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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↗
PubMed2006

Factors contributing to intervention fidelity in a multi-site chronic disease self-management program.

BACKGROUND AND OBJECTIVES: Disease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design. METHODS: The Florida Health Literacy Study (FHLS) was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance. RESULTS: This report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation. CONCLUSION: Effective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity.

Journal Article↗
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↗
PubMed2005

Nursing informatics knowledge and competencies: a national survey of nursing education programs in the United States.

An online survey of deans/directors of 266 baccalaureate and higher nursing programs in the U.S. was developed by informatics expert nurses. Participants (1) identified nursing informatics (NI) competencies and knowledge of undergraduate and/or graduate students in their nursing programs; (2) determined faculty preparedness to teach NI and to use informatics tools; and (3) provided perceptions of NI requirements of local practicing nurses. Frequency data and qualitative responses were analyzed. Approximately half of undergraduate nursing programs were teaching information literacy skills and required students to enter with word-processing and email skills. Least visible informatics content at all levels included the use of information system data standards, the Nursing Information and Data Set Evaluation Center criteria, the unified medical language system (UMLS), and the nurse's role in the life cycle of an information system. Almost 50% of respondents perceived faculty as "novice" and "advanced beginners" in teaching and using NI applications. Participants reported no future plans to offer NI training in their region. Findings have major implications for nurse faculty, staff developers, and program administrators who are planning continuing education opportunities and designing nursing curricula that prepare nurses for use of the electronic health record and 21st century professional practice.

Clinical Competence↗
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↗
PubMed2006

Breaking the hype cycle: using the computer effectively with learners with intellectual disabilities.

There has been huge growth in the use of information technology (IT) in classrooms for learners of all ages. It has been suggested that computers in the classroom encourage independent and self-paced learning, provide immediate feedback and improve self-motivation and self-confidence. Concurrently there is increasing interest related to the role of technology in educational programs for individuals with intellectual disabilities. However, although many claims are made about the benefits of computers and software packages there is limited evidence based information to support these claims. Researchers are now starting to look at the specific instructional design features that are hypothesised to facilitate education outcomes rather than the over-emphasis on graphics and sounds. Research undertaken as part of a post-school program (Latch-On: Literacy and Technology - Hands On) at the University of Queensland investigated the use of computers by young adults with intellectual disabilities. The aims of the research reported in this paper were to address the challenges identified in the 'hype' surrounding different pieces of educational software and to develop a means of systematically analysing software for use in teaching programs.

Adolescent↗
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↗
PubMed1978

Literacy skills of long-term hospitalized mental patients.

The authors tested 48 patients who had lived in a state psychiatric hospital for extended periods to determine their literacy levels. Measures used were the reading test portion of the Adult Basic Learning Examination (ABLE) and selected questions from the Adult Performance Level (APL) test, which attempts to assess competencies necessary to function effectively in society. Nearly half of the patients scored at the fourth-grade level or below on the ABLE, and their scores on the APL were well below norms for other groups. No correlation was found between number of years of hospitalization and test performance. From the findings the authors conclude that both in-hospital and aftercare programs must recognize that literacy level is an important factor in the the rehabilitation or recidivism of patients.

Adolescent↗
PubMed2006

Impact of interactive school-based media literacy lessons for reducing internalization of media ideals in young adolescent girls and boys.

OBJECTIVE: The primary objective of the current study was to examine the efficacy of single media literacy lessons in reducing media internalization in young adolescents. METHOD: Eleven classes of 237 students (100 girls and 137 boys; mean age = 13.79 years, SD = .42) randomly received 1 of 6 lessons. Eating disorder risk factors were assessed at baseline, and the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) was used to assess media internalization postintervention. RESULTS: At postintervention, boys had significantly lower SATAQ-3 scores on 4 of the 5 subscales (effect sizes = .42-.71), whereas girls had significantly lower scores on 1 subscale (effect size = .54). Higher baseline levels of dietary restraint, magazines bought/read, and perceived sociocultural pressure predicted smaller reductions in boys' scores, whereas depression predicted smaller reductions in girls' scores. CONCLUSION: The current study provides support that boys be included in eating disorder prevention programs and that media literacy may represent a promising prevention approach.

Adolescent↗