If health providers are aware of their patients' literacy skills, they can more appropriately tailor their communication with patients. Few providers, however, assess patient's literacy skills for fear of offending patients, but no research has ever determined if patients object to such assessments. Our objectives were to determine the percentage of patients seen for routine health care that would agree to undergo literacy assessment and if satisfaction of patients differs in practices that perform literacy assessments versus practices that do not. We randomized 20 private and public medical practices to an intervention group that implemented literacy assessments with the Newest Vital Sign and a control group that did not. For intervention practices, we noted the percentage of patients agreeing to undergo the assessment. For both intervention and control practices, we assessed patient satisfaction. Of 289 patients asked to undergo literacy assessment in the intervention practices, 284 (98.3%) agreed to do so, including 125 (46.1%) with low or possibly low literacy skills. There was no difference in satisfaction between the intervention group and the control group. We conclude that patients are willing to undergo literacy assessments during routine office visits and performing such assessments does not decrease patient satisfaction.

The Alzheimer's Respite Care Program is an innovative project designed to serve caregivers of Alzheimer's clients. This unique model offers both in-home and institutionally based respite care. Two community organizations which offer Adult Day Care respite forged a partnership to coordinate and expand their continuum of care, bringing many of the benefits of a day care setting into the home. This paper compares the original project conceptualization with its current design today. Factors affecting this evolution are explored together with program modifications incorporated to more appropriately respond to local needs. Key marketing strategies are discussed coupled with a presentation of program successes and recommendations for the future.

The Florida Clergy End-of-Life Education Enhancement Project was a model program developed to provide an interdenominational and statewide model of clergy education on loss, grief dying, and death. The authors describe the project including materials and curriculum as well as present data from the project's evaluation. Clergy and their partners in ministry responded enthusiastically to the project. As a whole, they reported higher levels of knowledge on end-of-life (EOL) issues at the conclusion of the training. Clergy and their ministerial teams also reported that they were better informed about the technical, procedural, medical, and legal issues that arise at the end of life and expressed the desire for subsequent training. The project indicates that clergy both recognize the need for additional training and are anxious to improve their abilities to minister to the dying and bereaved. The model presented here could easily be applied to local organizations such as hospices or denominational training.