Dear Colleagues:
Greetings! October is Health Literacy Month, an idea started by Helen Osborne.
October 2015 provides an important opportunity at the midpoint of the decade to ask, "Are we moving closer to the overarching goals set forth in Healthy People 2020?" [Healthy People 2020 website and brochure]
- Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
- Achieve health equity, eliminate disparities, and improve the health of all groups.
- Create social and physical environments that promote good health for all.
- Promote quality of life, healthy development, and healthy behaviors across all life stages.
Improving health literacy is seen as essential to the success of our national health agenda. In the National Action Plan to Improve Health Literacy, adult educators and community services providers play a direct role in supporting improved health literacy (see pages 35-36).
GOAL 4—Support and Expand Local Efforts to Provide Adult Education, English Language Instruction, and Culturally and Linguistically Appropriate Health Information Services in the Community.
Here’s a partial list of activities under Goal 4.
- Support community-based programs that empower people to be more involved and active in health and teach skills, such as computer use, to assist people in acquiring credible health information
- Infuse health literacy skills into curricula for adult literacy, ESOL, and family literacy programs
- Facilitate collaboration among the adult literacy and ESOL communities; health care partners; and community-, faith-, and academic-based organizations
- Include high school, college, and professional school students in health literacy programs to bridge cultural and generational divides
- Provide professional development in health education topics and skills for those teaching adult literacy, ESOL, and family literacy programs.
I believe many adult educators are doing these activities. Which activities are you able to provide in your classroom, your program, your community? How do you weave health literacy into your work?
Cynthia Zafft
Health Literacy Moderator
Comments
Hi Cynthia and Health Literacy Educators!
Lenore Balliro here. I have a few simple idea for weaving health literacy into everyday classroom settings. These are applied ideas that can serve as departure points for more learning. Some of these ideas come from my work in the Managing Stress to Improve Learning project at World Education:
--Provide a pitcher of water at each class. A great number of adults in the U.S. are chronically dehydrated, and this affects learning and memory. Use the water as a departure for lessons about the value of hydration. You can also expand into a lesson about the need, or no need, to filter tap water, about how water transports nutrients in the body, and so on. Students could explore the controversy about fluoride in water, and even extend to geo-political issues around drought and its consequences.
--If funds allow (we are always creative in adult ed!), provide a simple snack for students--cut up fruit, grapes, whole wheat crackers. Use as a departure for a lesson to discuss keeping a stable blood sugar level and how this affects learning and well being. This could lead into a full unit on nutrition.
--Before class, as a way to transition into learning, spend a few minutes doing stretching or "brain gym" activities. These few minutes can energize students and model healthy movement exercises one can actually fit into a busy day.
--Provide breaks (we often forget, in our passion to fit everything in!) where students get up and move, even for 5 minutes. Use this as a way to explore how sitting for long periods affects the body. This could expand into students exploring what happens to body alignment with continued bad posture,etc.
--At the end of class, allow a few minutes for a guided meditation or deep breathing ritual. This models relaxation techniques that can help students relax.
In my experience, some students may find the relaxation and stretching activities a little odd at first, but most come around to liking, and anticipating them!
Best wishes,
Lenore
Hi Lenore:
Thanks so much for the post. I like that the ideas are straightforward and doable in most classrooms. For folks that haven't visited the Managing Stress website, I think you will find that the work completed by Lenore, participating adult educators and their students is pretty impressive.
What about others in our group? How do you weave health literacy into your work?
Cynthia
Yesterday I was strongly reminded that as educators we need to be VERY careful in assuming that our students NEED health literacy to the extent that we think they do and not to be overly zealous in promoting our own cultural views of healthy eating and behaviors. I was having lunch with a friend who has "adopted" a large, newly arrived refugee family from southern Africa. She was telling me that she had taken the father of this family to BJ's to do shopping (she was merely the driver as this family does not own a vehicle) and when they finished, she was impressed that the huge shopping cart was overflowing with everything fresh in the store-- vegetables and fruits, some meat and fish. Until one of the daughters added a package of cookies, there was NO processed food whatsoever in the cart. Then they had to stop at Walmart to get all the family sized bags ( 6 lbs each) of dried beans that Walmart had since BJ's does not carry staples of that kind. This experience of hers echoes research cited in the news a few months ago that showed that immigrants tend to have relatively healthy diets before coming to the US and then end up having poor health once they switch to American fast food and processed foods.
Maybe the health literacy lessons and suggestions need to stress that families should maintain their healthy diets as much as possible! I know this is difficult in some families. In the last couple of months, I have twice encountered families where one or more of the children would not eat the family's ethnic food and instead would eat ONLY the lunches at school or food from McDonald's-- in both instances, the parents were not able to do much about that. I think one of these children was just enamored of the new tastes, but in the other case, I think the child felt it made him "less American" to be eating his family's traditional food. When I sat at their table and swooned with joy at having the fresh-made food that I so love, this boy looked at me in amazement and asked, " You LIKE that food??"-- which made me think he has peers from other cultures-- and perhaps America-- who make him feel embarrassed about eating his own family's food.
