Welcome to Part 3 of our Discussion: Integrating Health Literacy into Basic Skills Instruction

Yes! You are already teaching all of those skills! So addressing health literacy simply means that you use health as a context area for teaching those same skills. This is why it should not take away from the comptetencies you are required to teach, but rather enhance them.

So you are teaching the same skills that are needed to improve both health literacy and literacy, and you are also teaching in a way that is particularly condusive to improving health literacy.

Let's look at some of the best practices that we use in teaching:

• Use students' life experience as part of the learning process
• Validate each person's knowledge and beliefs
• Incorporate new knowledge and skills into real life
• Practice these skills to make them meaningful
• Process and reflect on the new knowledge and skills
• Encourage students to teach others as a way to embed their knowledge and skills
• Use the creative process
• Use authentic materials

Any thoughts about this list? Do these make sense? Any more to add? 

How can these teaching practices be used to address health literacy? Please reply with your comments!

So let’s look at how we can use the best practices to integrate health literacy skills into our classes. The goal is to use our existing curriculum plan and our existing goals, but to infuse some health literacy into those. We do not want to take time away from those goals, but rather to use health as a context area for the skills we are teaching anyway. Often this can engage students and enhance to learning because it is so relevant to their everyday lives.

Throughout this section, I will refer to some excerpts from resource guides or curricula. The excerpts are all short, so I hope that you will read them as part of this overall discussion.

Here is an outline of how you might proceed.  These are the beginning steps. Later we will look at how to approach a specific teaching activity.

Please feel free to comment on any of the steps here! I would love to make this richer over time by hearing from you.

1.    Get your mindset ready for addressing health: It can feel threatening to be addressing health when your role is to teach literacy and language. The best way to frame it to yourself is that you are still playing the same role as always.

a.    Read this section from Family Health and Literacy: You Don’t Have to be a Health Expert.

2.    Introduce health in an open, non-threatening way: Health can be an emotional topic for many students. When you start out, it is good to approach health from a positive point of view. Frame it as good health rather than sickness.

a.    Read the paragraph: Introducing Health in the Classroom

b.    Look at this introductory lesson: Good Health. Please note that this lesson is the first in a full curriculum called HEAL:BCC. All the internal links in this lesson work EXCEPT for those to the Passport to Health. Use this link instead: http://healthliteracy.worlded.org/heal/passport/.

3.    Choose a topic together: To make this most relevant to your learners, it is always best to decide together what they want to study. The process you use to decide can flow from the lesson I mentioned in #2 above. You can do this orally: brainstorm and discuss as a large group or in smaller groups or partners. Or you can use some writing prompts to get people’s ideas: they can make lists or write a short piece about what they would like to study. They may choose a health topic like nutrition or colds & flu. Or they may choose access skills like talking to the doctor or finding their way around the health clinic.

4.    Talk, discuss and share knowledge, customs and beliefs: Health is an area where people from different families and different cultures will have their own beliefs, habits and traditions. These are all important to address and validate as you move forward in this process.

a.    Read this paragraph: How to Engage Students

These first steps should help to get you started and feeling ready to infuse health into your classroom plan. The next step is to choose teaching materials to use. Please share your thoughts!

We've talked about how to get started and introduce the topic of health to our learners. Now let's talk about the next steps: using the available resources to teach health literacy skills while teaching literacy and language skills.

There are many choices of activities and lessons to use. You need to think about how much time you want to devote to this, what kinds of activities you want to use, and what language and literacy skills you want to work on.

You can also choose to follow a comprehensive curriculum or piece lessons together as you go. And the type of activity can range from tackling a story or reading to having a guest speaker in your classroom. Whatever it is, you want to prepare students, do the activity, then process it. Here’s a basic outline:

1.    Explore the chosen topic through a reading, an experience or an activity.

2.    Talk, discuss and share knowledge, customs and beliefs. (See #4 from the  last post.)

3.    Follow up with the kinds of literacy activities that you would do anyway. They will relate to the topic, but focus on specific skills, such as pronunciation, grammar or reflective writing. Many of the curricula or classroom activities you may be using will have these as options, but you may need or prefer to make your own practice exercises.

4.    Process the information and practice the skills with longer-term classwork. This could be a longer writing project, an oral presentation to the class, an interview with a family member, or a creative project.

