In 2003, the U.S. Department of Education, National Center for Education Statistics completed the National Assessment of Adult Literacy (NAAL; Kutner, Greenberg, Jin, & Paulson, 2006). This was conducted with the goal of measur• ing the status of English adult literacy in the United States and for the first time included a specific section to measure health literacy. TI1e health literacy section focused on the ability to read, understand, and apply health-related information in English (White, 2008) and focused on health tasks that were grouped into clin i• cal, preventive, and navigation of the health system categories. As reported in the NAAL, many adults have difficulty functioning in the health care system due to a lack of health literacy skills. And according to the American Medical Association (AMA) report (Weiss, 2007) Health Literacy and Patient Safety: Help Patients Understand, "poor health literacy is a stronger predictor of a person's health status than age, income, employment status, education level and race:' Additional research has shown that even well-educated persons of all ages, races, and socio• economic levels can experience low health literacy as they are expected to take on more responsibility for prevention and self-management of chronic illness.