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PubMedDate not supplied

Orality to literacy: effects on nursing knowledge.

BACKGROUND: Around the time of Plato and Aristotle, writing was introduced into the Western world and caused an epistemological revolution. Academics describe this change from pre-literacy to literacy as the alphabetization of a society. If societies have no written alphabet or words, knowledge transmission is oral. Words and ideas are fluid because they are always particularized to specific situations, rather than being written and available for scrutiny. With alphabetization, people record events, experiences and exchanges. Meanings no longer change slightly with each telling because writing solidifies knowledge as people attach increasingly limited meanings to words. Nursing experienced a similar revolution from orality to literacy with the proliferation of nursing journals beginning in the 1970's. Consequently, nurses and nurse educators also experienced an epistemological revolution resulting in knowledge from literacy usually being automatically valued higher than knowledge from orality. PURPOSE: I critically examine changes to knowledge that nurse educators value as a result of an alphabetized discipline. DISCUSSION: By comparing epistemological changes resulting from alphabetization in ancient Greece with similar changes in nursing education, I discuss three important dynamics: the sedimentation of words, the growth of criticism, and the new rationality. CONCLUSION: Some epistemological changes resulting from literacy are positive for nursing (eg, the growth of criticism) while some changes are negative (eg, devaluing sensorial and experiential knowledge).

Communication↗
PubMed2006

Lexical processing in illiteracy: effect of literacy or education?

Difficulties in phonological processing in illiterates have been attributed to their limited phonological awareness, a consequence of their lack of literacy. We sought to explore the potential influence of education on auditory lexical processing above and beyond literacy per se. In order to achieve this goal, we compared a lexical decision making paradigm with a repetition paradigm using words and pseudo-words. We based this choice of tasks on previous research, which has shown that pseudo-word repetition is dependent on the phonological loop; such studies have thus demonstrated a literacy effect on repetition. Instead, lexical decision making is known to depend on the size of one's vocabulary, which is influenced by the level of education attained. Our sample comprised three groups: illiterate no education, literate/low education and literate/high education, individuals. The pattern of our findings confirmed that literacy has an effect on the capacity of the phonological loop, as our illiterate group alone had difficulty with repetition, as compared with both literate/educated groups. Also, our findings suggested an education effect on lexical decision making, as we found a gradation in the performance of the three groups. Therefore, we succeeded in dissecting the effect of literacy and education on auditory lexical processing through the application and comparison of two simple paradigms.

Aged↗
PubMed2004

Maternal literacy and health behavior: a Nepalese case study.

This article addresses the question of whether literacy could be mediating the relationships of schooling to maternal health behavior in populations undergoing demographic transition. Recent studies in which literacy was directly assessed suggest a literacy pathway to demographic change. The literacy skills of 167 urban and rural mothers of school-aged children in Lalitpur District of the Kathmandu Valley of Nepal were assessed by tests of reading comprehension, academic language proficiency, health media skills and health narrative skill, as part of studies in the urban and rural communities that included a maternal interview and ethnographic fieldwork on the contexts of family life, health care and female schooling. Regression analysis of the data indicates the retention of literacy skills in adulthood and their influence on health behavior; ethnographic evidence shows that selective bias in school attainment does not account for the results. Further direct assessment studies are recommended.

Adult↗
PubMedDate not supplied

Books and babies: clinical-based literacy programs.

INTRODUCTION: The purpose of this study was to assess parental response to a clinic-based literacy program at a health maintenance organization. It was hypothesized that participation would be associated with increased literacy orientation by children. METHOD: This randomized community trial took place at a Midwestern health maintenance organization. Six clinics were paired and randomly assigned to participate or not participate in Project Read. The main outcome variable was literacy orientation (book use). The target population was parents of children younger than 12 months (N = 165). After 6 months of participation, parents were surveyed by telephone. RESULTS: Seventy-five percent and 77% of the treatment and control groups, respectively, had positive literacy orientation; this difference was not significant. Persons receiving a videotape were more likely to have a positive literacy orientation (82.9% vs 69.2%; P <.05). The multivariate regression analyses also showed that receiving the free videotape was a significant intervention exposure. DISCUSSION: The members of the population in this study are reading to their children. Parents who receive a videotape on the importance of reading are likely to read more to their children.

Ambulatory Care Facilities↗
PubMed2004

Embedded-explicit emergent literacy intervention II: goal selection and implementation in the early childhood classroom.

This article, the second in a two-part series, provides guidance to speech-language pathologists (SLPs) for implementing the explicit component of the embedded-explicit emergent literacy intervention model for at-risk preschool and kindergarten children. The explicit component refers to the provision of regular structured therapeutic interactions that intentionally target critical emergent literacy goals. This article describes fundamental principles of explicit literacy instruction, identifies literacy domains targeted as part of explicit literacy instruction, and presents examples of how early childhood classrooms can be organized to implement the embedded-explicit model.

