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PubMedDate not supplied

Patient literacy levels: a consideration when designing patient education programs.

The purposes of this study were to examine (a) the relationship between patients' own reports of the highest grade completed in school and their actual reading level and (b) the relationship between literacy and the level of knowledge about self-care after patients had received education involving written discharge instructions. In addition, the content of the materials was analyzed for its cultural sensitivity. Twenty-six patients who had had either hip- or knee-replacement surgery at an inner-city hospital participated in this correlational descriptive study. There was a significant negative relationship between patients' own reports of highest grade completed in school and their actual reading level (r = -.39, p < .05). Rehabilitation nurses should find this study beneficial for developing, assessing, and using written patient education materials appropriate for the reading level of their patient populations.

Adult↗
PubMed1992

Nutrition education for cardiovascular disease prevention among low income populations--description and pilot evaluation of a physician-based model.

Low income Americans are at greatest risk for coronary heart disease but have least access to health promotion programs for life style modification. Primary care physicians may represent one of the few sources of preventive care available to the poor. However, the majority of physicians feel unprepared to help patients achieve dietary change, and few existing nutrition intervention programs address the special needs of low literacy populations. The Food for Heart Program was developed to facilitate dietary counseling experienced by primary care physicians who care for low literacy patients and to overcome barriers to behavior change faced by patients. The program consists of three components: (1) a validated dietary risk assessment that rapidly identifies atherogenic eating habits and requires no nutritional expertise to administer or interpret, (2) a structured diet treatment program that is culturally specific for a southern patient population and links practical behavior change recommendations with results of the diet assessment, and (3) a system for monitoring and reinforcement that prompts physicians to review progress, reinforce prior messages, and reward positive change. Behavior change theory is used to guide the intervention and readability of the material has been assessed at the 5-6th grade level. An evaluation study of the Food for Heart Program suggests that it has a positive impact on physician counseling and that patients are responding favorably to these efforts.

Cardiovascular Diseases↗
PubMedDate not supplied

Information literacy as the foundation for evidence-based practice in graduate nursing education: a curriculum-integrated approach.

As part of a system-wide initiative to advance evidence-based practice among clinicians, graduate students, and educators, the New York University Division of Nursing embarked on a curricular initiative to integrate components of information literacy in all core courses of the master's program. Increasing competency in information literacy is the foundation for evidence-based practice and provides nursing professionals with the skills to be literate consumers of information in an electronic environment. Competency in information literacy includes an understanding of the architecture of information and the scholarly process; the ability to navigate among a variety of print and electronic tools to effectively access, search, and critically evaluate appropriate resources; synthesize accumulated information into an existing body of knowledge; communicate research results clearly and effectively; and appreciate the social issues and ethical concerns related to the provision, dissemination, and sharing of information. In collaboration with the New York University Division of Libraries' Health Sciences Librarian, instructional modules in information literacy relevant to each of the 5 core nursing master's courses were developed, complemented by a Web-based tutorial: http://library.nyu.edu/research/health/tutorial. The Web site is multifaceted, with fundamentals for the beginner, as well as more complex content for the advanced user. Course assignments were designed to promote specific competencies in information literacy and strategies for evaluating the strength of the evidence found. A survey of information literacy competencies, which assessed students' knowledge, misconceptions, and use of electronic information resources, was administered when students entered the program and at 1-year intervals thereafter.

Computer Literacy↗
PubMed1990

Providers link health with human service.

This issue's cover story looks at a handful of hospital leaders who appear to be radically redefining their hospital's role, but who are really just returning to the basics of hospital management and the basic hospital mission of community service. These CEOs of innercity hospitals are taking a leadership role in community development programs, ranging from literacy to housing. They bring together community groups to solve problems, work to find funding for projects, and attract new business to the hospital's service area. They also provide community residents with a sense of hope and a sense of stability. But their actions have ramifications that extend beyond their communities. These leaders may also be providing other health care executives with an approach to strategic planning that will add new meaning to the term "community hospital" in the 1990s.

Chicago↗
PubMed1996

MDs' failure to use plain language can lead to the courtroom.

Two recent court cases in British Columbia reveal the importance of using plain, simple language to communicate with patients. This is particularly important because almost half of Canadians have low literacy levels. The CMA, which promotes the use of plain language in professional practice, is participating in the Canadian Public Health Association's National Literacy and Health Program. Resources are available to help physicians better serve patients.

British Columbia↗
PubMed1997

Effect of a bicultural community health worker on completion of diabetes education in a Hispanic population.

