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PubMedDate not supplied

Contemporaneous and longitudinal associations between social behavior and literacy achievement in a sample of low-income elementary school children.

This study investigates associations between social skills (aggression and prosocial behavior) and literacy achievement in a sample of low-income children (between 4 and 6 years old when the study began) during elementary school. Results revealed consistent associations between social skills and literacy achievement in the first, third, and fifth grades, but the patterns of the associations were different for aggression and prosocial behavior. While the strength of the association between aggression and literacy achievement increased over the elementary grades, the association between prosocial behavior and literacy achievement decreased. In addition, path analyses revealed that poor literacy achievement in the first and third grades predicted relatively high aggressive behavior in the third and fifth grades, respectively.

Age Factors↗
PubMed2006

Re-counting 'illiteracy': literacy skills in the sociology of social inequality.

Recent media reports have repeated claims that there are very large numbers of illiterate people in Britain, seven million adults being the most common figure. The moral panic this engendered has helped to justify educational initiatives and greater public spending on basic skills. However, a closer investigation of definitions and measurements of illiteracy in major national studies reveals the peculiarity of this social construction of illiteracy. Not least, it is argued that the numbers actually suffering significant literacy deficits are much lower than reported. Partly because British sociology has given literacy little attention (despite the advent of the 'New Literacy Studies'), official accounts of illiteracy remain unduly 'normative', seriously under-estimating cultural differences like gender, ethnicity and class. A new classification of low literacy skills is proposed, with the intention of demonstrating connections with structural accounts of social inequality and sociological theory. Low levels of literacy skill remain important because they are related to other forms of social inequality, even when the number of people disadvantaged in this way is much smaller than previously claimed.

Adult↗
PubMed2004

Literacy and health outcomes: a systematic review of the literature.

OBJECTIVE: To review the relationship between literacy and health outcomes. DATA SOURCES: We searched MEDLINE, Cumulative Index to Nursing and Allied Health (CINAHL), Educational Resources Information Center (ERIC), Public Affairs Information Service (PAIS), Industrial and Labor Relations Review (ILLR), PsychInfo, and Ageline from 1980 to 2003. STUDY SELECTION: We included observational studies that reported original data, measured literacy with any valid instrument, and measured one or more health outcomes. Two abstractors reviewed each study for inclusion and resolved disagreements by discussion. DATA EXTRACTION: One reviewer abstracted data from each article into an evidence table; the second reviewer checked each entry. The whole study team reconciled disagreements about information in evidence tables. Both data extractors independently completed an 11-item quality scale for each article; scores were averaged to give a final measure of article quality. DATA SYNTHESIS: We reviewed 3,015 titles and abstracts and pulled 684 articles for full review; 73 articles met inclusion criteria and, of those, 44 addressed the questions of this report. Patients with low literacy had poorer health outcomes, including knowledge, intermediate disease markers, measures of morbidity, general health status, and use of health resources. Patients with low literacy were generally 1.5 to 3 times more likely to experience a given poor outcome. The average quality of the articles was fair to good. Most studies were cross-sectional in design; many failed to address adequately confounding and the use of multiple comparisons. CONCLUSIONS: Low literacy is associated with several adverse health outcomes. Future research, using more rigorous methods, will better define these relationships and guide developers of new interventions.

Educational Status↗
PubMed2005

The roles of low literacy and social support in predicting the preventability of hospital admission.

BACKGROUND: Prior studies found higher hospitalization rates among patients with low literacy, but did not determine the preventability of these admissions or consider other determinants of hospitalization, such as social support. This study evaluated whether low literacy was a predictor for preventability of hospitalization when considered in the context of social support, sociodemographics, health status, and risk behaviors. METHODS: A convenience sample of 400 patients, admitted to general medicine wards in a university-affiliated Veterans Affairs hospital between August 1, 2001 and April 1, 2003, completed a face-to-face interview to assess literacy, sociodemographics, social support, health status, and risk behaviors. Two Board-certified Internists independently assessed preventability of hospitalization and determined the primary preventable cause through blinded medical chart reviews. RESULTS: Neither low literacy ( or =12 people talked to weekly (P<.023). Among nonbinge drinkers with lower social support for medical care, larger social networks were predictive of preventability of hospitalization. Among nonbinge drinkers with higher support for medical care, lower outpatient utilization was predictive of the preventability of hospitalization. CONCLUSIONS: While low literacy was not predictive of admission preventability, the formal assessment of alcohol binge drinking, social support for medical care, social network size, and prior outpatient utilization may enhance our ability to predict the preventability of hospitalizations and develop targeted interventions.