Child, Preschool↗
PubMed2003

Emergent literacy intervention for vulnerable preschoolers: relative effects of two approaches.

This study determined the relative efficacy of an experimental explicit emergent literacy intervention program for preschoolers experiencing multiple risk factors. Using an alternating treatment research design, children completed two 6-week waves of intervention in small groups; one wave featured the experimental explicit intervention program, whereas the other featured a comparison program. Emergent literacy assessment was conducted at pretest and at the end of each wave. Results indicated significant widespread gains in emergent literacy knowledge over the entire 12-week intervention program; growth was significantly greater during the experimental explicit intervention program compared to the comparison program. An examination of individual differences and intervention outcome showed oral language skills and literacy orientation to predict emergent literacy performance at the end of the program.

Child, Preschool↗
PubMed2006

African American preschoolers' language, emergent literacy skills, and use of African American English: a complex relation.

PURPOSE: This study examined the relation between African American preschoolers' use of African American English (AAE) and their language and emergent literacy skills in an effort to better understand the perplexing and persistent difficulties many African American children experience learning to read proficiently. METHOD: African American preschoolers' (n = 63) vocabulary skills were assessed in the fall and their language and emergent literacy skills were assessed in the spring. The relation between students' AAE use and their vocabulary and emergent literacy skills was examined using hierarchical linear modeling (HLM), controlling for fall vocabulary and other child, family, and school variables. Children's use of AAE was examined across two contexts-sentence imitation and oral narrative using a wordless storybook prompt. RESULTS: There was a significant -shaped relation between the frequency with which preschoolers used AAE features and their language and emergent literacy skills. Students who used AAE features with greater or lesser frequency demonstrated stronger sentence imitation, letter-word recognition, and phonological awareness skills than did preschoolers who used AAE features with moderate frequency, controlling for fall vocabulary skills. Fewer preschoolers used AAE features during the sentence imitation task with explicit expectations for Standard American English (SAE) or School English than they did during an oral narrative elicitation task with implicit expectations for SAE. CONCLUSIONS: The nonlinear relation between AAE use and language and emergent literacy skills, coupled with systematic differences in AAE use across contexts, indicates that some preschoolers may be dialect switching between AAE and SAE, suggesting emerging pragmatic/metalinguistic awareness.

Black or African American↗
PubMed2002

Language development and emergent literacy in preschool.

To promote school readiness, preschool and Head Start teachers are incorporating more emergent literacy activities into their curriculum. This article argues that emergent literacy is subordinate to oral language development, rather than language development being subordinate to emergent literacy. Literature on components of emergent literacy is reviewed and a framework for a preschool curriculum that promotes oral language development and emergent literacy is presented. The article concludes with the recommendation that phonologic sensitivity and letter knowledge be taught in developmentally appropriate ways within the context of a language-rich preschool environment that specifically targets vocabulary enrichment.

Child, Preschool↗
PubMed2001

Emergent and early literacy interventions for students with severe communication impairments.

Speech-language pathologists (SLPs) can play a pivotal role in fostering the acquisition of literacy skills in students using augmentative and alternative communication (AAC). SLPs have unique skills in the areas of vocabulary development, phonological processing, selection of graphical symbol systems, and knowledge of strategies for facilitating interactive communication. SLPs can support parents in providing meaningful emergent literacy activities, and they can extend or initiate classroom literacy learning with interventions. This article presents some of the literacy difficulties experienced by students with severe communication impairments and suggests strategies that SLPs can use to support emergent and early literacy in children who use AAC.

Adolescent↗
PubMedDate not supplied

Asthma patients' assessments of health care and medical decision making: the role of health literacy.

The objectives of this cross-sectional study were to measure health literacy and its associations with asthma patients' assessments of care and their desire to participate in making decisions about their treatment. A total of 175 patients completed the Test of Functional Health Literacy in Adults and questions about satisfaction with asthma status, access to care, quality of care, and the desire to participate in treatment decisions. Patients' mean age was 42 years and 83% were women. Lower literacy was associated with less satisfaction with asthma status and worse assessment of quality of care received for asthma and other medical conditions (p < or = .005). Patients with lower literacy also were more likely not to want to participate in decisions about their care (OR .29, 95% CI .13, .65). These relationships persisted after controlling for demographic and asthma characteristics. These results provide additional incentives for physicians to find better ways to explain asthma treatments to low literacy patients.

Adult↗
PubMed2000

The association between age and health literacy among elderly persons.

