Return-Path: <nifl-health@literacy.nifl.gov> Received: from literacy (localhost [127.0.0.1]) by literacy.nifl.gov (8.10.2/8.10.2) with SMTP id fA9LxW008529; Fri, 9 Nov 2001 16:59:32 -0500 (EST) Date: Fri, 9 Nov 2001 16:59:32 -0500 (EST) Message-Id: <83.12b394f7.291dab43@aol.com> Errors-To: listowner@literacy.nifl.gov Reply-To: nifl-health@literacy.nifl.gov Originator: nifl-health@literacy.nifl.gov Sender: nifl-health@literacy.nifl.gov Precedence: bulk From: Lendoak@aol.com To: Multiple recipients of list <nifl-health@literacy.nifl.gov> Subject: [NIFL-HEALTH:3448] Re: approaching adults regarding literacy levels X-Listprocessor-Version: 6.0c -- ListProcessor by Anastasios Kotsikonas X-Mailer: AOL 6.0 for Windows US sub 10536 Content-Type: multipart/alternative; boundary="part1_83.12b394f7.291dab43_boundary" Status: O Content-Length: 5782 Lines: 106 Content-Type: text/plain; charset="US-ASCII" Content-Transfer-Encoding: 7bit Dear Rosalie and net, Regarding your question on approaching patients to assess their literacy skills, there are variopus ways to do this. You can get good advice on this from the developers of the REALM test. Our experience was earlier and made use test instruments available then, the WRAT and Close tests. Under a contract with the USPHS, Ceci Doak and I tested the literacy skills of 100 patients at the Public Health Service Hospital at Norfolk, Va. in 1979. These were both out patients in patients. The results were reported in Patient Counseling and Health Education 1979-80 Winter Ed. Only 2 or 3 out of 100 declined to participate in the literacy assessment. Most participated very willingly. Our process was as follows: For in-patients we checked with the nurse to assure that the patient was not too ill to participate. First, and perhaps most important, we asked patients if they would help us. (This puts the transaction on an entirely different footing.) We explained that it would only take a few minutes, and if they were called we would stop right away. We explained that we were trying to make health instructions easier to understand and needed to find out what the problems might be. For screening purposes, the patient was then asked to read the word list on the WRAT test. We broke the WRAT word list into two pages, and offered only the first page initially.) If the patient had trouble with the first page, they were not shown the second. We recorded their scores. If the patient scored 5th to 8th grade, they were asked to read a health instruction that was written at the 6th grade level to test comprehension via a Cloze test. If they scored 9th grade and above they received a 10th grade Cloze test. If the patient scored below the 6th grade, they had the instruction read to them. Thus, we could later show relationships between their WRAT scores and comprehension of health instructions. And by examining the Cloze results, we could see which parts of the health care instructions gave the most trouble. These data were reported to the USPHS. Each patient session took about 10 minutes. Patients were thanked sincerely after they had participated. We hope this helps Rosalie. By the way, our postion is that unless there is a very specific reason to test a patient's literacy skills, it should not be done. After all, even if every patient's literacy skills were tested and recorded in their records, would the health care provider have the training and skill to modify thier instructions appropriately? best wishes, Len and Ceci Doak Patient Learning Assoc. Inc.
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