5.    Revisit this activity or unit at later points in the year to continue processing.

Let’s look at an example of integrating health literacy into an ESOL or a beginning ABE class. Say the students decided to learn about taking medicines. We’ll use this resource for the example:

Staying Healthy: An English Language Learners Guide to Health Care and Healthy Living

http://www.floridaliteracy.org/FLCHLP/files/TE%20Files/CompleteTEBook.pdf

Scroll down to Chapter 3: Medicines

> > page 39 of the Teacher’s Guide (page 48 of the PDF)

Take a look at this chapter and see the kinds of activities it includes. I will note a few things that relate to some of the best practices we mentioned.

First, see the CASAS competencies that are addressed in this lesson. These are listed at the beginning of each chapter to show how these activities can align with the CASAS requirements.

Things to notice:

• The guide takes you through the process of starting with a picture and giving prompts to discuss it. (This is like a code from Freire’s work.) This allows everyone to have a say and share their experience, beliefs and knowledge about the topic.
• The key vocabulary that will be part of this topic is highlighted, and can be reviewed in the picture glossary in the back of the book.
• The activities include a variety of ways to practice the new information while addressing grammar, pronunciation and math skills.
• Authentic materials (pill bottles) are used.
• There is a review of the material at the end with a short quiz.
• There are suggestions for how the students can share this new information with others in order to reinforce their learning.

Activities:

• Tap the stress: pronunciation
• Grammar exercise: “How much?” vs. “How many?”
• Hands-on activity: looking at medicine bottles
• Math activities: measuring, equivalencies
• Internet activities: suggestions for online exploration of medicines
• Dialog: to practice speaking AND to empower learners to speak up!

So please explore this a bit and then share your thoughts or questions with us!

How would this fit with what you already do in your class setting?

How do you think your students would react?How much or how little does this feel

Now let's look at an example of a unit on filling out a health history form. This is a skill that everyone who sees a doctor needs to have, and using it as a class activity is very meaningful. Students are likely to be motivated, since they are likely to have been frustrated by this in the past. This is also an area where we as teachers can assure them that we, too, get confused by these forms!

This comes from the Queens Library Health Literacy curriculum for ESOL Learners.

From the Main Page, look at Lesson #7: Filling Out a Health History.

There are five activities in this unit:

• Doing telephone role plays of making an appointment
• Reviewing medical vocabulary that you might find on a health history form
• Filling out a health history form (with support!)
• Listening exercise with recorded health histories
• Question and answer activity with partner

This unit is designed for ESOL classes, so there is a lot of speaking and listening practice. The Main Page has audio files for the listening activites. There is also an activity about the vocabulary itself, since this is a such a big challenge with health history forms. There is a sheet where students can write in the translations from their own language or a definition in their own words.

This does not have specific grammar or math activities, but can there are ways that those could be built around this.

Any thoughts on this?

In Part 1 of this discussion series, we talked about what kinds of skills adult learners need in order to take care of their health. One skill that came up was digital literacy skills. David Rosen wrote: "Important digital literacy skills I think we need to teach ELLs include how to find these web sites, how to navigate in them, and how to know if or why the information they provide is accurate."

So this next example addresses those skills.

Who Can You Trust? Health Information and the Internet: Curriculum Sourcebook

The curriculum was developed by ABE teachers and librarians, and designed to use with middle school students and young adults in a non-formal educational setting. It has also been used with 5th and 6th graders, and would be appropriate or adaptable to use with ABE students.

It includes three 1-hour lessons:

1. Using the Internet to Find Health Information
2. Evaluating Health Information You Find on the Internet
3. Demonstrating Health Information Literacy Skills

The activities include

• Doing a structured “Treasure Hunt” for health information online
• Using a “Quality Information Checklist” to assess the viability of the websites
• Comparing Google searches with searching on recommended health websites
• Researching online: practicing finding answers to specific health questions on the internet
• Processing their experiences and self-assessment
• Doing a community outreach project (e.g. create an educational poster, tutor seniors at a local library, etc.)
• Writing a story-based self-evaluation

As you can see, this includes many components of literacy and language skills such as speaking, listening, reading writing and critical thinking. It also includes hands-on digital literacy skills, interacting simultaneously with checklists, screens and printed materials, and learning by doing.

This also serves a good model for the process of developing a curriculum like this. There was a needs-assessment, a pilot and an evaluation, all of which are described at the end of the sourcebook. There’s also an article about the process: Health Information Literacy Outreach: Improving Health Literacy and Access to Reliable Health Information Online in Rural Oxford County Maine.

Any comments on this?