Aged↗
PubMed2001

Relation of health literacy to gonorrhoea related care.

OBJECTIVE: To assess the relation between health literacy and receipt of a screening test for gonorrhoea in the past year. METHODS: Study design was multisite, cross sectional survey of subjects enrolled from clinics, from community based organisations, and by street intercept. Data were obtained using face to face interview. The dependent variable was self reported receipt of a test for gonorrhoea in the past year. Health literacy was measured by the Rapid Estimate of Adult Literacy in Medicine (REALM), recoded to represent 8th grade or lower reading or 9th grade and higher reading level. Statistical analyses were adjusted to account for selection bias in literacy assessment. RESULTS: 54% of the sample reported at least one gonorrhoea test in the previous year. 65% of the sample read at a 9th grade level or higher. REALM score was moderately correlated with the respondent's years of education. After adjustment for missing REALM data, past suspicion of gonorrhoea, self inspection for gonorrhoea, self efficacy for care seeking, REALM score of 9th grade reading level or higher, and younger age were independently associated with gonorrhoea testing in the previous year. For the average respondent, REALM reading grade level of 9th grade or higher is associated with a 10% increase in the probability of having a gonorrhoea test in the past year. CONCLUSIONS: Low literacy appears to pose a barrier to care for sexually transmitted infections such as gonorrhoea.

Adolescent↗
PubMed1999

The prevalence of low literacy in an indigent psychiatric population.

Research has shown that individuals with low or limited literacy experience significant obstacles in gaining access to and using health care services. In a study of the prevalence of low literacy in an indigent psychiatric population, 45 patients seeking mental health services at a shelter-based clinic for the homeless were given the Rapid Estimate of Adult Literacy in Medicine screening test. Thirty-four participants (76 percent) read at or below the seventh- to eighth-grade level. Ten patients in this low-literacy group (29 percent) reported that they read "very well," 16 (47 percent) that they read "well," and eight (24 percent) that they read "not well." The results suggest the need for providers to consider formal screening for low literacy in clinical settings.

Adult↗
PubMedDate not supplied

Relationship between home literacy environment and reading achievement in children with reading disabilities.

Past research has indicated that a significant relationship exists between young children's early home literacy environment and their reading-related skills. However, this relationship has rarely been investigated among older children with reading disabilities (RD). In the present study, the relationship between parent and child home literacy activities and children's academic functioning was investigated with a sample of 65 elementary-age children with RD. The results indicated that children's home literacy activities were not significantly related to any of their academic abilities, whereas parents' home literacy activities were significantly related to children's passage comprehension and spelling scores. However, relationships between home literacy environment and reading may be different for children with and without RD.

Child↗
PubMedDate not supplied

Development and validation of a literacy assessment tool for persons with diabetes.

PURPOSE: This research was conducted to develop a valid, reliable, quick, and nonstigmatizing tool for assessing literacy in the healthcare setting. METHODS: The Literacy Assessment for Diabetes (LAD) instrument was developed as a word recognition test composed of 3 graded word lists in ascending difficulty. This literacy test, which was specific to diabetes, measured a patient's ability to pronounce terms that they would encounter during clinic visits and in reading menu and self-care instructions. The majority of the terms were on a 4th-grade reading level, with the remaining words ranging from the 6th-through 16th-grade levels. To assess reliability and validity, the LAD was compared with the Wide Range Achievement Test (WRAT3) and the Rapid Estimate of Adult Literacy in Medicine (REALM) by administering all 3 tests to 203 participants in a test-retest study design. RESULTS: All 3 tests (LAD, REALM, and WRAT3) reliably detected true intrasubject variation in word recognition from test to retest. In addition, LAD measured word recognition ability similar to the REALM and WRAT3. CONCLUSIONS: The LAD is a reliable and valid instrument for measuring literacy in adults with diabetes. It can be administered in 3 minutes or less, and the raw score is scaled to a reading grade level.

Diabetes Mellitus↗
PubMed1999

Cancer control research and literacy.

Low literacy may be an important predictor of increased cancer risk and poor participation in cancer control programs. Results of the National Adult Literacy Survey indicate that about 90 million individuals, slightly less than half of the U.S. adult population, demonstrate low or limited literacy skills. In contrast, the average health education brochure, pamphlet, or instruction sheet requires a 10th-grade or higher level of reading ability to be understood. Guidelines exist for the development of more readable printed materials; studies have also found that nonprint approaches such as video education are viable alternatives to printed materials. Research on patient populations indicates that educational approaches targeted to low-literacy groups can be effective in reaching individuals with cancer control information. This review identifies the most important areas of needed research and makes recommendations for the development of a research agenda on cancer control and literacy.