Another lesson on health literacy lessons was learned in a class I observed in NY a couple of years ago-- where the teacher was doing a unit on healthy eating and other health practices. At the end of the lesson, she asked students to tell what healthy activities they had participated in or done since the last class. Each cited things such as having a salad at lunch, taking a walk, going for a jog, choosing to eat more fruit, etc. Because she knew her class well, the teacher challenged them when they were finished and asked if that was all true. They ALL said, no and confessed they were just saying what they knew she wanted to hear......
It seems to me that part of the lack of buy in can be due to the fact that some teaching materials do not include foods that immigrants prefer and buy from their own cultures. The pictures and lessons are about super market food that we all know-- pears, plums, oranges, apples,-- and rarely include other tropical or foreign fruits (except the picture dictionaries, which have gotten better about this....) or lessons about making tortillas and beans, or njera and spinach sauces or fresh spring rolls or kimchi. I don't remember seeing star fruit, or papaya, or yucca and yams, guanabanas, or other fruits in the lessons in textbooks used in ESOL classrooms.
While I think Lenore's suggestions are very useful and do-able, I want to repeat the caution of making sure we are not pushing our cultural values too much. Just a month ago, there was an article in the NY Times refuting the widespread belief that we need to have 8 glasses of water a day. The writer noted that this belief was based on a misconstrued interpretation of ONE person's research back in the 1950's and that the study has never held up to scrutiny ever since. The writer expressed the regret that despite repeated attempts to clarify that interpretation, the belief that we need that much actual WATER persists.
I definitely feel there is room for education about the effects of sugar, for example, or the need to read labels carefully and there is also room for helping students find value in the foods they already eat and for valuing the healthy choices our students already make.
Robin Lovrien
Hi Robin:
Thank you for the warning to go carefully. I was wondering what others do to help support healthy eating habits that students bring to this country.
I use ChooseMyPlate.gov (it includes star fruit, papaya, yucca and yams, but no guanabanas) for most of the nutrition discussions here but I did notice that when it comes to illustrations, the usual oranges, apples, and grapes tend to show up.
Cynthia
It is very true. Often we Instructors with limited knowledge of other cultures, eating habits, and life style choices teach immigrants our idea and definition of what is healthy in eating, life style, and health care.Yes, the text books and resources are not very helpful either. In my class. I pick and choose the lessons based on what I know is missing from my students' culture and home country. I have never had a student who had unhealthy eating habits. Bad habits; yes, smoking and drinking. Often times I create lessons using materials from USDA, CDC etc. I also teach them about genetic predispositions using research based data and what they should watch for based on their ethnicity. I also teach my students how to make ethnic food more acceptable to their own kids by making minor tweaking of their recipe. Noodles and beef is a traditional American staple. They can cook their noodles in a similar way. So are a lot of other dishes. In my opinion, two topics that must be taught to ESOL students are 'making an appointment' to see a doctor. That is not the custom in most other countries. They go to the doctor/hospital when they are sick. I teach them why it is necessary and the cost of walking into an ER and go through a lot of tests when they have a headache. We study about walk in clinics and have the students take note of the phone numbers and time, so they can go there during after hours instead of an ER .Another lesson is the vaccination schedule. Most have no clue about the legal need for vaccinations for their children's schooling. They also have very little understanding of the abbreviations for the diseases and the recommended timeframe to get the vaccination. A lesson on vaccinations is very important.
Preventive care is not something most immigrants are familiar with. Even though most go through yearly physicals for medial insurance purpose they don't understand the importance doing it to prevent something from happening. We have a class on flu clinics and the importance of getting a flu shot to avoid missing work because of flu or developing complications and secondary issues from a flu. We also talk about tetanus shots and why they are important and the need to get the boosters as recommended. Students also need to be taught about the need to check their vaccination record to see what and when they need a booster shot. We do it in summer, and have them mark the ones on their calendar so they can call the clinic to get one for themselves or their children,
Hi Anitha, Robin, and HL Colleagues:
As part of Health Literacy Month, I was going through the LINCS Resource Collection, looking at the instructional materials. Some are becoming a bit dated (food pyramid vs plate; insurance issues) but I think there are many lessons you may want to revisit.
As Robin mentioned, you may want to use the overall lesson plan but ask your students to help you rethink examples, such as the foods and menus that are discussed.
*Details of the National Reporting System (NRS) Educational Functioning Levels (EFL) can be found here.
Are you, like Anitha, creating your own materials as you need them? Are the instructional materials in the LINCS Resource Collection ones that you use? Did you know, you can suggest a resource for the collection? To suggest a resource for inclusion in the Resource Collection or to inquire about serving as a reviewer, please send a link to the resource and a summary of the material to the LINCS Resource Collection editor at support@lincs.ed.gov.
Cynthia Zafft
Health Literacy Moderator
Dear Colleagues:
To close out this week, I thought I would send out a poem. Elspeth Murray recites the poem that was included at the International Initiative in Mental Health Leadership Conference in Edinburgh in 2006, where she conducted poetry workshops: This is Bad Enough
Cynthia Zafft
Health Literacy Moderator