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 i5E1VD907991; Sun, 13 Jun 2004 21:31:13 -0400 (EDT) Date: Sun, 13 Jun 2004 21:31:13 -0400 (EDT) Message-Id: <000001c451ae$ac8a7150$6501a8c0@Thinkpad> 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: "Mark V. Williams, MD" <mwillia@emory.edu> To: Multiple recipients of list <nifl-health@literacy.nifl.gov> Subject: [NIFL-HEALTH:4468] Re: Which Test? X-Listprocessor-Version: 6.0c -- ListProcessor by Anastasios Kotsikonas Content-Transfer-Encoding: 8bit X-Mailer: Microsoft Outlook, Build 10.0.4510 Content-Type: text/plain; Status: O Content-Length: 8473 Lines: 222 Sandy, I think it may be unfortunate that you did not include an assessment of patients' health literacy. Despite administering this to many thousands of patients, we never had problems except one PhD student who was alarmed about what we were doing. In the instructions to the S-TOFHLA, I believe it explains that one should honestly introduce the purpose of this evaluation--to improve health care delivery and our ability to more clearly communicate with patients. Participants were typically eager to participate. You are carrying out an important study, and I suspect that patients' health literacy (or basic literacy skills) influences willingness to participate in clinical trials. Good luck with your research. >From a co-developer of the TOFHLA. Take care, Mark -----Original Message----- From: nifl-health@nifl.gov [mailto:nifl-health@nifl.gov] On Behalf Of Sandy Diehl Sent: Friday, June 11, 2004 3:36 PM To: Multiple recipients of list Subject: [NIFL-HEALTH:4466] Re: Which Test? I've been following this discussion with great interest because of an issue that arose recently in our setting. We are conducting a federally funded (National Cancer Institute) study to examine factors that encourage or discourage participation in clinical trials, particularly among African Americans. Our methods include a battery of surveys that measure attitudes, beliefs, and experiences with health, health care and cancer. One instrument that we considered including was the S-TOFHLA because we are interested in how health literacy may affect seeking and completing treatment. After some discussion, we decided for now not to include a measure of health literacy because the two prominent tools, the TOFHLA and the REALM, are both administered as a 'test' and we felt very uncomfortable asking our participants to be tested, although we believe that literacy is very important. We are conducting a literature search and recently contacted the author of the S-TOFHLA to find out if other investigators recognized any discomfort with administering 'tests,' but we haven't found much evidence yet. As an adult educator and health professional, I think it's really important to recognize and be sensitive to the needs of our low-literacy patients, whether it's to improve treatment or to gather data for future intervention. We'll continue to look for alternate methods to measure literacy. Does anyone know of alternate methods for this setting that aren't so test-like? Sandy Diehl, MPH -----Original Message----- From: nifl-health@nifl.gov [mailto:nifl-health@nifl.gov] On Behalf Of Beccah Rothschild Sent: Friday, June 11, 2004 12:49 PM To: Multiple recipients of list Subject: [NIFL-HEALTH:4461] Re: Which Test? I am posting the following email (below) on behalf of Resonja Willoughby, an adult literacy student and staff member at Second Start Adult Literacy Program at the Oakland (California) Public Library. This email is in response to the dialogue about testing patients for their literacy levels when they go to the doctor. Thanks, Beccah Rothschild Health Literacy Manager California Literacy, Inc. 1475 Powell Street, Suite 106 Emeryville, CA 94608 ph: 510-655-3264 fax: 510-655-3268 beccahrothschild@caliteracy.org www.caliteracy.org www.cahealthliteracy.org ************************ I'm responding to testing patients for literacy when they go to the doctor: I'm outraged about this. The health professionals need to leave adult literacy to adult literacy professionals. I think it's really good that you all are discussing literacy and trying to partnership with people that know more about this issue, but testing needs to be done with people that are more sensitive and educated about adult literacy. I'm in agreement with Archie Willard about the fact that literacy students are already going through enough. We are required to take a test at the adult literacy programs to get in to learn how