OBJECTIVE: To examine why older age groups have worse functional health literacy. METHODS: Home interviews were conducted with community-dwelling elderly persons (n = 2,774) to determine demographics, years of school completed, newspaper reading frequency, chronic diseases, and health status. Participants completed the Short Test of Functional Health Literacy in Adults (S-TOFHLA, range 0-100) and the Mini Mental State Examination (MMSE). RESULTS: Mean S-TOFHLA scores declined 1.4 points (95% CI 1.3-1.5) for every year increase in age (p < .001). After adjusting for sex, race, ethnicity, and education, the S-TOFHLA score declined 1.3 points (95% CI 1.2-1.4) for every year increase in age. Even after adjustment for performance on the MMSE, the S-TOFHLA score declined 0.9 points (95% CI 0.8-1.0) for every year increase in age (p < .001). Differences in newspaper reading frequency, visual acuity, chronic medical conditions, and health status, did not explain the lower literacy of older participants. DISCUSSION: Functional health literacy was markedly lower among older age groups even after adjusting for differences in MMSE performance, newspaper reading frequency, health status, and visual acuity. Future studies should prospectively examine whether functional literacy declines with age and whether this is explained by declines in cognitive function.

Activities of Daily Living↗
PubMed2001

Health literacy in health systems: perspectives on patient self-management in Israel.

Health systems will face new challenges in this millennium. Striking the balance between the best quality of care and optimal use of dwindling resources will challenge health policy makers, managers and practitioners. Increasingly, improvements in the outcomes of interventions for both acute and chronic patients will depend on partnerships between health service providers, the individual and their family. Patient education that incorporates self-management and empowerment has proven to be cost-effective. It is essential that health care providers promote informed decision making, and facilitate actions designed to improve personal capacity to exert control over factors that determine health and improve health outcomes. It is for these reasons that promoting health literacy is a central strategy for improving self-management in health. The different types of health literacy--functional, interactive and critical health literacy--are considered. The potential to improve health literacy at each of these levels has been demonstrated in practice among diabetics and other chronic disease patients in Clalit Health Services (CHS) in Israel is used as an example to demonstrate possibilities. The application of all three types of health literacy is expressed in: (i) developing appropriate health information tools for the public to be applied in primary, secondary and tertiary care settings, and in online and media information accessibility and appropriateness using culturally relevant participatory methods; (ii) training of health professionals at all levels, including undergraduate and in-service training; and (iii) developing and applying appropriate assessment and monitoring tools which include public/patient participatory methods. Health care providers need to consider where their patients are getting information on disease and self-management, whether or not that information is reliable, and inform their patients of the best sources of information and its use. The improved collaboration with patient and consumer groups, whose goals are to promote rights and self-management capabilities and advocate for improved health services, can be very beneficial.

Delivery of Health Care↗
PubMed2001

Schools, health literacy and public health: possibilities and challenges.

Health literacy is a concept that can be widely embraced by schools. Schools throughout the world contribute to the achievement of public health goals in conjunction with their educational commitments. In this paper, the interface between a school's core business of education and public health goals is identified, and examples provided in the area of nutrition demonstrating how these links can operate at school level. The structure and function of the health promoting school is described and the author proposes that there is a very close connection between the health promoting school and the enabling factors necessary in achieving health literacy. Major findings in the literature that provide evidence of good practices in school health education and promotion initiatives are described. Also, those factors that make schools effective and which facilitate learning for students are identified. There is a substantial overlap between the successful components of a health promoting school and effective schools. This enables schools to potentially achieve all three levels of health literacy, including level 3-critical health literacy. However, there are three challenges that must be addressed to enable schools to achieve this level: the traditional structure and function of schools, teachers practices and skills, and time and resources. Strategies are proposed to address all three areas and to reduce the impediments to achieving the goals of health literacy and public health using the school as a setting.

Australia↗
PubMed2004

The effects of live music groups versus an educational children's television program on the emergent literacy of young children.

Research suggests that music is beneficial in teaching both social and academic skills to young children. The purpose of this study was to examine the effects of a music therapy program designed to teach reading skills versus the "Between the Lions" television program on the early literacy behaviors of Kindergarten children from a low socioeconomic background. Subjects (n = 86) were children, aged 5-7 years, enrolled in one of four different Kindergarten classes at a public elementary school in Northwest Florida. Each class was assigned one of four treatment conditions: Music/Video (sequential presentation of each condition), Music-Only, Video-Only, and no contact Control group. Growth in early literacy skills was measured using the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) and 3 subtests of the Test of Early reading Ability-3rd edition (TERA-3). Teachers' perceptions of classroom literacy behaviors were measured using a pre and poststudy survey. This study also compared on- and off-task behavior of students during video versus music conditions. Results of the 7 subtests measuring early literacy were varied. The Music/Video and Music-Only groups achieved the highest increases in mean scores from pre to posttest on 4 of the 7 subtests. Students in the Video-Only group scored significantly better on the phonemic segmentation portion of the DIBELS than peers in the Music/Video condition. Furthermore, strong correlations were found between the Letter Naming, Initial Sounds Fluency tests, and total raw score of the TERA-3 tests for both pre and posttesting. Additionally, graphic analysis of mean off-task behavior per session indicated that students were more off-task during both video conditions (video alone and video portion of Music/Video condition) than during the music conditions. Off-task behavior was consistently lower during music sessions for the duration of the study. This study confirmed that music increases the on-task behavior of students. Additionally, the combination of music and video enrichment showed gains in 4 of the 8 tests used to measure students' progress. This pattern supports the need for further investigation regarding benefits of enrichment programs specifically designed to enhance curricula for students from low socioeconomic backgrounds, particularly programs that incorporate music activities.

