Our literacy program and our community college are linked through our ABE classes. The literacy program has received a health literacy grant for the past 3 years to provide health literacy curriculum for the ABE classrooms and family literacy classes offered by the college.  
 
We offer 3 in-class and 3 open workshops each year. We sponsor a health literacy fair at the end of the year.  We have also developed (grant-funded) a health literacy teaching file that is at each location of the program. Teachers and tutors can come and get information about over 40 topics with lesson plans, materials and activities all at an easy reader level (3.0 - 6.O gle).  
 
We send the teachers in the program a preparatory packet that includes materials to begin familiarizing their students with the workshop topic, then post workshop materials to provide assessment and feedback.  The teachers have been very receptive and the students love it.  Some of our topics have included: Women's Health, Healthy Hearts, , Business of Health, Stress Management & Mental Illness, Dental Care, First Aid and Emergencies, Fitness & Nutrition, Family Nutrition, Diabetes & High Blood Pressure and we are currently working on a Men's Health workshop.  
 
We have had much success with this and the anecdotal evidence supports more confident, assertive students who now go to the doctor with their AskMe3 questions and a bag with all of their prescriptions, who eat more regularly and make healthier choices in what they eat and students who found out they were diabetic by being tested at our health fair.
 
It is worth the work, thanks for the opportunity to share!
 
Thanks,
Mary Lynn Carver
ABE/GED Instructor
College of Lake County
Building 4, Office 405
19351 W. Washington Street
Grayslake, IL  60031
Phone:847/543-2677
mlcarver at clcillinois.edu
Fax: 847/543-7580
 
"Blessed are they who laugh at themselves, for they shall be constantly amused" -- Unknown
 
We now accept the fact that learning is a lifelong process of keeping abreast of change. And the most pressing task is to teach people how to learn. --Peter F. Drucker 

________________________________

From: healthliteracy-bounces at nifl.gov on behalf of Julie McKinney
Sent: Mon 10/22/2007 8:45 AM
To: healthliteracy at nifl.gov
Subject: [HealthLiteracy 1427] Re: bridging the gap between healthand literacy educators



Thanks, Marg, for these resources! I like this emphasis on the support network. That's where I think adult education programs can really have an impact. If learners can use the safe and supportive environment of their classroom to practice the kind of dialog, questioning and vocabulary they will need for effective communication in the more intimidating environment of the health system, then they can gain confidence and make real progress.

Here's a link to a chapter in "Family Health and Literacy" about collaborating between literacy and health programs:

http://healthliteracy.worlded.org/docs/family/started.html#collaborating

I'd love to hear from some other teachers who have addressed health in the classroom, or from health educators who have been a guest in an ABE classroom!

Julie

Julie McKinney
Discussion List Moderator
World Education/NCSALL
jmckinney at worlded.org


>>> "Marg Rose" <bcmrose at telus.net> 10/20/07 6:09 PM >>>

HI folks. This topic has raised not only questions, but great input and
change agent ideas. Kudos. When conducting field research on the factors
that hinder or enhance collaboration between literacy and health educators,
one health promotion director exhorted the literacy teachers in the room to
encourage learners to take a tape recorder into every medical interview.

Often, emotions and learning modalities (as Dr. Zeitz has discussed in the
last exchange) are working full-time to make the most of the limited face
time with a medical professional these days. So, comprehension is limited,
and that affects the "compliance" factor.  She said that research shows that
clinicians actually judge those patients who tape interviews as more engaged
and positive. Learners then can take the tape (or these days, Ipod or MP3
player!) back to their families and to their literacy program for more
careful analysis, discussion, planning and enlist what Thomas Sticht has
called a "group mind". Much like what some of us do when trying to load a
new computer program, or program a VCR--we turn to the younger generation or
our children.

Is a low health literacy score for an individual really an indicator of
their ability to navigate various settings or health information? Perhaps
not, since the impact of their support team also plays a factor. Bill Putnam
talks about the impact of isolation in his book "Bowling alone: The future
of communities" as outweighing many other social determinants. So, whatever
we can do in our various settings to link people to support systems is
crucial to improving their health.

