health literacy separate from education level?

There are at least three very different ways to look at the problem of measuring education levels for students interested in personal, family and community health:

1. Find out the health topics the students are interested in, assess their literacy and numeracy levels, then choose materials that match those levels, and offer them lessons in the topic(s) in which they are interested.

2. Find out the health topics the students are interested in, find good materials -- including audio and video materials  -- that address those interests/needs, and help (motivated) students to get the information they need from the materials, even if some require a stretch. In the process they can actually improve their literacy and numeracy skills.

3. Find out the health topics the students are interested in, and if they are also interested in making materials that will be effective with members of their community, help them to organize a health lliteracy project in which they make brochures, posters, presentation slides, mp3 (audio) files, and/or videos. Obviously, before they make these outreach materials, they need to gain expertise on the topic, and they will need to have a health expert in that topic area review their materials for accuracy. This project-based approach is highly motivating for many students, however, and through it the learners not only provide a useful community service but, as teachers know, when they prepare presentations and teach or present they will learn much, much more.

I recommend the second and third approaches. If designed well -- within the students' zones of proximal development (challenging but not out of reach to learn), adult learners who are motivated to learn more about a health topic so that theiy can improve their own lives, and the lives of family and community members, will learn a great deal more and will apply the knowledge.

Of course, those are different ways -- in an education context. In a health context, for example a hospital or clinic, what is most important -- to the patient and care providers -- is that the patient understands what s/he needs to, to prevent or manage a condition. I do not recommend that health care providers try to assess literacy or health literacy. Patients -- especially those with reading and writing difficulties -- often resent this. Instead, focus on providing a range of ways that patients can learn about their disease or condition, some which do not depend on reading, or which have audio or video alternatives that do not require reading. The caregiver can explain the options and ask which one(s) the patient prefers -- perhaps including talking with a caregiver skilled in explaining verbally -- without even asking about reading or numeracy skills, not to mention assessing them. Some numeracy skills can be taught in the context of managing a condition.

David J. Rosen

djrosen123@gmail.com