Return-Path: <root> Received: (from root@localhost) by literacy.nifl.gov (8.10.2/8.10.2) id f7VBsrW10398 for health-archive@nifl.gov; Fri, 31 Aug 2001 07:54:53 -0400 (EDT) Resent-Message-Id: <200108311154.f7VBsrW10398@literacy.nifl.gov> Received: from imo-m05.mx.aol.com (imo-m05.mx.aol.com [64.12.136.8]) by literacy.nifl.gov (8.10.2/8.10.2) with ESMTP id f58Dx1f14242 for <nifl-health@nifl.gov>; Fri, 8 Jun 2001 09:59:01 -0400 (EDT) Received: from Dwyoho@aol.com by imo-m05.mx.aol.com (mail_out_v30.22.) id p.118.92e1d (4386) for <nifl-health@nifl.gov>; Fri, 8 Jun 2001 09:58:47 -0400 (EDT) From: Dwyoho@aol.com Message-ID: <118.92e1d.28523416@aol.com> Date: Fri, 8 Jun 2001 09:58:46 EDT Subject: Re: [NIFL-HEALTH:3113] health literacy To: nifl-health@nifl.gov Content-Type: multipart/alternative; boundary="part1_118.92e1d.28523416_boundary" X-Mailer: AOL 6.0 for Windows US sub 10520 Resent-From: root@literacy.nifl.gov Resent-Date: Fri, 31 Aug 2001 07:54:53 -0400 Resent-To: health-archive@nifl.gov Status: O Content-Length: 8991 Lines: 156 Content-Type: text/plain; charset="US-ASCII" Content-Transfer-Encoding: 7bit In a message dated 06/06/2001 7:54:36 PM Eastern Daylight Time, c.brown@ballarat.edu.au writes: > That is, how beneficial is improving health literacy when > factors like economic status, housing, access to services etc are still > making life difficult. Are there any key studies that have shown an > Chris, normally as moderator I stay out of the discussions, but the list is quiet and this is one of my favorite issues, so I'm going to indulge myself. As a literacy professional, I can share that the same question applies to literacy instruction. One of our constant frustrations is the hit and miss effectiveness of helping people deal with a myriad of barriers that stymie adult parpticipation in our literacy programs. The gurus and powers-that-be often talk about "seamless" services, "case management" techniques, etc. This is a prime criticism of the crowd that comlains about duplication of services. But after 25 years, I have come to the conclusion that we can't just "adopt" the entire person's life, almost like becoming a parent. If you give me 10 people to work with, I will not be successful with all 10, and I know that the reason(s) I am not successful with some are almost always beyond my control. The trouble is, I cannot tell you either how many or WHICH of the ten will not work out, although researcher after researcher has tried to determine what factors might predict success or might be most likely to prevent it. Some have succeeded. We know, for example, that the single most powerful factor in whether or not a child will finish high school is whether or not the mother did. But this is a sweeping general predictor, applied to very large populations. From where I sit, dealing with people day to day, it isn't very helpful in determining which of my literacy students will make it. Most of them have parents who didn't finish school, but I know from experience that does not mean most can't learn to read. In short, I take the philosophical stance that in education, you cannot prove causation, only correlation, and the difference is profound. It is a very hard pill to swallow among health professionals, who expect data that draw conclusions which can be replicated, and which generate reliable figures about efficacy and effectiveness. For the most part, in my opinion, it is tilting at windmills when we are dealing with human beings whose lives include ten thousand factors that defy research controls. And so I work with those ten people with the same attitude applied to each one--that what I can provide MIGHT help, and rest my job satisfaction on the pleasure of human relationships that I know intuitively are productive and helpful most of the time, even if I can't prove it so in terms of numbers, only case studies. Of course, the rubber meets the road when the accountability geeks come along. I can't dismiss them. So I just do my best to incorporate some of those sweeping generalizations that research has uncovered (i.e. "risk factors") whenever I write a grant, for instance. And I take a stab at achieving "benchmarks" like percentages of the population that I expect will meet xyz outcome. When we meet the benchmarks, no one is more pelasantly surprised than me. And the benchmarks I set are not pulled from the air, but based on experience and fairly wise guesstimates. When we miss the mark spectacularly, I incorporate that experience into the next guess. And so it goes. If someone here suggests some research results, look at the study carefully. And don't hesitate to react and report on what you find out right here. Thanks for the question, Debbie Deborah W. Yoho Co-moderator, NIFL Health Literacy Discussion Group Chief Executive Officer Greater Columbia Literacy Council 921 Woodrow Street Columbia, SC 29205 803/765-2555 dwyoho@aol.com
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