Health literacy and the Internet: a study on the readability of Australian online health information

OBJECTIVE: Almost 80% of Australian Internet users seek out health information online so the readability of this information is important. This study aimed to evaluate the readability of Australian online health information and determine if it matches the average reading level of Australians. METHODS: Two hundred and fifty-one web pages with information on 12 common health conditions were identified across sectors. Readability was assessed by the Flesch-Kincaid (F-K), Simple Measure of Gobbledygook (SMOG) and Flesch Reading Ease (FRE) formulas, with grade 8 adopted as the average Australian reading level. RESULTS: The average reading grade measured by F-K and SMOG was 10.54 and 12.12 respectively. The mean FRE was 47.54, a 'difficult-to-read' score. Only 0.4% of web pages were written at or below grade 8 according to SMOG. Information on dementia was the most difficult to read overall, while obesity was the most difficult among government websites. CONCLUSIONS AND IMPLICATIONS: The findings suggest that the readability of Australian health websites is above the average Australian levels of reading. A quantifiable guideline is needed to ensure online health information accommodates the reading needs of the general public to effectively use the Internet as an enabler of health literacy.

Techno-literacy and blogging within a formal higher education setting

For the last two decades, higher education institutions have been actively engaged in the use of online technologies with the aim of transforming the ways we teach and learn to improve students’ learning experiences and outcomes. However, despite significant investment in infrastructure and training and a wide-scale uptake of such technologies, the promised transformative effect on student learning is yet to be actualised outside of small pockets of innovation. In this paper, we argue that one of the factors contributing to lack of qualitative large-scale transformation is students’ lack of preparedness and experience in using online tools for academic purposes. Focusing on students’ experience of a learning activity that used blogging to promote critical thinking and reflection, we draw on data from a doctoral study to demonstrate how a techno-literacy framework can be used to analyse the nuances of students’ preparedness to put such technologies to work within a formal higher education setting. We argue that, although contemporary university students are largely operationally literate when using online learning tools, they often lack the cultural and critical skills required to use such technologies in a meaningful way to support powerful learning. We argue that, for online learning technologies to transform learning, students need to be supported to develop these higher order techno-literacies.

Health literacy and the determinants of obesity: a population-based survey of sixth grade school children in Taiwan

BACKGROUND: Health literacy has become an important health policy and health promotion agenda item in recent years. It had been seen as a means to reduce health disparities and a critical empowerment strategy to increase people's control over their health. So far, most of health literacy studies mainly focus on adults with few studies investigating associations between child health literacy and health status. This study aimed to investigate the association between health literacy and body weight in Taiwan's sixth grade school children.

METHODS: Using a population-based survey, 162,209 sixth grade (11-12 years old) school children were assessed. The response rate at school level was 83%, with 70% of all students completing the survey. The Taiwan child health literacy assessment tool was applied and information on sex, ethnicity, self-reported health, and health behaviors were also collected. BMI was used to classify the children as underweight, normal, overweight, or obese. A multinomial logit model with robust estimation was used to explore associations between health literacy and the body weight with an adjustment for covariates.

RESULTS: The sample consisted of 48.9% girls, 3.8% were indigenous and the mean BMI was 19.55 (SD = 3.93). About 6% of children self-reported bad or very bad health. The mean child health literacy score was 24.03 (SD = 6.12, scale range from 0 to 32). The overall proportion of obese children was 15.2%. Children in the highest health literacy quartile were less likely to be obese (12.4%) compared with the lowest quartile (17.4%). After controlling for gender, ethnicity, self-rated health, and health behaviors, children with higher health literacy were less likely to be obese (Relative Risk Ratio (RRR) = 0.94, p < 0.001) and underweight (RRR = 0.83, p < 0.001). Those who did not have regular physical activity, or had sugar-sweetened beverage intake (RRR > 1.10, p < 0.0001) were more likely to report being overweight or obese.

