Abstract

Post-incarcerated men experience substantial barriers to healthcare access and low health literacy, leading to delayed diagnoses and poor outcomes for chronic conditions like hypertension, diabetes, and prostate issues. Incarceration often fails to provide needed health education for successful reentry. The purpose of this quality improvement project was to increase Northern California residential facility facilitators’ health literacy scores. The educational intervention was delivered in-person and via synchronous Zoom meetings. Materials included printed handouts, along with corresponding digital versions. The Health Literacy Survey 2019– 2021 12-item Questionnaire (HLS19-Q12), a validated 12-item measure of general health literacy, was administered pre-intervention and twice post-intervention. Qualitative questions were included in the final assessment. A one-way analysis of variance (ANOVA) with Bonferroni post-hoc tests was conducted. The ANOVA was significant, F(2) = 5.57, p = .009. The immediate post-test score (M = 35.3, s = 6.18, n = 9) was significantly different than the pretest score, (M = 23.7, s = 7.12, n = 10), p = .01. The 1-month post-test (M = 31.8, s = 9.5, n = 11) was not significantly different from the pre-test or the immediate post-test, p = .77 and .986, respectively, inferring that their levels of general health literacy increased and remained high a month later. The facilitators requested more information regarding medical, vision, and dental insurance. The education program was successful and will be used for future facilitator cohorts.

Author Details

Amanda Lee Ellis, DNP, MSN, BSN, RN - 13 years emergency department nurse

Sigma Membership

Non-member

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Mixed/Multi Method Research

Keywords:

Health Education, Prisoners, Recidivism, Health Literacy, Public Health

Advisor

Suzanne McWilliams

Second Advisor

Dawn Rivas

Third Advisor

Beth McManis

Degree

DNP

Degree Grantor

Northern Arizona University

Degree Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2026-05-21

Full Text of Presentation

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Available for download on Sunday, November 21, 2027

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