ObjectiveThis study aimed to evaluate the effect of a new health communication intervention focusing on knowledge management skills on health literacy and medication adherence during the first year following kidney transplantation. MethodsWe randomized 195 patients during 2020–2021, to either intervention- or control group. Questionnaires were completed at baseline and at 12 months post-transplantation with a 12-month response rate of 84%. Health literacy was measured by the multidimensional Health Literacy Questionnaire (HLQ) instrument. Medication adherence was measured by the self-reported questionnaire (BAASIS©). ResultsResults showed that the intervention group had a significant increase in 2 HLQ domains compared to the control group capturing the “ability to appraise health information” Domain 5, (p-value = 0.002) and the “ability to navigate the healthcare system” Domain 7, (p-value <0.04). The effect sizes of SRM were 0.49 (Domain 5) and 0.33 (Domain 7). Medication adherence was comparable in the groups at any measure points. ConclusionsThis study contributes to important knowledge about how a health communication intervention focusing on knowledge translation using motivational interviewing techniques positively strengthens health literacy in kidney transplant recipients. Practical implicationsCurrent patient education practice may benefit from focusing on knowledge translation in combination with motivational interview technique.