to read, and now we have to take a test at the doctor's office? What will be done with that information? That's a bigger question. And what will the test results be used for? I may be sorry for saying this, but it makes me question the intention of the test. Studies showed that people that have reading difficulty have the worst heath and most likely won't go the doctor because of filling out forms. Just think what will happen, if they found out if they come to the doctor and they will have to take a test to see how well they read and understand. People that are in the literacy field can foresee what will happen -- if people have to take a literacy test at the doctor, they will stop seeing the doctor. And this includes myself, and I am also an adult literacy student. Resonja Willoughby Second Start Adult Literacy (Oakland, CA) -----Original Message----- From: nifl-health@nifl.gov [mailto:nifl-health@nifl.gov]On Behalf Of Archie Willard Sent: Tuesday, June 08, 2004 3:33 PM To: Multiple recipients of list Subject: [NIFL-HEALTH:4442] Re: Which Test? To All I have said this before, but I think it is worth repeating. I do not like to take written tests to receive health care. As a dyslexic and an adult learner with reading problems I speak for a lot of adult learners. We hate having to take another written literacy test. People with other kinds of handicaps are not continually asked to expose their weaknesses to whatever degree they are handicapped. There is no physical pain in taking a written test, but when we have to take a written test there is a lot of frustration inside of us. We grow up feeling humiliated because we had poor reading skills and now we are adults. More written tests are seen as another step backwards for us and it turns us away. Archie Willard Adult Learner David Rosen wrote: > NIFL Health Colleagues, > > I have not seen the REALM before, so thanks, Carol, for the Web page. > Now that I have seen it, I am concerned. > > It is not clear to me what this assessment measures. It doesn't > measure grade level, which is what it appears to report, and it > doesn't measure comprehension. It appears to measure one's ability to > pronounce medical vocabulary. I, for one can probably pronounce > hundreds of medical words which I do not understand the meaning of. > And I know people who do understand the meaning of some medical words > but cannot pronounce them. So, can someone explain what this > assessment does validly measure? > > I also have some concerns about administering literacy assessments in > medical contexts. If someone comes in for medical help, isn't it the > institution's or agency's responsibility to provide medical help, not > to assess their literacy. For example, at least one hospital in > Boston does not bring up literacy, per se. Instead, patients with > diseases or medical conditions are told "You have a disease that you > need to learn about. What ways would you prefer to learn about it? > Would you like to talk with someone? Read about it? Watch a video?" > Patients who do not choose to read may or may not have difficulty > reading, but that isn't the problem. Especially a time of crisis is > not the time to confront problems of literacy. The problem is how to > help patients learn what they need to in ways which work best for them. > > Others views on this? Do you use the REALM? How? Why? Please help > me to understand the conditions under which it would be useful. Have I > missed something? > > Thanks, > > David J. Rosen > djrosen@comcast.net > > > > On Tuesday, June 8, 2004, at 04:37 PM, Walter F. Wallace wrote: > >> Tx everyone for the leads on REALM...got to the heart of the matter... >> >> Walter >> >> Walter F. Wallace >> ACGME Regulations Manager >> GME Office >> Dartmouth-Hitchcock Medical Center >> 603-653-0466 (V) >> 603-653-0405 (F) >> Pager 5860 >> ******************************************** >> IMPORTANT NOTICE REGARDING THIS MESSAGE This e-mail transmission is >> for the sole use of the intended >> recipient(s) and may contain confidential and privileged information. >> Any unauthorized review, use, disclosure, or distribution violates >> confidentiality and privacy laws, and is prohibited. If you are not >> the intended recipient, please contact the sender immediately and >> destroy all copies of the message. Thank you for your cooperation. >> > -- Archie Willard millard@goldfieldaccess.net URL - http://www.readiowa.org/archiew.html
This archive was generated by hypermail 2b30 : Thu Dec 23 2004 - 09:47:29 EST