Arnold School of Public Health investigators in collaboration with community and clinical partners were funded by The Duke Endowment grant #6816-SP. This focus of this grant was to understand clinic readiness for implementing a health literacy initiative and to implement a pragmatic evidence-informed health literacy intervention. The intervention improved patient-provider communication practices using three basic questions (“What is my main problem?,” “What do I need to do about it?,” “Why is it important for me to do this?”) to help patients better understand their diagnosis and treatment plan.