Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Teaching and Leadership


Sandra D. Lane


Adult Education, Health Literacy, Marginalized Patients, Patient-Provider Communication

Subject Categories



This qualitative study, which takes place in a free medical clinic for low-income and uninsured patients, addresses the patients' health literacy and access to health information inside and outside of the clinic setting, as well as the strategies clinic providers use to effectively communicate health information. This study is based on participant observation in an urban clinic in the Northeast, interviews of 22 patients and 20 health-care providers, and direct observation of the patient/provider communication in nine instances. In the clinic, the providers serve as educators for vulnerable, stressed patients, who are adult learners. The patients were interviewed in order to understand their health education needs, their comprehension of the health information that they received at the clinic, and their access to health information outside of the clinic. The providers, who were volunteers at the clinic, were interviewed to understand their strategies to effectively communicate with their patients. This study, therefore, provides insights into how adults learn in nonformal educational settings and what strategies appear to be effective to communicate with people who are marginalized and stressed.


Open Access

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