Another resource is the Literacy Audit Kit, sold by Literacy Alberta (see
http://www.literacyalberta.ca/resource/auditkit/audktpg1.htm). The series of
checklists and accompanying video depict ways to adjust intake and client
interaction in various social services settings to make them more welcoming
to all, and especially to encourage adults with low literacy to feel more
comfortable about asking questions.

The Askme3 campaign, which encourages ALL of us to be more assertive abuot
asking questions is the ultimate solution. Instead of relying on health
professionals or literacy folks to intervene after the fact, it is more
efficient to encourage patients themselves feel more comfortable speaking
up. Of course, iin some cultures, open dialogue is just not a common trait
for authoritarian situations like a medical interview. So, the Ask Me 3
campaign sets the stage for expecting dialogue. That's why we devleoped the
Patient Prompt Card in our coalition, to encourage all adults to own their
own information and practice asking questions. The Going to the Doctor
booklet  and facilitator's guide is available through Literacy Partners of
Manitoba at http://www.plainlanguage.mb.literacy.ca/resource.htm  or
204-947-5757 or a northern learner's original edition through Yukon Learn
http://www.yukonlearn.com/publications/index.php.

Hope this helps!

Marg Rose, M.Ad.Ed
Health Literacy Consulting Group
Victoria, BC
250-592-7321

"Life is 10% what you make it and 90% how you take it."
                                                                   ~Irving
Berlin

-----Original Message-----
From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov]On Behalf Of
healthliteracy-request at nifl.gov
Sent: Saturday, October 20, 2007 9:00 AM
To: healthliteracy at nifl.gov
Subject: HealthLiteracy Digest, Vol 25, Issue 32


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Today's Topics:

   1. [HealthLiteracy 1423] Discussion continues through Monday!
      Some      questions... (Julie McKinney)
   2. [HealthLiteracy 1424] Re: Use of pictures for Deaf        and
      hearingpatients (Helen Osborne)


----------------------------------------------------------------------

Message: 1
Date: Fri, 19 Oct 2007 16:31:30 -0400
From: "Julie McKinney" <julie_mcKinney at worlded.org>
Subject: [HealthLiteracy 1423] Discussion continues through Monday!
        Some    questions...
To: <healthliteracy at nifl.gov>
Message-ID: <4718DBE20200002D000041AC at bostongwia.jsi.com>
Content-Type: text/plain; charset=US-ASCII

I just want to remind everyone that this discussion will not end today, but
continue officially through Monday the 22nd. I will continue to check for
messages over the weekend for those who will have time to read and respond.
Of course, as always, we can continue as long as we want, but the panelists
plan to be available through Monday.

Today's discussion has been interesting, practical and informative! Howard's
information below really gave me a new way to understand communication and
learning.

To think about in the next couple days:

How can we encourage patients to be open and forthright about how they
prefer to get information?  ("Dr., I will understand this much better if you
can show me a picture...")

How can ABE and ESOL teachers use their unique environment to encourage this
kind of self-advocacy and help improve communication skills for learners?

How do we create a "shame-free" environment for people with lower literacy
skills?

Thank you all for your contributions!

Julie

Julie McKinney
Discussion List Moderator
World Education/NCSALL
jmckinney at worlded.org


>>> "Zeitz, Howard" <hzeitz at uic.edu> 10/19/07 3:28 PM >>>

Julie: I have come to understand visual, auditory and kinesthetic learning
as a result of: a)professional development for medical school faculty
(teacher training workshops); and b)collaborations with K-12 teachers and
administrators.

Technically, we are not talking about learning styles; we are talking
about "portals of entry". Information enters the brain through 3 portals
of entry (eyes/vision, ears/hearing, hands/feet/touch/movement=kinesthetic
actions). Once information enters a portal (for example, the eyes), it
travels along one or more pathways to one or more regions of the brain
where it is processed. If the eye, the pathway and the brain region are
all normal, the result will be understanding. So called "visual learners"
generally use this learning strategy preferentially for any number of
reasons. However, the best results occur if the learner can acquire
information on the topic at hand through all 3 portals. So if I talk about
asthma, the person with asthma listens and asks me questions, I answer
those questions with words AND pictures I draw, AND the person takes notes
(kinesthetic movement), the new information is entering all 3 portals
(sight, hearing and touch) and will be processed in multiple brain
compartments. If I give a mini-lecture  without pictures, discussion and
note taking, very little learning will occur.

