Health Confianza Pledge Program

The RFA for the Pledge Program is closed.
10 organizations were accepted into the program for the pilot cohort.
We hope to continue the offer this program again in the future!

Request for Applications (RFA)

Funding Agency:  Dept. of Health and Human Services through the Center for Medical Humanities & Ethics, UT Health San Antonio

Submission Instructions: 

Purpose:  Health Confianza is seeking applications from San Antonio health and social service organizations who are interested in evolving into more health literate organizations.

Program Objective:  Develop and pilot an innovative health literacy pledge program for health and social service organizations in San Antonio.


  • This is a voluntary program that organizations apply to.
  • This goal is 10 participating organizations for this pilot.
  • The organization will identify 3-5 Health Literacy Champions to be a participant in an eight -month learning collaborative.
  • During this 8-month program, the Champions will participate in a monthly learning collaborative and develop an Organizational Health Literacy Plan.
  • A team of health literacy resource mentors with experience in organizational health literacy will be available to the Champions throughout the learning collaborative.
  • One Champion per organization will have the opportunity to enroll in the self-paced, online IHA Health Literacy Certification program during the learning collaborative period.
  • Successful completion of the program will earn the organization a health literacy pledge certificate.
  • SAMHD will develop a city-wide media campaign that advertises the pledge program to the public and what it means.

Background: The COVID pandemic has highlighted need for improved health literacy.  The goal of Health Confianza is to increase the availability, acceptability, and use of COVID-19 health information and services among Hispanics and African Americans living in 22 target zip codes (Fig. 1) in San Antonio through a multilevel approach.  The pandemic has also highlighted that many people do not go to traditional health care for their health information and services, but rather, trusted community-based organizations (CBOs).

Organizational health literacy is an organization-wide effort to make it easier to people to navigate, understand and use information and services to take care of their health.  Based on the National Action Plan to Improve Health Literacy, Healthy People 2030 updated the health literacy definition to include organizational health literacy: 

Efforts to improve organizational health literacy amongst San Antonio organizations will help make it easier for clients to access and use COVID-19 information and services, as well as help to overcome cultural and linguistic barriers to health care.  In the long run, improving health literacy at the community-based organizational level will increase health equity for community members.

Target Population:

  • A total of 10 organizations will be accepted for this pilot.
  • Encouraged to apply are community-based San Antonio organizations providing health services and social services to clients in the 22 target zip codes.  Examples include: community centers, health department clinics, libraries, local health system clinics, non-profits that provide health education and/or health services, social service agencies, federally qualified health center, food banks, school health, etc.
  • The pledge program application is open to any organization that fits the criteria of serving clients in at least one of the target zip codes, and providing health education and/or health services, inclusive of COVID-19 and COVID-19 vaccines.

Why should your organization participate?

By improving organizational health literacy, your organization may expect the following types of benefits:

  • Improved patient navigation of your facilities and services
  • Increased patient/client engagement in health promoting activities
  • Better health outcomes
  • Quality improvement
  • Improved access to care
  • Improved readability and understanding of printed and electronic health information
  • Improved patient/client satisfaction
  • Improved health equity for San Antonio community members

What will your organization receive?

  • Technical assistance and peer support learning for health literacy-related quality improvement and patient safety initiatives
  • Minimum of $2,000 stipend per organization to offset time for participation and/or costs, to be awarded at the time of submission of the finalized Organizational Health Literacy Plan.
  • Networking with others interested in improving organizational health literacy
  • Earn Health Literacy Pledge Certificate
      • San Antonio Metropolitan Health District will develop a city-wide media campaign that advertises the pledge program to the public and what it means.
      • Being a pledge member will bring increased awareness of your organization and its commitment to health literacy by clients and community members.
  • One Champion per organization will have the opportunity to take the self-paced, online Institute for Health Care Advancement’s training to earn the Health Literacy Certification during the learning collaborative period.  ($2,000 value).  This person can serve as a health literacy trainer for others at the organization.

What will your organization deliver?

