Funding to Address the Digital Divide in Health Literacy

Health Literacy, Technology and Learning, and Program Management Colleagues,

While the Internet access digital divide, including for adult basic skills learners, appears to be narrowing, we still have the digital use divide. This plays out, for example, when adult learners need to apply online for jobs, benefits, or college financial aid; or when they need to communicate with their children's teachers. Now there is research evidence that there is a digital divide in health literacy.

A new health literacy study concludes that "About half of Americans have low health literacy and struggle to find and use health information, which is associated with negative outcomes, including overall poorer health. Health information technology (IT) can be used to make health information directly available to patients via electronic tools, such as patient portals, wearable technology, and mobile apps." The  study in Journal of Medical Internet Research "found that the use of health IT, such as fitness and nutrition apps, activity trackers, and patient portals, are significantly associated with improved health literacy, but patients with low health literacy were less likely to use health IT tools or perceive them as easy or useful. The study also explored whether health literacy is associated with patients’ perceived ease of use and usefulness of these health IT tools, as well as patients’ perceptions of privacy as offered by health IT, and trust in media, government, technology companies, and healthcare."

There was a period, in my state and a few others, when state agencies funded adult basic education programs to increase adult learners' health literacy but, as far as I know, that funding no longer exists. Do you have funding in your state for health literacy? The overwhelming emphasis of public funding on college and career readiness seems to me to have eclipsed the need to address family literacy and individual and family health literacy.

Perhaps with the new WIOA legislation, and its emphasis on the importance of the provision of digital literacy, there will be opportunities for state adult education agencies and programs to newly support health literacy as part of digital literacy. I wonder if anyone is seeing evidence of that yet. I also wonder if programs have been seeking funding from charitable foundations and the United Way for these important aspects of adult basic skills education, to address the digital use divide and health literacy divide together, for adult basic skills learners. If so, let us (or me) know about them.

David J. Rosen, Moderator

Technology and Learning, and Program Management CoPs

djrosen123@gmail.com

 

Comments

I am not aware of anything in Kentucky at the moment but I think a couple of us are getting ready to look at that. I do have a question though. The latest thing I could find (http://www.nytimes.com/2013/08/19/technology/a-push-to-connect-millions-who-live-offline-to-the-internet.html?_r=0) stated that even though 98% of the homes in America have broadband access, 20% of them still do not access the Internet. Also a little more than half of those Americans over 65 access the internet. It seems to me that would have implications for health literacy. Based on these numbers it would seen that the Internet would not be the answer for older Americans as far as finding information related to health. What do you think would be the best way to address this issue?

Brian and others,

I am very glad to hear, Brian, that you are looking at the health literacy digital divide in Kentucky. Please let us know what you find out. I hope others will do the same in their states, and also let us know what they find.

The best source of U.S. data on who is /isn't getting access to the Internet, and how they are using their access, is the Pew Research Center's Internet and American Life Project. I believe that their latest data on older adults is from 2014. They reported that "America’s seniors have historically been late adopters to the world of technology compared to their younger compatriots, but their movement into digital life continues to deepen," and "Two different groups of older Americans emerge. The first group (which leans toward younger, more highly educated, or more affluent seniors) has relatively substantial technology assets, and also has a positive view toward the benefits of online platforms. The other (which tends to be older and less affluent, often with significant challenges with health or disability) is largely disconnected from the world of digital tools and services, both physically and psychologically."

The 59% rate of access to the Internet in 2014 that they reported represented a 6% increase over the 2012 data in the NYTimes article you cited. While this is an encouraging trend, I would agree that much lower access by adults who are 65 and older has implications for their health literacy. Since nearly all adult learners in basic skills and English language programs are under 65, I am not sure that adult basic skills education can have an impact on that problem; however, we may be able to have a significant impact on how out-of-school adults, aged 16 and up, who _are_ enrolled in basic skills programs, make use of their Internet access to address their own and family-related health issues using acquired digital literacy and problem solving skills. A huge opportunity is being lost because community health centers and community adult basic skills programs do not often collaborate, even in communities where there is a great overlap between health center patients and the learning center students. I am hoping that, working together, we can build those partnerships at the community level, and that part of the community health solution is to focus on adults digital literacy and problem solving in family health.

What would that look like?

As a result of strong, well-funded partnerships between community health centers and community adult education programs that provide basic skills (including English for immigrants), "learner-patients", the majority of whom are low-income, would have:

1) Free or low-cost, daily broadband access by computer and portable digital device;

2) Many and varied opportunities to acquire health-contextualized digital literacy and problem-solving skills, including those contextualized in individual, family and community health;

3) Excellent information literacy skills so they could acquire -- and competently judge the quality of -- basic health-related information, and learn about how to access and use affordable health care options and services; and

4) A regular health care provider team with whom they could communicate orally by phone and in person, and by text in English.

That's my vision. I wonder what you and others might add to that, or what questions you might have.

Who else is working on bridging this digital use divide in their community or state, and are you working specifically on bridging the digital health literacy divide?

David J. Rosen

djrosen123@gmail.com

Dear Health Literacy Colleagues:  Please consider tuning in to this discussion.  It seems important as more interactions with healthcare providers and health information occurs in technology environments.  Cynthia

From October 24-28, the LINCS Technology and Learning Group will host a panel discussion on teaching students practical skills to solve problems in technology-rich environments. The topic is relevant and timely: Of the domains assessed by the PIAAC Survey of Adult Skills, Americans performed most poorly in Problem Solving in Technology-Rich Environments (PSTRE). This discussion may be especially useful for teachers, tutors, program administrators, and other practitioners interested in assessing and teaching these skills.

The panel, hosted by Moderator David J. Rosen, includes experts specializing in researching and/or teaching these skills:

  • Dr. Jill Castek, Portland State University assistant professor, Department of Applied Linguistics, focused on instructional techniques and digital tools to support reading, writing, and content learning
  • Dr. Stephen Reder, Portland State University professor, Department of Applied Linguistics, interested in adult literacy and second language acquisition
  • Jennifer Vanek, World Education, Inc., interim director for IDEAL Consortium, working to develop effective distance education programs for adult learners
  • Kenneth Tamarkin, experienced technology coordinator, workforce and adult basic education professional with the Asian American Civic Association
  • Edward Latham, education specialist with Axiom Education & Training Center, leveraging technology to bring educational opportunities to impoverished and remote communities in rural New England

Registration is not required, and no resources are needed to join the panel discussion. Digital Inclusion and Digital Literacy in the United States: A Portrait from PIAAC’s Survey of Adult Skills, a research paper by Stephen Reder published by the American Institutes for Research, will be referenced, as will Jennifer Vanek’s new research on helping practitioners teach PSTRE skills, which will be published and available to share publicly this fall.

Questions and requests for more information can be directed to David J. Rosen.

Thanks,

-The LINCS Team