During discussion/conversation, the best way to recognize "visual
learners"  is to observe their facial expressions. Perhaps the 3 most
common  are: blank look, facial question mark and deer-in-the-headlights.
A second way to recognize visual learners is through their verbal
responses: I'm not sure I understand; could you repeat that; and the
ever-popular "dead silence". The final way is by  asking them to
"teach-back" the information; after discussion without visual input, an
auditory or kinesthetic learner usually can complete the teach-back but a
visual learner cannot.

As to your last question re quick access to visuals, I have little to add.
Perhaps other participants in this discussion can answer. When I have
searched for usable/helpful visuals, I generally have found visuals that
are as complicated as the usual Grade 12-16 written documents that pretend
to teach health related topics. I would be happy to learn more about
reliable sources of usable/productive/helpful visuals.

Howard

============================================================================

On Fri, October 19, 2007 12:47 pm, Julie McKinney wrote:

> Howard,

>

> Thanks for bringing up the issue of different learning styles, such as

> visual, auditory, and kinesthetic. This is something that teachers are

> often aware of, but the medical community may not be. (This is one reason

> why collaborations between adult literacy programs and health programs can

> be so helpful to everyone involved!)

>

> I would love to know how you became aware of this phenomenon, and how you

> learned to recognize when you are talking with a visual learner? What cues

> do you look for?

>

> I love that you draw pictures during an explanation, and agree that this

> act is a "symbol of personal care", AND will help the patient to retain

> the information better. But for those clinicians who are not comfortable

> doing that, how else could they access visuals quickly to help with an

> explanation?

>

> Such as...

> * lots of posters on wall

> * collection of good brochures/fact sheets with pictures to point to

> * index card file with variety of pictures you could refer to

> * other ideas?

>

> Thanks again for a great example of clear communication!

>

> Julie

>

> Julie McKinney

> Discussion List Moderator

> World Education/NCSALL

> jmckinney at worlded.org

>

>>>> "Zeitz, Howard" <hzeitz at uic.edu> 10/19/07 11:55 AM >>>

> When working as a clinician doctor (Latin root = teacher), I "teach" all

> day long. (In my world, teach=helping someone understand something.)

>

> I hand-draw pictures most of the time, and I use file pictures once in a

> while. The common phrase is "a picture is worth a thousand words"; in the

> medical world, a picture is worth a million words. Teachers sometimes talk

> about people either as visual learners, auditory learners or kinesthetic

> learners. Pictures are ESSENTIAL/MANDATORY for visual learners. Through

> practice I can now recognize easily when I am having a conversation with a

> "visual learner"; I immediately start drawing pictures, then talk from the

> pictures--adding labels as I talk. Finally, the act of creating the

> picture on the spot carries the symbol of personal care (this is not an

> off-the-rack picture that everyone receives, this is MY picture). The

> picture then goes home with the individual to help them share what they

> learned with other family members.

>

> Kinesthetic learners need models they can touch and/or manipulate.

> Auditory learners do not need pictures and/or models, but their learning

> is deeper and broader with pictures and/or models. Individuals with

> auditory disabilities MUST have pictures and/or models.

>

> There are several reasons why these strategies are not used more often.

> The most commonly cited reason is the time it takes to help someone truly

> understand something; time is money in the modern world and reimbursement

> for healthcare education is not reimbursed well if at all in most

> healthcare scenarios. Perhaps an even more common but unacknowledged

> reason is that most clinicians have little if any training in teaching and

> LEARNING. If the clinician knows nothing about learning, s/he cannot

> possibly appreciate the value of pictures in medical/health education.

> Both of these root causes are remediable---but only with the development

> of the political will to make it happen.

