms
What is my main problem?
What do I need to do?
Why is it important for me to do this?
Definitions
Understanding the reason and motivation behind the plan.
Understanding the diagnosis or health issue.
Knowing the concrete next steps or treatment.

Culturally and linguistically appropriate care

CHWs and providers must effectively help people from all different cultures and languages. This includes practicing cultural competence and cultural humility. Two core ideas to keep in mind:

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Cultural Competency
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Knowing how to work and communicate well with people from different cultures. Involves awareness, knowledge, and skills needed to succeed in cross-cultural situations.
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When it comes to health education, cultural competence means making an effort to learn how different cultures might affect healthcare decisions. This helps you communicate in ways that fit the patient's culture and what they want.

Linguistically appropriate care — 3 best practices

To enhance the effectiveness of healthcare services for community members from diverse linguistic backgrounds, CHWs play a crucial role in ensuring that care is linguistically accessible and inclusive. By doing so, CHWs can significantly elevate patient understanding, trust, and engagement, leading to more effective healthcare outcomes.

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Use Professional Translators
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Facilitate accurate and sensitive communication. Avoid relying on patients' family members to prevent misunderstandings and privacy breaches.
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What California requires

In California, hospitals and health plans are legally required to help patients who don't speak English well. They must:

  1. Have a translator available — in person or over the phone.
  2. Provide important written materials in the main languages their members speak, including: a handbook explaining benefits; notices about changes to or end of coverage; and information on how to file complaints or request changes.
Note
Knowing this law is one of the simplest ways to advocate for a non-English-speaking patient. They have the right to a professional translator. They have the right to materials in their language. Help them know that — and help them use it.

Other tips of the trade

Countless ways exist for CHWs to support health literacy. Some strategies:

  • Use a health literacy questionnaire to understand the patient's perception of their literacy and experiences.
  • Follow up after appointments — ask if they need help understanding what their doctor said.
  • Ask how they prefer to receive information (written, spoken, visual diagrams, video demos) and provide it that way.
  • Encourage patients to take notes or check off key information during discussions.
  • Advise patients to write down concerns and list medications before appointments, bring a trusted companion, and ask pharmacists when something is unclear.

Resources to know

  • TRAIN Learning Network — A national network providing no-cost training for public health workers. Topics: Health Literacy and Public Health Professionals, Writing for the Public, Speaking with the Public, Creating Easier-to-Understand Lists/Charts/Graphs, Fundamentals of Communicating Health Risks, Using Numbers and Explaining Risk, and Effective Communication for Healthcare Teams. (train.org)
  • National Center for Cultural Competence (NCCC) — Georgetown University. Helps healthcare and mental healthcare programs serve culturally and linguistically diverse populations so everyone gets quality care and equal chances at health. (nccc.georgetown.edu)
  • CDC Spanish-language site — The CDC website is available in Spanish. (cdc.gov/spanish)
Knowledge Check — Select all that apply

Under California law, what are hospitals and health plans required to provide for patients with limited English? Select all that apply.

A translator available in person or over the phone.
A handbook explaining benefits in the languages members speak.
Notices about changes to or the end of coverage in the member's language.
A requirement that patients bring their own family member to interpret.
Knowledge Check

Which statement best captures what health literacy actually measures?

AHow intelligent or well-educated a patient is overall.
BWhether the healthcare system communicates in a way the patient can find, understand, and use.
CHow many years of schooling the patient completed.
DWhether the patient can read at a college reading level.
Lesson Takeaways

🌟 Lesson takeaways

Health literacy isn't about how smart someone is — it's about whether the healthcare system communicates in a way they can use. CHWs help people gain the skills, knowledge, and confidence to take control of their health using three core methods: simplifying language, teach-back, and Ask Me 3™. Add cultural competence and humility — plus patients' legal right to professional translators and materials in their language — and you have the toolkit. Listen carefully, use interpreters when needed, and follow up after appointments.

🎉Great work!
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Coming up

At the end of this module, you'll join a live discussion with your cohort and an instructor. We'll see you there.