Adult↗
PubMed1991

Note on adolescents' time-use and scientific literacy.

This study investigated the relative influence of self-reported, out-of-school experiences on 13-yr.-olds' scientific literacy, including the often studied variables of homework time and television time. Results, based on a national probability sample of 3,116 students, indicated that time spent doing homework, reading, and viewing television programs with an educational focus had significant and positive independent influences on scientific literacy net of home environment and students' background factors. Viewing television programs that emphasized entertainment negatively contributed to scientific literacy. The number of hours of television viewed was unrelated to literacy. Factors associated with the transition to adolescence, dating, and peer relations, were negatively related to scientific literacy. Findings were discussed in regard to improving students' performances in science.

Achievement↗
PubMed2002

Improving Australians' depression literacy.

Community awareness and understanding of depression ("depression literacy") underpins successful implementation of prevention, early intervention and treatment programs. Improving depression literacy is a major goal of beyondblue: the national depression initiative. Although other countries have previously attempted to address this issue, there is little evidence to indicate that those attempts have achieved their aims. Work in other areas of health promotion, such as the widely used PRECEDE model, offers a useful framework from which to develop effective depression literacy initiatives in Australia. This model proposes that effective health promotion strategies should focus not on health actions per se, but on the knowledge and attitudes that encourage or impede individuals from taking such actions. We identify the goals of an effective depression literacy campaign and a range of educational strategies for achieving change in each of these areas. Applying these strategies may give a stronger basis for improving depression literacy than previous initiatives.

Attitude↗
PubMed2000

Precursors of literacy delay among children at genetic risk of dyslexia.

This paper reports the literacy skills of 63 children selected as being at genetic risk of dyslexia compared with 34 children from families reporting no history of reading impairment. Fifty-seven per cent of the at-risk group were delayed in literacy development at 6 years compared with only 12% of controls. The "unimpaired" at-risk group were not statistically different from controls on most cognitive and language measures at 45 months, whereas the literacy-delayed group showed significantly slower speech and language development, although they did not differ from controls in nonverbal ability. Letter knowledge at 45 months was the strongest predictor of literacy level at 6 years. In addition, early speech and language skills predicted individual differences in literacy outcome and genetic risk accounted for unique variance over and above these other factors. The results are discussed in terms of an interactive developmental model in which semantic and phonological skills support early reading acquisition.

Child↗
PubMed2001

Effect of literacy on breast-feeding outcomes.

BACKGROUND: We studied the effect of functional health literacy on the initiation and continuance of breast-feeding in women at a public health clinic. METHODS: Subjects were 61 first-time mothers aged 18 years or older who spoke English as their first language. They were divided into two groups, one who exclusively breast-fed for at least the first 2 months and one who never initiated breast-feeding or did not exclusively breast-feed for at least 2 months. The Rapid Estimate of Adult Literacy in Medicine (REALM) was administered, providing reading grade-level estimates for each subject. RESULTS: An association between functional health literacy and breast-feeding was seen, with only 23% of the women in the lower literacy group exclusively breast-feeding during the first 2 months compared with 54% of women in the higher literacy group. CONCLUSION: Many patients need simpler health education materials encouraging breastfeeding. These materials are needed both before and during pregnancy.

Adolescent↗
PubMedDate not supplied

Literacy and health research in Canada: where have we been and where should we go?

This article reviews current literature and research on literacy and health and identifies priorities for research on this topic in Canada. Information sources included documents found through an environmental scan, the Alpha Plus collection and a computer search of recent documents. The information was analyzed using a conceptual framework. The review found that low literacy has direct and indirect impacts on health. Families are at risk due to difficulty reading medication prescriptions, baby formula instructions and health and safety education materials. People with lower levels of literacy tend to live and work in less healthy environments. They have more difficulties obtaining employment and income security. Determinants of literacy include: education, early childhood development, aging, living and working conditions, personal capacity/genetics, gender and culture. Action is needed to improve literacy and health through a combination of health communication, education and training, community development, organizational development, and policy development. There is some evidence that such interventions can have a positive effect on health, particularly when combined with one another. Further program and policy development requires greater evidence and evaluation of existing initiatives, more cost/benefit analyses, more culturally specific studies, and greater attention to current social trends and needs.

Adolescent↗
PubMed2005

[Promotion of general health and scientific literacy via consumer and patient information: the role of the IQWiG].