  • Organizational Health Literacy Plan with action steps and policy/practice changes (described below)
  • Agree to complete a baseline and a follow-up assessment to document organizational change.
  • Poster presentation of health literacy plan, best practices, and lessons learned at the May 2023 Health Confianza Summit

Time Commitment

  • Team’s baseline assessment of organization: estimated 2 months
  • 8 monthly learning sessions of 1.5 hours
  • Team’s work on developing Health Literacy Plan- varies
  • Health Literacy Specialist Certificate (completed by one team member) consists of 7 modules and will take an estimated 50 hours.

Program Contacts:

Melanie Stone, MPH, MEd or Jason Rosenfeld DrPH, MPH
Center for Medical Humanities & Ethics
UT Health San Antonio
(210) 567-0795

Program Details


  • As part of the application, each org will identify a health literacy team (3-5) to participate in the program, consisting of different staff levels (e.g. health educator, operational staff, manager).  The team, who will be called Health Literacy Champions, will engage in a health literacy needs assessment of their organization and participate in an 8-month learning collaborative.  The Champions need to be persons who have the ability to influence change at their organization.
  • Senior leaders from participating organizations are expected to guide, support, and encourage the teams and to bear responsibility for the sustainability of the Health Literacy Plan that will be developed.  Senior leaders will receive regular communication about the learning collaborative and invited to attend as available.

Baseline Assessment:

  • Once accepted into the program, each health literacy team will conduct a health literacy assessment of their organization.
      • The team will be trained on how to use HLE2 (Health Literacy Environment of Hospitals and Health Centers) Assessment.
      • The team will have 2-3 months to conduct the assessment.
      • The team will be assisted to identify their organization’s top (and most feasible) health literacy areas to focus on during the Pledge Program’s learning collaborative.  This could be in the area(s) of organizational policies/ practices, navigation, culture and language, and/or communication.

8-Month Learning Collaborative:

  • The learning collaborative will be modeled on the learning system developed by the Institute for Healthcare Improvement (IHI).  Called the Breakthrough Series, this structure allows organizations to learn from each other and recognized experts in topic areas where they want to make improvements.
  • There will be monthly in-person learning sessions in which the health literacy teams from all participating organizations come together to learn about organizational health literacy and to plan changes.  The teams will report on their health literacy plans, collectively reflect on lessons learned, and provide social support and encouragement for making further changes.
  • 1.5 hour In-Person Format (Lunch provided)
  • Didactic topics covered during the learning sessions will include:
      • Introduction to Health Literacy and its role in COVID, health equity,
      • Introduction to Organizational Health Literacy and 10 Attributes of Health Literate Organization,
      • Introduce National CLAS Standards and how they apply to health literacy organizations,
      • How to develop an organizational health literary plan.
  • The pledge program will utilize a guidebook to help participants move forward in becoming a health literate organization.  This resource, called Building Health Literate Organizations: A Guidebook to Achieving Organizational Change, includes background, resources, examples, and lessons learned to help you build a health literate organization.
  • The Organizational Health Literacy Plan will include development of the following, not currently in practice:
      • 1 policy/practice that falls under the 10 attributes of a Health Literate Healthcare Organization (Table 1)
      • 1 policy/practice that falls under the National CLAS standards (Table 2)
      • 1 policy/practice to make it easier for clients to access COVID-19 and other health information and services.
  • Each learning session will allow time and space for organizations to share their best practices with each other.  The aim is to build collaboration between the teams, the facilitator, the guest experts, and the health literacy mentors to support the organizations during their progress.
  • In between the monthly sessions will be “Action Periods” in which the teams return to their organizations to work together on the Health Literacy Plan.  The team will be asked to submit a monthly progress report that discusses their work on the Health Literacy Plan.
  • A team of health literacy resource mentors with experience in organizational health literacy will be available to the Champions throughout the learning collaborative during the in-person sessions, as well as through email during the Action Periods.
  • The team will be asked to present their health literacy plan, best practices, and lessons learned at the May 2023 Health Confianza Summit


Applications Open:  January 5 – February-15, 2022

Organizations Notified of Acceptance:  March 1, 2022

Baseline Needs Assessment:  March – May 2022

Learning Collaborative:  September 2022 – April 2023

Media Campaign:  April-June 2023

Health Confianza Summit: May 2023