The problem: Health literacy is defined by the Office of the Surgeon General as "the ability of an individual to access, understand, and use health-related information and services to make appropriate health decisions." Unfortunately, health literacy is low among certain population groups in the United States—particularly those on a low income. As a result, these population groups frequently report poorer health status and significantly more problems managing chronic illnesses and other health conditions. When health literacy is limited, patients are less able to understand and act on the advice of health care providers and cannot make informed decisions about their health.

The Solution: One Economy Corp. seeks to help low-income populations help themselves. Through its Web site, www.thebeehive.org, One Economy reaches out to the working poor. According to the Beehive site, "When people have access to the Internet and can connect to good resources like the Beehive, they have the power to change their lives." One Economy created the Beehive as a "means of distribution," explains CEO Reynard Ramsey, J.D. "We created the Beehive to be the place to go for information and resources around the things that matter in our lives-money, health, jobs, school and family."

"Over 9 million people have used our Web site as a self-help portal," says Ramsey.

Prototype for management of diabetes in progress: With support from an RWJF planning grant, One Economy has started developing a multimedia prototype for the Beehive Web site on diabetes. Low-income patients with diabetes, and others who are managing diabetes in family members, are involved in the planning and design process. Ramsey understands firsthand the ravages of diabetes; his mother died from complications of the disease.

"After patients have been to their doctor and received a diagnosis, we want the Beehive to be their next stop when they ask, 'Now what?'" says Ramsey.

The diabetes prototype will address physical activity, nutrition, medication and monitoring the disease through video vignettes, animation, patient testimonials and a virtual health coach.

"The virtual health coach-which will be semi-personalized-will do for patients and caregivers electronically what a real coach would do in person," says Ramsey.

RWJF perspective: The low level of health literacy among poorer populations in this country is a major problem. In fact, according to Albert Shar, Ph.D., M.A., RWJF vice president of information technology, some consider it intractable.

"One Economy has taken an intriguing and novel approach to improving health literacy through a different kind of medium: the Internet," says Shar. "One Economy does not view technology as a solution in and of itself, rather it is the resources technology can bring to bear."

RWJF saw One Economy as a natural choice for this innovative effort because its constituency is the working poor.

"The organization has strong track record of bringing resources to this population in a holistic way to help eliminate disparities-including health disparities," says Shar. "Through funding of projects of this type, RWJF seeks to help eliminate some of these disparities."