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At least 343 records · Page 19Linked to original sources
PubMed2005

Improvement in maternal health literacy among pregnant women who did not complete compulsory education: policy implications for community care services.

This paper examined factors that influence the improvement in maternal health literacy among pregnant women in Paraguay, including those who did not complete compulsory education but participated in a community-based antenatal care program. Structured interviews were conducted to evaluate the pregnant women's maternal health literacy during their first, second, and third visits to the program in the Caazapa Region. The associations between individual maternal health knowledge scores and its gains, healthcare personnel capabilities, available health facility equipment, community social network, and living environment were analyzed by multiple regression analysis. The mean maternal health knowledge score from 124 women who completed three-consecutive assessments increased between the first and third interviews. Higher capabilities of healthcare personnel and better living environment were significantly related to gains in the maternal health knowledge score (p<0.01). Wider application of a community-based antenatal care program to meet the needs of those who are functionally illiterate in the standard language of the country, training for community healthcare personnel to improve capabilities, and resources for social network in the community would contribute to the improvement in maternal health literacy.

Adolescent↗
PubMed1999

Development of a brief test to measure functional health literacy.

We describe the development of an abbreviated version of the Test of Functional Health Literacy in Adults (TOFHLA) to measure patients' ability to read and understand health-related materials. The TOFHLA was reduced from 17 Numeracy items and 3 prose passages to 4 Numeracy items and 2 prose passages (S-TOFHLA). The maximum time for administration was reduced from 22 minutes to 12. In a group of 211 patients given the S-TOFHLA, Cronbach's alpha was 0.68 for the 4 Numeracy items and 0.97 for the 36 items in the 2 prose passages. The correlation (Spearman) between the S-TOFHLA and the Rapid Estimate of Adult Literacy in Medicine (REALM) was 0.80, although there were important disagreements between the two tests. The S-TOFHLA is a practical measure of functional health literacy with good reliability and validity that can be used by health educators to identify individuals who require special assistance to achieve learning goals.

Adolescent↗
PubMed1996

Understanding medication-related needs of low-literacy patients.

An important thrust in preparing pharmacy students to provide pharmaceutical care is acquiring sensitivity to the unique medication-related needs of at-risk patient populations. Low literacy, which affects 21% to 23% of the American population, defines one such population. In collaboration with the Lafayette Adult Reading Academy (LARA), the authors developed an evolving project to increase pharmacy studies' understanding of the medication-related needs and perspectives of low-literacy patients. This was accomplished through a relation-building, three-step oral interview process. The interviewers asked open-ended questions to assess each patient's medication use habits and perspectives. The interview sensitized the pharmacy students to the needs of low-literacy patients for pharmaceutical care. The principal finding was that a caring relationship between pharmacists and patients is prerequisite to patients' openness to share and receive advice about problems and misconceptions associated with their medication use experiences.

Adult↗
PubMed2006

Early speech- and language-impaired children: linguistic, literacy, and social outcomes.

The aim of this study was to follow-up prospectively a cohort of preschool children originally recruited from successive referrals to speech and language therapy community clinics and to investigate their linguistic, literacy, and social outcomes at 7 to 10 years of age. Three hundred and fifty children aged 84 to 113 months (mean age 99.9mo [SD 5.4mo]) were singletons from monolingual backgrounds where there was concern about their speech and language development. Children who had severe learning difficulties, autism, oromotor deficits, dysfluency, or dysphonia were excluded. Altogether 196 (56%), 134 males and 62 females, were seen at follow-up. A control group of children who had never been referred for speech and language therapy, 57% of whom were males, was also recruited (n=94; mean age 104.4mo [SD 6.8mo]). All children were assessed on standardized measures of speech, language, and literacy. Teachers and parents completed questionnaires on educational and social outcomes. In total, 139 children in the cohort were within the normal range on standardized language assessments. About 30% of the original cohort of children continue to struggle with language, literacy, and social difficulties. The study demonstrates the long-term nature of language impairment and reinforces the need for awareness among professionals in child development and education of the ongoing needs of this population of children.

Age Factors↗
PubMed2005

Phonological awareness intervention and the acquisition of literacy skills in children from deprived social backgrounds.