OBJECTIVE: To determine the effect of a bicultural community health worker (CHW) on completion of diabetes education in an inner-city Hispanic patient population and to evaluate the impact of completion of the education program on patient knowledge, self-care behaviors, and glycemic control. RESEARCH DESIGN AND METHODS: Patients were randomized into CHW intervention and non-CHW intervention groups. All patients received individualized, comprehensive diabetes education from a certified diabetes nurse educator after baseline demographic information, diabetes knowledge, diabetes self-care practices, and glycohemoglobin levels were assessed. Rates of education program completion were determined. Diabetes knowledge, self-care practices, and glycohemoglobin levels were reassessed at program completion and at a later postprogram follow-up medical appointment and compared to baseline. Logistic regression analysis and the Mantel-Haenszel chi 2 statistic were used to determine the effect of the CHW assignment on program completion. Analyses of covariance were performed with end-of-treatment behavior scores, knowledge scores, and glycohemoglobin levels as outcome variables, controlling for baseline values and testing for the effect of CHW assignment. RESULTS: Of 64 patients enrolled in the study, 40 (63%) completed and 24 (37%) dropped out before completing the diabetes education program. Of the patients having CHW intervention, 80% completed the education program, compared with 47% of patients without CHW intervention (P = 0.01). "Dropouts" were younger (age 47.5 +/- 12.5 years [mean +/- SD]) compared with patients who completed the program (55.9 +/- 9.9 years) (P = 0.004). Dropout status showed no significant relationship to educational level achieved or literacy level. For the program "completers," knowledge levels and selected self-care practices significantly improved, and glycohemoglobin levels improved from a baseline level of 11.7% to 9.9% at program completion (P = 0.004) and 9.5% at the postprogram follow-up (P < 0.001). The effect of the CHW assignment on program completion, controlling for financial status and language spoken, was extremely robust (P = 0.007). The effect of the CHW on knowledge, self-care behavior, or glycohemoglobin outcome variables was not statistically significant. CONCLUSIONS: These findings suggest that intervention with a bicultural CHW improved rates of completion of a diabetes education program in an inner-city Hispanic patient population irrespective of literacy or educational levels attained. Our data further suggests that completion of individualized diabetes educational strategies leads to improved patient knowledge, self-care behaviors, and glycemic control.

Adult↗
PubMed2024

Evaluation of the Master's in Genomic Medicine framework: A national, multiprofessional program to educate health care professionals in NHS England.

PURPOSE: Genomic medicine is revolutionizing health care but requires health care professionals to update their understanding of genomics and its application to clinical practice for successful implementation. To meet this need, Health Education England developed the Master's in Genomic Medicine, a national multiprofessional program to increase genomic literacy in the National Health Service workforce. This study summarizes an evaluation of the program, which will inform its future development. METHODS: Underpinned by Moore's evaluation framework, a mixed methods approach was used to characterize (1) learner demographics, (2) perceptions of the program, (3) knowledge and/or qualifications achieved, and (4) the outcome(s) for practice in the workplace. RESULTS: Learners were a diverse cohort of health care professionals, including doctors, health care scientists, nurses and midwives. Participant satisfaction was high for all elements of the program, including the curriculum, learning environment(s), and multiprofessional cohort(s), despite the challenges of engaging working professionals in part-time learning. Both learners and their managers reported enhanced genomic practice after completion of their studies. CONCLUSION: The Master's in Genomic Medicine program is an effective approach to professional education in genomic medicine. This broad multiprofessional learning complements training aimed at specific groups of health care professionals.

Humans↗
PubMed1992

Fostering literacy learning in supportive contexts.

Young children with learning disabilities typically encounter difficulty with academic tasks requiring intentional effort and effective use of metacognitive skills--qualities that competent readers and writers possess. In response to these difficulties, special educators often modify literacy instruction, isolating the "basic skills" of literacy (such as decoding and penmanship) from meaningful reading and writing activities. Such instruction contributes to impoverished notions of literacy and exacerbates problems of metacognition. The two research programs reported here challenge the conventional literacy instruction provided to many young students with LD. The programs are rooted in developmental and cognitive theory and research, as well as emergent literacy theory. The social nature of learning is emphasized, with a focus on the role of the teacher, the form of discourse, and the role of text in literacy instruction. Results show that children with learning disabilities benefit from strategy instruction occurring within classroom cultures that support collaborative discourse, the flexible application of comprehension strategies, and appropriate, meaningful opportunities for reading and writing.

Child↗
PubMed2002

Health literacy and preventive health care use among Medicare enrollees in a managed care organization.

