Background <p>Urban marginalised populations face intersecting barriers, such as poverty, unstable housing and discrimination, that erode health literacy in primary-care contexts. We examined whether an inter-professional, low-barrier primary care model improves health literacy competencies compared with usual care.</p> Methods <p>A convergent mixed-methods study took place at Centretown Community Health Centre (CCHC), Ottawa (2019–2023). Phase 1 compared Health Literacy Questionnaire (HLQ) scores between clients receiving tailored care (<i>n</i> = 37) and matched community members using usual services (<i>n</i> = 36). Phase 2 explored experiences through four focus groups and semi-structured interviews (<i>n</i> = 23). Independent samples t-tests and inductive thematic analysis were used.</p> Results <p>Overall health literacy was moderate in both groups; however, the tailored-care group scored higher on <i>appraisal of health information</i> (M = 3.03 ± 0.57 vs. 2.76 ± 0.46, <i>p</i> = 0.025, d = 0.53). Qualitatively, tailored-care participants described clearer chronic-disease self-management, strategic navigation of appointments, and fewer inappropriate emergency department visits. Persistently low <i>social support</i> scores highlighted systemic isolation.</p> Conclusions <p>Embedding social supports, outreach, and client-centred education within primary care can strengthen critical appraisal skills in marginalised settings. Scaling such models should pair literacy interventions with broader community-support strategies.</p> Trial registration <p>Not applicable (observational study).</p>