PURPOSE: This study examined the effect of phonological awareness intervention that focused on syllable and rhyme awareness on the acquisition of literacy and the development of phonological awareness skills 2 years post intervention. The longitudinal study compared two groups of children from deprived socioeconomic backgrounds in the United Kingdom. One group received a program of phonological awareness intervention and one did not. METHOD: Ninety-nine children received a 9-week program of phonological awareness intervention in the summer term of their final preschool year. These children were then assessed on measures of phonological awareness and language in the first term of their first year at school (M age = 4;7 [years; months]) and again 2 years later (M age = 6;8) on measures of phonological awareness and literacy. One year earlier, a control group of 114 children from the same schools were also assessed at these two points in their schooling on the same measures. This group did not receive any phonological awareness intervention. RESULTS: At the second assessment, the group of children who received phonological awareness intervention performed better than those children who received no intervention (control group) on rhyme awareness and nonword spelling. Surprisingly, however, the control group performed better than the children who had received intervention on the phoneme segmentation task. CONCLUSION: The phonological awareness intervention that was implemented, which focused on enhancing syllable and rhyme awareness, had little effect on later literacy development and may have interfered with the acquisition of phoneme awareness. Implications for intervention with children from deprived socioeconomic backgrounds are discussed in the context of current research.

Awareness↗
PubMed2006

A narrative therapy approach to counseling: a model for working with adolescents and adults with language-literacy deficits.

PURPOSE: Remediation efforts with adolescents and adults with language-literacy deficits (LLD) may be hindered by concomitant factors such as decreased self-esteem and self-efficacy. Despite sound linguistically based remediation practices, treatment lacking integrated counseling components may fail to achieve optimal outcomes. In this tutorial, we recount a counseling approach, specifically a narrative therapy counseling approach based on constructivist theory, to be used with adolescents and adults with LLD. METHOD: A review of the literature includes research on the use of counseling in communication disorders settings and on the application of a narrative therapy counseling approach with individuals with decreased self-esteem. The key components and steps of narrative therapy are described, and applications for use with adolescents and adults with LLD are suggested. Sample vignettes of a counseling component for a 22-year-old student with LLD who is enrolled in literacy intervention are used to illustrate some of the key points of a narrative therapy counseling approach. IMPLICATIONS: A narrative therapy counseling approach that is integrated into language-literacy remediation may be an effective way of addressing concomitant factors such as decreased self-esteem in adolescents and adults with LLD. Readers of this article are challenged to seek additional counseling training and to begin to conduct research to determine the feasibility, effectiveness, and efficacy of integrating a counseling component into speech and language therapy.

Adolescent↗
PubMed2003

Literacy, readability and cultural barriers: critical factors to consider when educating older African Americans about anticoagulation therapy.

The number of patients on anticoagulation therapy has increased dramatically over the past two decades. Yet, few studies have examined the psychosocial barriers of low literacy, culture and inappropriate patient education materials used to teach older African Americans about their anticoagulation therapy. The aims of this study were to investigate literacy levels among older patients, and evaluate the readability and determine the cultural sensitivity of written information used in an anticoagulation management clinic. A descriptive, correlational design was used. Patients' (n = 62) knowledge levels and the readability and cultural sensitivity of written materials were examined. The Rapid Estimate of Adult Literacy in Medicine (REALM) was used to measure reading skills of patients, while the SMOG formula (a formula for assessing readability) was used to test the readability of written educational materials used in an Anticoagulation Management Clinic. A Knowledge Information Profile, developed for this study by one of the authors (Wilson), was used to measure patient knowledge about warfarin, medication side-effects and food sources of vitamin K. A modified, culturally sensitive and easy-to-read pamphlet was used as an alternative teaching tool in the study. The results of the study revealed the average self-reported for highest grade completed in school was twelfth grade; however, the actual mean reading skills were between seventh and eighth grade. The readability of the written information was three to four grades higher than patients' reading abilities. None of the patient education materials were culturally sensitive. This study underscores the importance of having information that is understandable and culturally relevant to prevent the outcome of internal bleeding. Nurses have a vital role in educating patients and ensuring that teaching materials are appropriate for the target population.

Adult↗
PubMed2005

A qualitative study of literacy and patient response to HIV medication adherence questionnaires.

The purpose of this study was to elicit patient feedback regarding the perceived clarity and level of difficulty associated with self-report human immunodeficiency virus (HIV) medication adherence measurement tools. HIV-infected patients from clinics in Shreveport, Louisiana, and Chicago, Illinois, were recruited to participate in four focus group discussions. Three groups consisted of patients with limited literacy skills (< ninth-grade reading ability), and one group contained patients with adequate literacy skills (> or = ninth-grade reading ability). Five themes emerged: (1) respondent understanding of the term "adherence," (2) recall, (3) question format, (4) visual aids, and (5) instrument administration. Participants struggled to define adherence, relied on visual cues to identify medications, and had a short recall time frame for missed doses (< or =3 days). Most preferred simple question formats and for their physician to assess adherence orally. Patients receiving treatment for HIV infection, especially those with limited literacy skills, may find it difficult to respond to existing HIV medication adherence questionnaires.