BACKGROUND: Many older adults in Medicare managed care programs have low health literacy, and this may affect use of preventive services. OBJECTIVES: To determine whether older adults with inadequate health literacy were less likely to report receiving influenza and pneumococcal vaccinations, mammograms, and Papanicolaou smears than individuals with adequate health literacy after adjusting for other covariates. RESEARCH DESIGN: Cross-sectional survey; home interviews with community dwelling enrollees. SUBJECTS: Medicare managed care enrollees 65 to 79 years old in four US cities (n = 2722). MEASURES: Short Test of Functional Health Literacy in Adults and self-reported preventive service use. RESULTS: In bivariate analyses, self-reported lack of preventive services was higher among individuals with inadequate health literacy than those with adequate health literacy: never had an influenza vaccination: 29% versus 19% (P = 0.000); never had a pneumococcal vaccination: 65% versus 54% (P = 0.000); no mammogram in the last 2 years: 24% versus 17% (P = 0.017); never had a Papanicolaou smear: 10% versus 5% (P = 0.002). After adjusting for demographics, years of school completed, income, number of physician visits, and health status, people with inadequate health literacy were more likely to report they had never received the influenza (OR, 1.4; 95% CI, 1.1-1.9) or pneumococcal vaccination (OR, 1.3; 95% CI, 1.1-1.7), and women were less likely to have received a mammogram (OR, 1.5; 95% CI, 1.0-2.2) or Papanicolaou smear (OR, 1.7; 95% CI, 1.0-3.1). CONCLUSIONS: Among Medicare managed care enrollees, inadequate health literacy is independently associated with lower use of preventive health services.

Aged↗
PubMed2003

Literacy for health: an interdisciplinary model.

Traditionally, many literacy and health education programs have had difficulty in significantly affecting vulnerable priority populations. The materials used were largely generalized for one language, one level of literacy, and one culture. A multidiscipline review of literature discusses the relationship between literacy, health, and culture and provides rationale for the interdisciplinary literacy for health model. The model's synthesis of anthropology, linguistics, literacy, nursing, and community partnership guides development of culturally and linguistically appropriate materials for successful adoption and diffusion within a priority population. In Nepal, the model is being used in the Mugom first-language literacy project among a group of remote Tibetan Buddhist peoples.

Culture↗
PubMed2003

Reaching for the stars: SLPs shine on literacy teams.

Speech-language pathologists (SLPs) who work with school-age children have the opportunity to contribute to the literacy development of specific students as well as the literacy instruction and intervention programs in their district. These efforts are made in collaboration with other professionals and parents and may be referred to as participation on literacy teams. This article describes successful literacy teams in elementary schools including the variety of possible members as well as common characteristics of successful literacy teams. We describe how SLPs participate by developing collegial relationships with their team, using best practices for literacy, and supporting children as they progress in the general curriculum. Finally, we discuss some strategies for SLPs to take stock of their own literacy team participation, identify new goals, and map out a plan to reach new heights in literacy as integral members of literacy teams.

Adolescent↗
PubMed2000

Prescribing books for immigrant children: a pilot study to promote emergent literacy among the children of Hispanic immigrants.

OBJECTIVES: To assess book-sharing activities within first-generation Hispanic immigrant families, and to assess the effect of pediatricians giving books to their patients. DESIGN: Survey. PARTICIPANTS: Convenience sample of 122 predominantly Hispanic immigrant parents of children aged 2 months to 5 years. Of these parents, 56 had received children's books from the pediatrician, and 66 had not. SETTING: House staff continuity clinic at a university children's hospital. MAIN OUTCOME MEASURE: Frequent Book Sharing (FBS) was defined as a parent's reporting more than 3 days per week of sharing books with the child. Main independent variables included the following: (1) exposure to the Reach Out and Read program, defined as having received a children's book from the pediatrician; (2) socioeconomics, as measured by parents' years of education and Medicaid enrollment; (3) acculturation, as defined by 4 questions relating to parents' proficiency with the English language; (4) parent's country of origin; (5) parent literacy, as measured by a parent's reporting more than 3 days per week of reading alone; (6) parent's age; (7) marital status; (8) household size; (9) child's age; (10) child's sex. RESULTS: Ninety percent of the parents were born outside of the United States (71% in Mexico), 85% spoke Spanish in the home, and 63% had completed less than a high-school education. Seventy-five percent of children's medical insurance was provided by Medi-Cal (Medicaid), and 9% of children were uninsured. Sixty-seven percent spoke exclusively Spanish at home, and 84% of parents want their children to learn to read in both English and Spanish. High FBS was reported among parents whose children had received books from the physician when compared with parents whose children had received no books. The odds ratio (OR) was 3.62 (95% confidence interval [CI], 1.40-9.37; P<.05). Also associated with FBS were parents reading frequently to themselves (OR = 9.52; 95% CI, 2.09-43.27; P<.05) and national origin outside Mexico (OR = 5.54; 95% CI, 1.59-19.27; P<.05). These findings were independent of parent's educational level, parent's employment, parent's age, acculturation, and family size. CONCLUSIONS: Pediatricians can promote literacy development among Hispanic immigrant children through the provision of free books at well-child visits. Our findings also suggest the independent effects of adult literacy and child age. Further research is needed to understand the effect of pediatric literacy programs on Hispanic immigrant children, their bilingual environments, and their readiness for school entry. Arch Pediatr Adolesc Med. 2000;154:771-777

Adult↗
PubMed2001

Interaction patterns between children and their teachers when using a specific multimedia and communication strategy: observations from children with autism and mixed intellectual disabilities.

