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Health literacy and communication skills are necessary for family caregivers who often work in pairs, known as collective caregiving. Health literacy management is a relational process where communication between caregivers can be a barrier or pathway to improving or co-creating health literacy. The purpose of this study was to examine how collective caregivers manage health literacy. Semi-structured interviews were conducted separately for 42 caregiving pairs (n=84). The interview guide was developed using a cancer caregiver health lit