Adult↗
PubMedDate not supplied

Effects of general and alcohol-specific media literacy training on children's decision making about alcohol.

This article examines the immediate and delayed effects of media literacy training on third-grade children's perceptions of alcohol advertising, alcohol norms, expectancies for drinking, and behaviors toward alcohol. A Solomon four-group style experiment (N = 225) with two levels of the treatment factor assessed the effectiveness of in-school media literacy training for alcohol. The experiment compared a treatment that included the viewing of a videotape about television advertising along with the viewing of video clips of alcohol ads and discussion pertaining to alcohol advertising specifically versus one that included the viewing of the same general purpose media literacy videotape along with video clips of non-alcohol advertising and then discussion of advertising in general. The treatment had both immediate and delayed effects. Immediate effects included the children's increased understanding of persuasive intent, viewing of characters as less similar to people they knew in real life and less desirable, decreased desire to be like the characters, decreased expectation of positive consequences from drinking alcohol, and decreased likelihood to choose an alcohol-related product. Indirect effects also were found on their perceptions of television's realism and their views of social norms related to alcohol. Delayed effects were examined and confirmed on expectancies and behavior. The treatment was more effective when alcohol-specific, and it also was more effective among girls than boys.

Alcohol Drinking↗
PubMed2001

The role of inadequate health literacy skills in colorectal cancer screening.

Colorectal cancer is ideally suited for early detection strategies that are likely to improve survival rates. Screening with either a fecal occult blood test (FOBT) or flexible sigmoidoscopy has been shown to identify precancerous polyps or cancers in early stages. However, persons with limited education and of lower socioeconomic status infrequently participate in screening programs in general and have very low rates of colorectal screening. Low literacy, which is common among persons with limited education and low income, may be an overlooked factor in understanding patients' decision making about colorectal cancer screening. This article provides information from focus groups about colorectal cancer screening, which we examine in the context of relevant literature on cancer screening and literacy. Using the health belief model, we examine the association between inadequate health literacy skills and low rates of colorectal cancer screening. The theoretical model also provides insights into strategies for improving knowledge, attitudes, and beliefs and screening rates for this challenging patient population.

Colorectal Neoplasms↗
PubMed2001

Opportunities to improve maternal health literacy through antenatal education: an exploratory study.

This paper examines the concept of maternal health literacy, defined as the cognitive and social skills that determine the motivation and ability of women to gain access to, understand, and use information in ways that promote and maintain their health and that of their children. Specifically, it investigates the feasibility of using the concept of health literacy to guide the content and process of antenatal classes. The paper reports on the results of focus groups and interviews conducted with a range of health care providers, pregnant women and new mothers to obtain different perspectives on the issues surrounding antenatal education and parenting. The results give us a realistic look at what women are learning from existing antenatal education and how it can be improved. Comparing the results from the educators and the women, the same basic issues surface. Both recognize that there are serious time limitations in antenatal classes. These limitations, combined with natural anxiety and curiosity about childbirth, generally ensure that the content of classes is confined to pregnancy and childbirth. The limitations of time are also cited as a reason for the teaching methods being heavily weighted towards the transfer of factual information, as distinct from the development of decision-making skills, and practical skills for childbirth and parenting The results indicate clearly that antenatal classes cannot possibly cover all there is to know about pregnancy, childbirth and parenting. If the purpose of antenatal classes is to improve maternal health literacy, then women need to leave a class with the skills and confidence to take a range of actions that contribute to a successful pregnancy, childbirth and early parenting. This includes knowing where to go for further information, and the ability to analyse information critically. The authors conclude that this would represent a very challenging change in orientation for both the educators and pregnant women included in this study. Work continues on the development of the tools that will be needed to support this change.

Australia↗
PubMed1993

Validation of self-report of literacy among periurban women in Bolivia.

Many surveys ask women to rate their literacy level, but the validity of these self-reports is not usually evaluated. In this study of infant health, conducted in Cochabamba, Bolivia, maternal literacy was assessed by the mother herself and by the interviewer, based on the mother's reading a short text aloud. The two ratings were highly correlated (P < 0.001). This finding suggests that maternal self-reports of literacy are very reliable.

Adolescent↗
PubMed1988

Maternal literacy modifies the effect of toilets and piped water on infant survival in Malaysia.

The effect of toilets, piped water, and maternal literacy on infant mortality was analyzed using data from the Malaysian Family Life Survey collected in 1976-1977. The effect of toilets and piped water on infant mortality was dependent on whether or not mothers were literate. The impact of having toilets was greater among the illiterate than among the literate, but the impact of piped water was greater among the literate than among the illiterate. The effect on the infant mortality rate for toilets decreased from 130.7 +/- 17.2 deaths in the absence of literate mothers to 76.2 +/- 25.9 deaths in the presence of literate mothers. The reduction in the mortality rate for maternal literacy dropped from 44.4 +/- 14.1 deaths without toilets to -10.1 +/- 23.9 deaths with toilets. Reductions in mortality rates for piped water increased from 16.7 +/- 12.7 deaths without literate mothers to 36.8 +/- 21.0 deaths with literate mothers. Similarly, reductions in the mortality rate for maternal literacy rose from 44.4 +/- 14.1 deaths in the absence of piped water to 64.5 +/- 19.5 deaths in the presence of piped water. The results from a logistic model provided inferences similar to those from ordinary least squares. The authors infer that literate mothers protect their infants especially in unsanitary environments lacking toilets, and that when piped water is introduced, they use it more effectively to practice better hygiene for their infants.

Adolescent↗
PubMed1996

Can the linguistic interdependence theory support a bilingual-bicultural model of literacy education for deaf students?

Drawing on Cummins' (1989) linguistic interdependence model, proponents of bilingual-bicultural models of literacy education for deaf students claim that, if ASL is well established as the L1, then literacy in English (L2) can be achieved by means of reading and writing without exposure to English through either speech or English-based sign. In our opinion, this claim is based on a false analogy: the situation of the deaf learner of English literacy does not match the conditions assumed by the linguistic interdependence model. We draw on the work of Vygotsky and Halliday to develop a conceptualization of the processes involved in becoming literate, examining the particular and unique challenges that deaf students face as they strive to become members of the linguistic community of users of written English. We argue that becoming literate involves mastering three modes of lanuage use: 'social speech,' 'inner speech,' and written text. In some respects the educational context for deaf students is analogous to that of other bilingual learners; in some crucial aspects, it is very different.

Journal Article↗
PubMed1997

A study of the relationship between American sign language and English literacy.

This article presents the findings of a study of the relationship between American Sign Language (ASL) skills and English literacy among 160 deaf children. Using a specially designed test of ASL to determine three levels of ASL ability, we found that deaf children who attained the higher two levels significantly outperformed children in the lowest ASL ability level in English literacy, regardless of age and IQ. Furthermore, although deaf children with deaf mothers outperformed deaf children of hearing mothers in both ASL and English literacy, when ASL level was held constant, there was no difference between these two groups, except in the lowest level of ASL ability. The implication of this research is straightforward and powerful: Deaf children's learning of English appears to benefit from the acquisition of even a moderate fluency in ASL.

Journal Article↗
PubMedDate not supplied

Low health literacy: a challenge to critical care.

Health literacy-"the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions"-has been identified as a cross-cutting quality-of-care issue by the Institute of Medicine. This article defines the scope of the health literacy problem, discusses the literacy demands of critical care, and offers strategies for nurses to improve the quality of health communication with patients and families in the critical care environment.

Attitude to Health↗
PubMedDate not supplied

Do your patients understand? Determining your patients' health literacy skills.

Despite teaching endeavors, nurses are constantly faced with patients who do not understand how to manage their healthcare. This problem has come to the forefront of healthcare issues. As a society, there is concern that despite medical advances, progress with healthcare may be in jeopardy because the skills needed by patients to manage their care are insufficient. This issue is affected by many factors. One of the most prominent factors is the lack of patient health literacy skill assessment. One of the first and most basic parts of the nursing process is to assess the patient. To teach patients, we must identify their learning needs, but the assessment cannot stop there. Nurses need to know patients' health literacy skills so that they can teach them in the best manner possible. This article provides specific information on health literacy assessment tools and the skills needed by nurses to use these tools. Each nurse must decide what tools will work for his or her patients, so that in the end, each patient will understand how to manage his or her healthcare.

Education, Continuing↗
PubMed2003

A shortened instrument for literacy screening.

The Rapid Estimate of Adult Literacy in Medicine (REALM-R), a new 8-item instrument designed to rapidly screen patients for potential health literacy problems, was administered to 157 patients. The REALM-R was correlated with Wide Range Achievement Test-Revised (WRAT-R) (.64) and demonstrated a Cronbach's alpha of 0.91. The REALM-R identified 26 of 30 persons scoring more than 1 standard deviation below the mean on the WRAT-R, corresponding to a sixth grade reading level. The REALM-R identified a substantial number of people who scored poorly on the WRAT-R, and depending on further studies of validity and reliability, may offer a practical approach to identify patients at risk for health literacy problems in a clinical setting.

Educational Status↗