>

> Howard J Zeitz, MD

> Co-Chair, Rockford Regional Partnership for Health Literacy (RRPHL)

>

> Medical Director, Asthma and Allergy Services

> University of Illinois College of Medicine--Rockford

>

>

============================================================================

>

> On Fri, October 19, 2007 7:48 am, Julie McKinney wrote:

>> Thank you, Nancy, for sharing with us this eye-opening information about

>> health literacy issues for the Deaf community. It certainly seems like

>> more efforts need to be initiated in this area. I have many questions,

>> but

>> for now I want to stick to those that relate to communication between

>> the

>> patient and the health team.

>>

>> How effective is it with Deaf patients to pair pictures with the

>> information that is being translated? It has been shown in hearing

>> patients that the use of pictures can improve compehension and

>> especially

>> recall of the information.

>> (See:  http://healthliteracy.worlded.org/doaks_houts_article.pdf )

>>

>> This is a question that I want to bring up for everyone now. We have not

>> yet talked about the use of pictures while communicating, yet they have

>> been found to be enormously effective not just in take-home materials,

>> but

>> during a clinical encounter as well. How many of you (whether as a

>> patient

>> or health professional) have experienced using pictures during a visit

>> while communicating? How well has it worked for you? Why don't we do it

>> more often?

>>

>> I would love to hear some responses to these questions!

>>

>> Thanks all,

>> Julie

>>

>> Julie McKinney

>> Discussion List Moderator

>> World Education/NCSALL

>> jmckinney at worlded.org

>>

>>>>> "Nancy Meyers" <njmeyers at gmail.com> 10/17/07 4:43 PM >>>

>> I would like to briefly comment on a couple of the topics that have come

>> up.

>> My primary experience has been with the Deaf Community in the area of

>> health

>> education and health literacy. First, health literacy assumes English

>> literacy for non-English users. It helped a great deal when I told an

>> audience of Deaf people that most medical terms are from Latin. We break

>> the

>> long words apart. Cario=heart, pulmonary=breathing/lungs etc. This helps

>> expand their knowledge "in context" of one topic. Second, "Teach Back"

>> is

>> not as effective or reliable when the physician/health professional is

>> completely dependent on an interpreter. It is difficult to measure

>> comprehension when all that is happening is the information is coming

>> back

>> through an interpreter. With American Sign Language this is particularly

>> true. In 2002, Sinai Health System in Chicago interviewed (in ASL) 204

>> adults here are examples of the results: "Forty percent of respondents

>> could

>> not list any symptoms of a heart attack, while over 60% could not list

>> any

>> symptoms of a stroke. Less than half of respondents identified chest

>> pain/pressure as a symptom of a heart attack. Only 61% reported that

>> they

>> would call 911 in response to cardiovascular disease symptoms." Some

>> people's health literacy is so low, that nothing short of someone from

>> the

>> culture teaching in the native language can fill the gap. For Deaf

>> people,

>> that means more Community Health Workers (3 in the whole of the US is

>> not

>> much), ALL health information in ASL which means video. Finally, the

>> issue

>> of people learning more about how to advocate for themselves. Deaf

>> people

>> do

>> not want to ask too many questions because if the physician comes back

>> with

>> another question, they will not be able to answer it. Without knowledge

>> and

>> access to information we cannot expect people to advocate...complain

>> sometimes...but not advocate. With HIPPA and other "restrictions" health

>> advocates and even chaplains are finding it difficult to visit and serve

>> as

>> support people. I recently was with a Deaf breast cancer survivor who is

>> in

>> her 3rd bout with cancer. She attended a conference we organized with

>> oncologists etc. One topic the Deaf women wanted to learn about was

>> lymphedema. Sitting there with her arm and hand swollen she asked, "Do

>> you

>> think that is what I have?" How could she have cancer for the 3rd time

>> and

>> no one has explained to her what that is. Currently we are making a

>> documentary about Deaf Breast Cancer Survivors and interviewing these

>> women.

>> Their stories are eye openers into all the questions posed about the

>> environment. I think the lessons and learnings with this population are

>> transferrable to many.