This study reports on observed interaction patterns between 20 children with autism and mixed intellectual disabilities (mean chronological age = 11:4 years; language age = 4:7 years) and their nine teachers working with a specially developed multimedia program aiming to increase literacy skills. An increase in verbal expression was found over time for the total group. Children with autism also showed increased enjoyment and willingness to seek help from their teachers. Teachers for both diagnostic groups reduced their instructions on how to handle the computer during the program but the decrease was greater in the teachers for children with autism. When the total group of children was subdivided according to language age (high versus low), it appears that those with a low language age showed an increase in verbal expressiveness from start to end of training. Those with a high language age showed increased enjoyment. It is concluded that more detailed studies of the interaction patterns between teachers and children are needed, and these should be related to children's language level as well as to diagnostic group.

Adolescent↗
PubMed1996

Motivating women. Bangladesh.

The Integrated Family Development Program (IFDP) in Bangladesh is expanding from the original project areas in Panchdona Union and Dhalian Union into four neighboring unions under the initiative of the Family Planning Association of Bangladesh (FPAB). The JOICFP-executed project entered its second cycle this year as part of the UNFPA-supported regional Capacity Building for Sustainable Community-based Reproductive Health/Family Planning (FP) Project Emphasizing Quality of Care. The community-based project has won wide acceptance from people at the grass roots who have helped fuel its expansion into other villages. In particular, villagers have welcomed the comprehensive approach of the project which integrates a range of components such as reproductive health including FP/maternal and child health (MCH), income-generating activities, skills and literacy education for women and children and primary health care including parasite control. The success of the project also convinced the Japanese Embassy in Bangladesh to extend funding under the Japanese government's Grant Assistance for Grass Roots Cooperation Projects. With the funds, FPAB will establish a Women's Multipurpose Training Center in Panchdona Union. The sum of US$68,157 was officially handed over to FPAB on March 29 by Japanese Ambassador Yoshikazu Kaneko. The center, which is to open within this year, will contribute to improving reproductive health and promoting the empowerment of women. Once completed, it will be used for such activities as training in health care, literacy and skills for income generation for women's empowerment.

Asia↗
PubMed1994

Computer speech-based training of literacy skills in neurologically impaired children: a controlled evaluation.

Twenty-two reading-disabled children were randomly assigned to one of four training conditions to evaluate the effectiveness of a computer speech-based system for training literacy skills. The sample included 17 children with significant neurological impairment of various etiologies (including spina bifida and hydrocephalus, seizure disorder, brain tumors, cerebral palsy, and head injury) and five developmental dyslexics. The training employed a "talking" computer system that provides synthesized speech feedback during the course of learning. The training conditions included three word recognition and spelling-training programs and a math-training control program. Three different literacy-training procedures were compared, with the size of the trained print-to-sound unit varying as letter-sound (LSD: train-->t/r/ai/n); onset-rhyme (OR: train-->tr/ain) and whole word units (WW: train-->train). All literacy-training groups made significant gains in word recognition and spelling, with the LSD- and OR-trained subjects making the greatest word recognition gains on the words that could be trained with segmented speech feedback (i.e., words with regular spelling-to-sound patterns). All literacy-training groups demonstrated significant transfer on uninstructed rhymes of instructed regular words, with the greatest degree of transfer achieved by the LSD-trained subjects. These findings suggest that the neurologically impaired children were able to profit from instructional procedures that segment the printed word into units corresponding to onsets, rhymes, and phonemes and that this segmentation training may facilitate transfer-of-training for them.

Analysis of Variance↗
PubMed2002

Reading with Abby: a case study of individual tutoring with a young adult with Down syndrome.

This case study examined the impact of a series of tutoring sessions on the literacy development of a young woman with Down syndrome. The sessions were conducted within the LATCH-ON (Literacy and Technology-Hands On) program at the Schonell Special Education Centre at the University of Queensland and made use of technology resources in addition to other methods of instruction. The first author assumed the role of participant observer through the reported sessions and acted as an individual tutor to the young woman. Data obtained from an initial screening indicated that the young woman had only limited word decoding strategies when reading text, and consequently, had significant problems with comprehension. Instruction during individual tutoring sessions focused primarily on phonics instruction, as well as other decoding strategies, such as sight word recognition. Specific instructional strategies employed by the first author are discussed. Within the context of the LATCH-ON program, the impact of individual instruction on the development of literacy is examined and discussed.

Adult↗