D. all of the above because when you are developing a customer-centric culture, there are typically only positive effects to that. all of the answers given there are positive effects, so it should be D.
Not sure if this will help but found on google:
The benefits of health literacy improvement include improved communication, greater adherence to treatment, greater ability to engage in self-care, improved health status, and greater efficiency and cost savings to the health system as a whole.
(https://health.gov/communication/literacy/quickguide/advocate.htm)
Answer: Don't join these guys, heard they are bad and hurt people
Explanation: