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At least 19 recordsLinked to original sources
PubMed2006

New literacies, multiple literacies, unlimited literacies: what now, what next, where to? A response to blue listerine, parochialism and ASL literacy.

This article is a response to Blue Listerine, Parochialism, and ASL Literacy (Czubek, 2006). The author presents his views on the concepts of literacy and the new and multiple literacies. In addition, the merits of print literacy and other types of literacies are discussed. Although the author agrees that there is an American Sign Language (ASL) literacy, he maintains that there should be a distinction between conversational "literacy" forms (speech and sign) and secondary literacy forms (reading and writing). It might be that cognitive skills associated with print literacy and, possibly, other captured literacy forms, are necessary for a technological, scientific-driven society such as that which exists in the United States.

Education of Persons with Hearing Disabilities↗
PubMed1999

Health literacy: report of the Council on Scientific Affairs. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association.

CONTEXT: Patients with the greatest health care needs may have the least ability to read and comprehend information needed to function successfully as patients. OBJECTIVE: To examine the scope and consequences of poor health literacy in the United States, characterize its implications for patients and physicians, and identify policy and research issues. PARTICIPANTS: The 12 members of the Ad Hoc Committee on Health Literacy, American Medical Association Council on Scientific Affairs, were selected by a key informant process as experts in the field of health literacy from a variety of backgrounds in clinical medicine, medical and health services research, medical education, psychology, adult literacy, nursing, and health education. EVIDENCE: Literature review using the MEDLINE database for January 1966 through October 1, 1996, searching Medical Subject Heading (MeSH) reading combined with text words health or literacy in the title, abstract, or MeSH. A subsequent search using reading as a search term identified articles published between 1993 and August 1998. Authors of relevant published abstracts were asked to provide manuscripts. Experts in health services research, health education, and medical law identified proprietary and other unpublished references. CONSENSUS PROCESS: Consensus among committee members was reached through review of 216 published articles and additional unpublished manuscripts and telephone and Internet conferencing. All committee members approved the final report. CONCLUSIONS: Patients with inadequate health literacy have a complex array of communications difficulties, which may interact to influence health outcome. These patients report worse health status and have less understanding about their medical conditions and treatment. Preliminary studies indicate inadequate health literacy may increase the risk of hospitalization. Professional and public awareness of the health literacy issue must be increased, beginning with education of medical students and physicians and improved patient-physician communication skills. Future research should focus on optimal methods of screening patients to identify those with poor health literacy, effective health education techniques, outcomes and costs associated with poor health literacy, and the causal pathway of how poor health literacy influences health.

American Medical Association↗
PubMed2005

The role of home literacy practices in preschool children's language and emergent literacy skills.

This study examined how 4 specific measures of home literacy practices (i.e., shared book reading frequency, maternal book reading strategies, child's enjoyment of reading, and maternal sensitivity) and a global measure of the quality and responsiveness of the home environment during the preschool years predicted children's language and emergent literacy skills between the ages of 3 and 5 years. Study participants were 72 African American children and their mothers or primary guardians primarily from low-income families whose home literacy environment and development have been followed since infancy. Annually, between 18 months and 5 years of age, the children's mothers were interviewed about the frequency they read to their child and how much their child enjoyed being read to, and the overall quality and responsiveness of the home environment were observed. Mothers also were observed reading to their child once a year at 2, 3, and 4 years of age, and maternal sensitivity and types of maternal book reading strategies were coded. Children's receptive and expressive language and vocabulary were assessed annually between 3 years of age and kindergarten entry, and emergent literacy skills were assessed at 4 years and kindergarten entry. The specific home literacy practices showed moderate to large correlations with each other, and only a few significant associations with the language and literacy outcomes, after controlling for maternal education, maternal reading skills, and the child's gender. The global measure of overall responsiveness and support of the home environment was the strongest predictor of children's language and early literacy skills and contributed over and above the specific literacy practice measures in predicting children's early language and literacy development.

Adolescent↗
PubMedDate not supplied

Does literacy education improve symptoms of depression and self-efficacy in individuals with low literacy and depressive symptoms? A preliminary investigation.

BACKGROUND AND OBJECTIVES: Individuals with low literacy and symptoms of depression have greater improvement of depression symptoms when their treatment includes education to enhance literacy skills. The reason why literacy enhancement helps depression symptoms is unknown, but we hypothesize that it might be due to improved self-efficacy. We studied whether providing literacy education to individuals with both depression symptoms and limited literacy might improve their self-efficacy. METHODS: We studied 39 individuals enrolled in an adult literacy program and who, on further testing with the Patient Health Questionnaire (PHQ-9) had symptoms of depression. While they participated in the literacy program, we monitored their self-efficacy using the General Self Efficacy (GSE) scale, and also monitored the severity of depression symptoms with the PHQ-9. Changes in GSE and PHQ-9 scores from baseline were assessed with the Wilcoxon Signed Ranks Test. RESULTS: Thirty-one (79.5%) subjects participated for 1 year. There was a significant increase in their self-efficacy (P = .019) and a significant decrease in depression symptoms (P < .002). CONCLUSION: The results of this preliminary study suggest that among persons with low literacy and symptoms of depression, depression symptoms lessen as self-efficacy scores improve during participation in adult basic literacy education.

Adult↗
PubMed2006

Literacy education as treatment for depression in patients with limited literacy and depression: a randomized controlled trial.

BACKGROUND: Individuals with limited literacy and those with depression share many characteristics, including low self-esteem, feelings of worthlessness, and shame. OBJECTIVE: To determine whether literacy education, provided along with standard depression treatment to adults with depression and limited literacy, would result in greater improvement in depression than would standard depression treatment alone. DESIGN: Randomized clinical trial with patients assigned either to an intervention group that received standard depression treatment plus literacy education, or a control group that received only standard depression treatment. PARTICIPANTS: Seventy adult patients of a community health center who tested positive for depression using the 9-question Patient Health Questionnaire (PHQ-9) and had limited literacy based on the Rapid Estimate of Adult Literacy in Medicine (REALM). MEASUREMENTS: Depression severity was assessed with PHQ-9 scores at baseline and at 3 follow-up evaluations that took place up to 1 year after study enrollment. Changes in PHQ-9 scores between baseline and follow-up evaluations were compared between the intervention and control groups. RESULTS: The median PHQ-9 scores were similar in both the intervention and control groups at baseline (12.5 and 14, respectively). Nine-question Patient Health Questionnaire scores improved in both groups, but the improvement was significantly larger in the intervention group. The final follow-up PHQ-9 scores declined to 6 in the intervention group but only to 10 in the control group. CONCLUSIONS: There may be benefit to assessing the literacy skills of patients who are depressed, and recommending that patients with both depression and limited literacy consider enrolling in adult education classes as an adjuvant treatment for depression.

Adult↗
PubMed1998

Communicating with patients who have limited literacy skills. Report of the National Work Group on Literacy and Health.

Between 40 and 44 million persons in the United States have rudimentary literacy skills, and are unable to understand written materials that require only basic reading proficiency. The purpose of this report is to characterize the current status of illiteracy in the United States, describe the relationship between poor literacy and poor health, and make recommendations on how to deal with patients who have poor reading skills. Data collected by the National Work Group on Literacy and Health indicate that one quarter of the US population has rudimentary reading skills, and another 25% has limited reading skills. This makes it difficult to have written communication with much of the US population. Poor reading skills are associated with poor health and greater use of health services, but the basis for this association is unclear. Instruments are available to measure patients' reading skills in clinical settings, and information can be transmitted to patients in ways that make it understandable to poor readers. However, it is not known if using special low-literacy education materials with these patients improves health outcomes. When written communication with low-literacy patients is essential, materials should be at the 5th-grade level or lower, supplemented by nonwritten communication. Simple and nonwritten materials are appropriate for persons with limited literacy, and also for those with well-developed literacy. Research is needed to clarify the mechanisms through which illiteracy influences health status and health services utilization, and to determine if using low-literacy health education materials improves health outcomes.

Adult↗
PubMed2004

Assessing health literacy in African American and Caucasian adults: disparities in rapid estimate of adult literacy in medicine (REALM) scores.

BACKGROUND AND OBJECTIVES: The influence of literacy on health and health care is an important area of investigation. Studies with a literacy focus are most valuable when literacy is assessed with psychometrically sound instruments. METHODS: This study used a prospective cohort sample of 1,610 primary care patients. Patients provided sociodemographics and took the Rapid Estimate of Adult Literacy in Medicine (REALM), a 66-item word pronunciation literacy test. RESULTS: The sample was 65% African American; 66% were men; 51% had a high school education or less. REALM scores were significantly related to education, age, and race but not gender. When stratified by education, differences between African Americans and Caucasians remained significant. Using 19 different strategies to shorten the 66-item instrument, reliability coefficients above.80 were maintained. CONCLUSIONS: The REALM is a robust assessment of health literacy. However, the discordance in scores between African Americans and Caucasians with similar educational attainment needs to be further addressed. A much shorter instrument would still have internally consistent scores and potentially be more useful in clinical settings.

Adult↗
PubMed2005

Effects of a family literacy program on low-literate children and their parents: findings from an evaluation of the Even Start family literacy program.

A randomized experiment was conducted to test the effectiveness of Even Start, a federally supported family literacy program providing early childhood education, adult education, parenting education, and joint parent-child literacy activities to children and parents from low-literate families. The evaluation of 18 Even Start projects followed 463 families for 2 years and found no statistically significant or educationally important impacts on Even Start families when they were compared with control families on child literacy outcomes, parent literacy outcomes, or parent-child interactions. The study concludes that Even Start projects were able to properly implement family literacy programs, and the observed lack of effectiveness is attributed to a combination of 2 factors: (a) a lack of full participation on the part of families and (b) instructional services that may be ineffective because of the curriculum content or the instructional approach.

Adolescent↗
PubMed2001

Using research to improve literacy practice and practice to improve literacy research.

The disconnection between research and practice is not a new phenomenon, but as researchers and educators look toward the future of deaf education, it seems crucial to look back at the reasons behind this disconnection with the goal of creating a professional milieu in which we use research to improve literacy practice and practice to improve literacy research with deaf students. This article examines the issues underlying the relatively insignificant impact of research on literacy practice from the perspectives of the fields of literacy, special education, and deaf education.

Journal Article↗
PubMed1995

The test of functional health literacy in adults: a new instrument for measuring patients' literacy skills.

OBJECTIVE: To develop a valid, reliable instrument to measure the functional health literacy of patients. DESIGN: The Test of Functional Health Literacy in Adults (TOFHLA) was developed using actual hospital materials. The TOFHLA consists of a 50-item reading comprehension and 17-item numerical ability test, taking up to 22 minutes to administer. The TOFHLA, the Wide Range Achievement Test--Revised (WRAT-R), and the Rapid Estimate of Adult Literacy in Medicine (REALM) were administered for comparison. A Spanish version was also developed (TOFHLA-S). SETTING: Outpatient settings in two public teaching hospitals. PATIENTS: 256 English- and 249 Spanish-speaking patients were approached. 78% of the English- and 82% of the Spanish-speaking patients gave informed consent, completed a demographic survey, and took the TOFHLA or TOFHLA-S. RESULTS: The TOFHLA showed good correlation with the WRAT-R and the REALM (correlation coefficients 0.74 and 0.84, respectively). Only 52% of the English speakers completed more than 80% of the questions correctly. 15% of the patients could not read and interpret a prescription bottle with instructions to take one pill by mouth four times daily, 37% did not understand instructions to take a medication on an empty stomach, and 48% could not determine whether they were eligible for free care. CONCLUSIONS: The TOFHLA is a valid, reliable indicator of patient ability to read health-related materials. Data suggest that a high proportion of patients cannot perform basic reading tasks. Additional work is needed to determine the prevalence of functional health illiteracy and its effect on the health care experience.

Adult↗
PubMedDate not supplied

Health status of illiterate adults: relation between literacy and health status among persons with low literacy skills.

BACKGROUND: In nonindustrialized nations, illiteracy is independently associated with poor health. The objective of this research was to determine whether such a relation exists in the United States. METHODS: One hundred ninety-three persons were randomly selected from a group of adult students enrolled in a publicly funded literacy training program. Subjects' health status was measured with the Sickness Impact Profile (SIP), a behaviorally based measure of sickness-related dysfunction. Subjects' literacy skills were also measured. Multivariate statistical techniques were then used to evaluate the relation between health status and literacy level and to adjust for confounding sociodemographic factors. RESULTS: The physical health (measured by the SIP) of subjects with extremely low reading levels was poor compared with that of subjects with higher reading levels. The relation between reading level and physical health was statistically significant (P less than 0.002), even after adjusting for confounding sociodemographic variables. Psychosocial health (measured by the SIP) was poor across all levels of reading skills and was comparable with the psychosocial health of populations with severe psychosocial disability. The relation between reading level and psychosocial health was statistically significant (P less than 0.02) after adjusting for confounding variables. CONCLUSIONS: In the United States, illiteracy and poor health status are independently associated.

Adolescent↗
PubMed2000

Home literacy activities and their influence on early literacy skills.

The relationship between the home environments of 66 children and their language and literacy development was examined. After accounting for child age, parent education, and child ability as indexed by scores on a rapid automatized naming task and Block Design of the WPPSI-R, shared book reading at home made no contribution to the prediction of the literacy skills of letter name and letter sound knowledge in kindergarten. In contrast, home activities involving letters predicted modest and statistically significant amounts of variance. For the areas of receptive vocabulary and phonological sensitivity, neither shared book reading nor letter activities were predictive. Follow-up to mid-Grade 2 underscored the importance of letter name/sound knowledge and phonological sensitivity in kindergarten in accounting for individual differences in later achievement in reading comprehension, phonological spelling, and conventional spelling.

Age Factors↗
PubMed1997

Assessing literacy for patient teaching: perspectives of adults with low literacy skills.

The purpose of this qualitative study was to gain an understanding of the response of English speaking adults with low literacy skills to screening of reading ability in order to facilitate the planning of patient teaching in a hospital setting. The Rapid Estimate of Literacy in Medicine (REALM) was the screening tool used to provide a screening experience for research subjects. A multiple case study design was employed to gain insight, describe participant experiences and generate an evidence-based conceptual model. While all participants supported the principle of screening in the context of the hospital, response to the actual experience was varied. Factors found to influence responses to screening included perceived risks of illiteracy exposure, perceived risks of non-disclosure during hospitalization and the attribution of characteristics to the hospital leading to it's designation as a 'special' place. A conceptual model of screening response was developed and compared to the Health Belief Model and Knox's Proficiency Theory of adult learning. Implications for the health professions are also discussed.

Adult↗
PubMed2004

Health and literacy in first- and second-generation Moroccan Berber women in the Netherlands: Ill literacy?

AIM: The present study was aimed at investigating the role of literacy and generation in the self-reported general health status of Moroccan Berber speaking women in the Netherlands. METHOD: Fifty women in our sample (N = 75) were first generation women, from which group 25 were literates and 25 illiterates. Another group of 25 literate women belonged to the second generation. The three groups were matched for demographic characteristics. Questionnaires were administered reflecting all concepts under study. We hypothesized that, within the first generation, illiterates compared with literates would report worse health. Our second hypothesis was that literates of the first generation compared with those of the second generation would have a similar health condition. RESULTS: After controlling for age, having a job, and having an employed partner, the first generation literates compared with the illiterates of the first generation indeed reported significantly better health. Additionally, we did not find any differences in health condition between both literate groups, even after controlling for age, number of children, and marital status. Health complaints that were most frequently reported by both groups, concerned pain in shoulders, back and head. CONCLUSIONS: Our results underline the importance of offering immigrants optimal access to opportunities and facilities that can improve their literacy and reading ability.

Journal Article↗
PubMed2005

Teaching literacy and mathematics skills to adult psychiatric inpatients: an evaluation of the adult literacy program at Hawaii State Hospital.

The Adult Literacy Program at Hawaii State Hospital utilized techniques drawn from the Morningside Model of Generative Instruction. In a study involving psychiatric inpatients, participants were taught reading, mathematics, or both over a 6- to 8-month time span. Using the Woodcock-Johnson Psychoeducational Battery-Revised, it was determined that nearly half of the participants demonstrated academic gains during the study period. Further, a behavioral observation system indicated that participants were on-task 80% of the observation time and staff engaged in positive interactions nearly 20% of the observation time. This study is the first of its kind to document any efficacy for academic instruction with a psychiatric inpatient population.

Adult↗