In April 2004, the Institute of Medicine (IOM) and the Agency for Healthcare Research and Quality (AHRQ) released health literacy reports citing the 1992 National Adult Literacy Survey (NALS) results as a cause for concern. The 1992 NALS indicated that nearly half of Americans demonstrated limited literacy skills. The NALS did not explicitly look at "health" literacy, but it did cover health-related tasks. In response, researchers developed methods to measure health literacy, such as the Health Activities Literacy Scale (HALS). Many governmental organizations, such as the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), continue to research methods and produce materials for implementing plain language and meeting health literacy needs.