Low literate patients face difficulties when they read health care information. The complex process of reading can be summarized in five steps: input, decoding, encoding, output, and feedback. Each occurs automatically for the fluent reader; the low literate reader might encounter stumbling blocks in one or more of the steps. Once the patient has the written material in hand, the senses--visual, auditory, and tactile modes--become involved. The health care professional should be aware of the sensory input level of the patient, which may impede the desired communication. Once the input step occurs, decoding or the word recognition stage begins. A dilemma for many low literate people is a lack of strategies for recognizing words. The alert health care professional might ask the patient to point out words recognized on a brochure or explain a brochure verbally and circle important words. A key to the next step, encoding or comprehending the information, is to help patients access prior and personal knowledge about the new health concept. Strategies include the following: K-W-L or "What I Know, What I Want To Know, and What Have I Learned"; graphical organization of the information; and guided discussion. The next stage, output, typically involves oral or silent reading and is less important with low literate readers than the previous stage. The crucial feedback stage involves thinking about new information and knowing when one understands and when one does not. The sensitive health care professional can help the patient by thinking aloud. (Contains 10 references.) (YLB)