The Institute of Quality and Economy in Healthcare (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen; IQWiG) was established to strengthen the scientific basis for decision making in German healthcare services, and to provide a scientific resource for the German healthcare community and general public. The Institute is committed to supporting informed decision making, patient choice, and patient autonomy. One of the key activities of the IQWiG is the provision of easily understandable consumer and patient information. These are made available to the general public via a website. The Institute's approach to health communication is based on goals and techniques of patient empowerment, scientific and health-specific knowledge (literacy building), health promotion, and evidence-based medicine. The promotion of general health- and scientific knowledge (critical health information, or health literacy) is strongly associated with good health outcomes and patient empowerment in several ways. Unlike other factors that determine health outcome and patient empowerment, health literacy is modifiable. In its role as provider of consumer and patient information, the IQWiG focuses therefore on continuous promotion and strengthening of health literacy in the German population. IQWiG intends to pursue this aim by means of publications and website activities, as well as by own academic work and projects that address scientific and health literacy at the population level. (Full English version online at www.iqwig.de)

Consumer Behavior↗
PubMed2005

The role of health literacy in achieving oral health for elders.

A mismatch between the literacy skills of individuals and the demands of oral health services may erect an unnecessary barrier to preventive care and treatment. Findings from the 1992 survey of adult literacy in the United States indicate that more than two-thirds of adults over the age of sixty were limited in their ability to use written health materials in prose format, had problems finding and processing quantitative information, and were very limited in their ability to use documents such as forms, lists, charts, and graphs. Thus, many older adults face barriers to oral care, to needed information, to full participation in decision making and informed consent, and for follow-up activities. The pathways between literacy and health outcomes are being examined, and the body of literature linking literacy to health continues to grow. However, similar studies examining literacy and oral health outcomes have not yet been undertaken. Research in this area might well begin with consideration of the skills needed to perform important oral health tasks. Rigorous studies of the impact of improved communication strategies on elders' access to care, participation in services, and action steps would lend insight into needed change.

Aged↗
PubMedDate not supplied

Culture-based literacy and Aboriginal health.

This is a summary report of the Aboriginal content of the Language and Culture theme at the Canadian Public Health Association's Second Canadian Conference on Literacy and Health. Our key premise is that Indigenous conceptualizations of literacy need to build on Indigenous understandings and perspectives. We support this premise through a review of the relevant literature in the disciplines of Aboriginal literacy, Indigenous education, health literacy, health promotion, and knowledge translation and our synthesis of the presentations, workshops, and discussions at the meeting. Key emergent themes include: the unique and culturally determined ways in which Aboriginal peoples and their languages conceptualize learning, education, and health; and the recognition that self-determination of language and learning are human rights. Aboriginal concepts of and approaches to literacy naturally link to and overlap with Aboriginal concepts of and approaches to health. The paper includes an overview of gaps in the field and an example of the way that research and practice can be brought together in the context of one First Nations community.

Canada↗
PubMedDate not supplied

Health literacy within the reality of immigrants' culture and language.

The Second Canadian Conference on Literacy and Health addressed issues of health literacy, culture, and linguistic diversity. This article aims to introduce the presenters' ideas, reports of the learners' discussion, and attendees' recommendations. There is also a literature review of the links between health literacy and use of health services among newcomers in Canada. Newcomers to Canada tend to be unfamiliar with the Canadian health care system in terms of navigating needed services and/or seeking health-related information. Health professionals report difficulties in communicating effectively with these populations about risk-taking behaviours. Educational resources and approaches only partially reach people from cultural minorities. E-health information does little for those with language and literacy limitations. Barriers to accessing information, specifically written material, are widely reported. Consequently, many ethnocultural groups do not participate in health promotion initiatives. Among newcomers to Canada, the problems of adapting to a new health culture are linked to both a lack of information about the new health care available and subsequently their experience with that health care system. There is also a structural barrier. It includes lack of access to preventive health care services and the lack of a formal and informal support network. This results in less effective use of these preventive services. Linguistic, religious, and cultural factors contribute to the newcomers' social isolation. Multidisciplinary work to enhance health literacy and awareness about health and healthy lifestyles will permit ethnocultural populations to develop their potential and more fully enjoy their lives in Canada. Simultaneously, health educators should have the opportunity to realize their limitations and challenges in dealing with the complexity of providing health education to this population. There remain gaps in our knowledge about the access and use of health services by subpopulations from different cultural groups in terms of their gender, learning practices, ways of navigating services, and help-seeking behaviours.

Canada↗