On break-up cliches guiding health literacy's future.

With the recognized need to increase health literacy, some practices have not worked and, therefore, "should be dumped." Herein we present alternative approaches that may increase health literacy.

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Is this the beginning ... or is this the end?

According to the U.S. Department of Health and Human Services, low health literacy is associated with poor health, higher hospitalization rates, less use of preventive medicine, and higher health care costs (U.S. Department of Health and Human Services 2009b). Unfortunately, the National Assessment of Adult Literacy suggests that only 12% of U.S. adults have "proficient" health literacy. This low level of literacy indicates that health care professionals need to break away from traditional communication methods that are based on the assumption that consumers are actively and rationally processing information and will fully integrate that information in their future decisions.

The pragmatic directive is to move beyond documenting consumer frailties, and turn to theory-based research designed to create health care systems which maximize consumer health literacy. This agenda must incorporate the communicators (the health care professionals, the insurance providers, the lawyers' requirements, the government regulators, the Courts, the bench scientists), the receivers of information, and the context in which the information is generated.

To this end, we present observations that use common life experiences as the framework for progress. Perhaps, we erroneously assume that most readers have experience with the romantic break-up, but we will forgo some of our own advice, reasoning that most of us have at least second-hand experience with these cliches. Undoubtedly, cliches become cliches because of the underlying element of truth. These common tales of break-up in life and popular culture provide a basis to explain the value of a new approach.

"IT'S NOT YOU; IT'S ME"