Child↗
PubMedDate not supplied

Health literacy as an empowerment tool for low-income mothers.

Health literacy commonly refers to the extent to which one can access and accurately interpret healthcare information. Statistics reveal that limited health literacy is prevalent among those of lower socioeconomic status. When working with low-income mothers, it is recommended in this article that healthcare professionals operationalize a broader conceptualization of health literacy than assessment of reading levels and translating knowledge of risk factors for illness and disease. Nutbeam's continuum of functional, interactive, and critical health literacy directs healthcare professionals to expand their health education mandate to encompass equipping low-income mothers with the necessary knowledge and skills to gain control over their lives and optimize the healthy development of their children. Tenets from social cognitive theory, principles from interdependence theory, and strategies from Freire's empowerment education model are integral to successful progression along Nutbeam's health literacy continuum.

Educational Status↗
PubMedDate not supplied

Health literacy: implications for teaching the adult patient.

Health literacy--the "ability to read, understand and use health information to make appropriate healthcare decisions"--was brought to national attention in April 2004 when the Institute of Medicine and the Agency for Healthcare Quality and Research published reports linking low health literacy with negative patient outcomes. Harvey Fineberg commented in the Institute of Medicine report, "Health Literacy, a Prescription to End Confusion": "Health literacy, enabling patients to understand and to act in their own interest remains a neglected final path to high quality healthcare." This article defines health literacy, describes the scope of the problem, identifies affected patient groups, and offers interventions to maximize patient understanding during the teaching process.

Adult↗
PubMed2006

Literacy and mental disorders.

PURPOSE OF REVIEW: This review examines recent evidence on the comorbidity between literacy problems and psychiatric disorder in childhood and discusses possible contributory factors. RECENT FINDINGS: Recent studies confirm the substantial overlap of literacy problems with a range of emotional/behavioural difficulties in childhood. Literacy problems and inattention may share genetic influences, contributing to associations with attention deficit hyperactivity disorder. To an extent, links with conduct problems may be also mediated by attentional difficulties. In addition, findings suggest bidirectional influences whereby disruptive behaviours impede reading progress and reading failure exacerbates risk for behaviour problems. Associations between literacy problems and anxiety disorders are not entirely mediated by inattentiveness. Rather, comorbid anxiety disorders seem likely to arise from the stressors associated with reading failure. Findings in relation to depression are less consistent, but suggest that poor readers may be vulnerable to low mood. Children with autism seem more likely to face problems in reading comprehension than the decoding difficulties more prominent in other disorders. SUMMARY: Literacy problems are associated with increased risks of both externalizing and internalizing disorders in childhood, with different mechanisms likely to be implicated in each case. When comorbid problems occur, each is likely to require separate treatment.

Anxiety↗
PubMed1993

Low literacy: a problem in diabetes education.

Eighty-five diabetic patients who were proficient in English were studied to assess the impact of educational material of varying literacy levels on patient comprehension. Two samples of available diabetes foot care material of Grade 11 and 9 readability (measured by SMOG formula) and purposely written in-house material of Grade 6 readability were used. Patients were randomized to read information of either Grade 6 and Grade 11 or Grade 6 and Grade 9 readability. Socio-demographic data and reading habits were collected to allow for identification of literacy markers. The mean CLOZE score (a measure of comprehension) was better in patients who read the Grade 6 information than for both the Grade 11 and Grade 9 information (59.5 +/- 11.8, 46.8 +/- 22.0, 45.8 +/- 22.2 respectively, p < 0.001). When evaluated in terms of percent of patients that could independently understand the material, Grade 6 information outperformed the Grade 11 and Grade 9 information (60%, 19%, 21%, respectively, p < 0.001). For the Grade 11 and Grade 9 information, poorer comprehension was associated with a non-English speaking background, early school leaving age, infrequent reading habits, and preference for tabloids (p < 0.02). Comprehension when patients read the Grade 6 information was no longer dependent on two of the four identified literacy markers. We conclude that reducing literacy demands of health literature improves patients' comprehension. Attention to socio-demographic data and reading habits can assist educators in assessing patients' literacy status and ensuring patients are given literature of compatible readability.

Diabetes Mellitus↗