ABSTRACT
Environmental health literacy is particularly relevant to racial/ethnic and linguistic minority populations who are likely to live near major roadways and highways. We conducted exploratory research to develop ways to communicate the risks of traffic-related air pollution to Puerto Rican adults living in and near Boston, Massachusetts. We held two initial focus groups with Spanish-speaking Puerto Rican adults (N = 16) enrolled in the Boston Puerto Rican Health Study (BPRHS). Most had only a high school education or less and earned a low income. We used thematic analysis of transcripts to suggest ways to improve three fact sheets designed to communicate BPRHS findings to the community. Based on these results, we made substantial revisions. We then conducted a second set of two focus groups with the same participants to assess revisions. Participants viewed the revised fact sheets more favorably and indicated that they found them easier to read. Lessons learned about improving readability and relevance included increasing text size, adding more graphics, chunking text, and providing more technical details. Designing successful environmental health communication tools that retain scientific accuracy is not a simple task. There is need for systematic attempts to evaluate and report on health literacy and community engagement processes for developing materials that are easy to read, culturally relevant, and that communicate complex environmental health information and concepts in ways people can understand and act on.