>>

>> Nancy Meyers, MS

>> Consultant to the Deaf Community

>> Founder of the Deaf Hospice Education & Volunteer Project

>>

>>



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----------------------------------------------------

> National Institute for Literacy

> Health and Literacy mailing list

> HealthLiteracy at nifl.gov

> To unsubscribe or change your subscription settings, please go to

> http://www.nifl.gov/mailman/listinfo/healthliteracy

> Email delivered to julie_mckinney at worlded.org

>

> ----------------------------------------------------



Howard J Zeitz, MD
University of Illinois
1601 Parkview Ave
Rockford, IL 61107
T: 815-395-5964
F: 815-395-5671

----------------------------------------------------
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Health and Literacy mailing list
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------------------------------

Message: 2
Date: Fri, 19 Oct 2007 17:12:19 -0400
From: "Helen Osborne" <helen at healthliteracy.com>
Subject: [HealthLiteracy 1424] Re: Use of pictures for Deaf     and
        hearingpatients
To: "The Health and Literacy Discussion List"
        <healthliteracy at nifl.gov>
Message-ID: <011c01c81294$bc4b9970$6401a8c0 at HLC>
Content-Type: text/plain; format=flowed; charset="iso-8859-1";
        reply-type=original

Julie asked where to buy already-drawn tear sheets. Here are some companies
that quickly come to mind (and likely there are many more):

Pritchett & Hull, http://www.p-h.com <http://www.p-h.com/> 
Krames, http://www.krames.com <http://www.krames.com/> 
Anatomical Chart Company, http://www.anatomical.com <http://www.anatomical.com/> 

~Helen

Helen Osborne, M.Ed., OTR/L
Health Literacy Consulting & Health Literacy Month
www.healthliteracy.com & www.healthliteracymonth.org
helen at healthliteracy.com
508-653-1199
Ask me about the new "Health Literacy Month Handbook"
----- Original Message -----
From: "Julie McKinney" <julie_mcKinney at worlded.org>
To: <healthliteracy at nifl.gov>
Sent: Friday, October 19, 2007 4:17 PM
Subject: [HealthLiteracy 1422] Re: Use of pictures for Deaf and
hearingpatients



> Helen,

>

> Do you know where to get these tear sheets with pre-drawn pitcures? What a

> great idea!

>

> Also, just to reinforce a point that Anne made, another nice thing about

> using pictures is that they encourage the subtle yet effective habit of

> sitting next to each other when communicating!

>

> Julie

>

> Julie McKinney

> Discussion List Moderator

> World Education/NCSALL

> jmckinney at worlded.org

>

>>>> "Helen Osborne" <helen at healthliteracy.com> 10/19/07 3:11 PM >>>

> One reason I think that clinicians don't draw is that they think they

> can't.

> To get beyond this hurdle, in some of my workshops I review how to draw

> stick figures, including proper body proportions. With little practice and

> lots of humor, most participants are soon able to draw recognizable

> figures.

>

> For those who can't or don't want to draw pictures (especially of internal

> body parts), I suggest using tear sheets with pictures already drawn on

> them. For instance, when explaining heart procedure the clinician only

> needs

> to highlight, draw, circle, or otherwise mark where the problems are and

> what was done.

>

> Whether drawing "from scratch" or adding to a pre-drawn picture, it is

> important to supplement it with simply written text. And then give the

> picture to the patient, of course!

> ~Helen

>

> Helen Osborne, M.Ed., OTR/L

> Health Literacy Consulting & Health Literacy Month

> www.healthliteracy.com & www.healthliteracymonth.org

> helen at healthliteracy.com

> 508-653-1199

> Ask me about the new "Health Literacy Month Handbook"

>

> ----------------------------------------------------

> National Institute for Literacy

> Health and Literacy mailing list

> HealthLiteracy at nifl.gov

> To unsubscribe or change your subscription settings, please go to

> http://www.nifl.gov/mailman/listinfo/healthliteracy

> Email delivered to julie_mckinney at worlded.org

>

> ----------------------------------------------------

> National Institute for Literacy

> Health and Literacy mailing list

> HealthLiteracy at nifl.gov

> To unsubscribe or change your subscription settings, please go to

> http://www.nifl.gov/mailman/listinfo/healthliteracy

> Email delivered to helen at healthliteracy.com




------------------------------

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