CONCLUSIONS: This study demonstrates strong links between health literacy and obesity, even after adjusting for key potential confounders, and provides new insights into potential intervention points in school education for obesity prevention. Systematic approaches to integrating a health literacy curriculum into schools may mitigate the growing burden of disease due to obesity.

The Ophelia (OPtimise HEalth LIteracy and Access) process : using health literacy alongside grounded and participatory approaches to develop interventions in partnership with marginalised populations

This paper seeks to explore the potential of a newly developed, grounded and participatory approach to development of health-literacy and health-care access interventions for equity – the Ophelia (OPtimising HEalth LIteracy and Access) process (Batterham et al., 2014). The methodology involves undertaking a needs assessment of the target population using intensive qualitative and quantitative methods, developing vignettes of key sub-groups within the population based on their health literacy profile of strengths and weaknesses, and then engaging with frontline practitioners and community membersin developing realistic solutions (Batterham et al., 2014).

Optimising health literacy and access of service provision to community dwelling older people with diabetes receiving home nursing support

Background. Health literacy is the ability to access, understand, and use information and services for good health. Among people with chronic conditions, health literacy requirements for effective self-management are high. The Optimising Health Literacy and Access (Ophelia) study engaged diverse organisations in the codesign of interventions involving the Health Literacy Questionnaire (HLQ) needs assessment, followed by development and evaluation of interventions addressing identified needs. This study reports the process and outcomes of one of the nine organisations, the Royal District Nursing Service (RDNS).

Methods. Participants were home nursing clients with diabetes. The intervention included tailored diabetes self-management education according to preferred learning style, a standardised diabetes education tool, resources, and teach-back method.

Results. Needs analysis of 113 quota-sampled clients showed difficulties managing health and finding and appraising health information. The service-wide diabetes education intervention was applied to 24 clients. The intervention was well received by clients and nurses. Positive impacts on clients' diabetes knowledge and behaviour were seen and nurses reported clear benefits to their practice.

Conclusion. A structured method that supports healthcare services to codesign interventions that respond to the health literacy needs of their clients can lead to evidence-informed, sustainable practice changes that support clients to better understand effective diabetes self-management.

What's in a name? Software, digital products, and the sale of goods

This article addresses how the advent of trade in computer software, and nowdigital products, has challenged the application of sales law and consumer law.It addresses the law of three jurisdictions: the United Kingdom (‘UK’),Australia and New Zealand. Often, applying the ‘goods’ criterion in theseregimes will be uncontroversial. Nevertheless, modern market conditions havecreated a need to move beyond the existing question of whether softwareconstitutes ‘goods’, and instead to ask how a range of different types of digitalproducts fit into sales law and consumer law regimes. Many legal systems havesettled the software-as-goods question. However, software is only one kind ofcommonly traded digital product. This article argues that other types of digitalproducts — including apps, firmware, digital music and electronic books —should be treated the same way as software by sales law and consumer lawregimes. Recent developments in UK consumer law are also analysed as aninnovative model for reform regarding party rights and obligations in the supplyof digital products.

Renewing assessment practices: literacy teaching and learning in digital environments

Interpretations of “literacy” and approaches to literacy pedagogy and assessment are under renewal as meaning-making and learning are increasingly situated in digitized environments. While the implications of these shifts are in part technological, they are also relational, as students are increasingly positioned as interactive with participatory roles in self-knowledge and increased responsibility for their learning. However, while shifts are occurring in understandings of literacy and approaches to literacy pedagogy, the same cannot be said for the way in which assessments of digital literacies are undertaken. There is a lack of valid, reliable, and practical assessments of new literacies to inform and help students to become better prepared for study, work, and citizenship in digital environments. This article maps five characteristics of effective formative assessment in print-based classrooms with seven affordancesin digital learning and assessment to suggest an analytical framework for examining teacher and student assessment in digital environments. Drawing on data from a research project in which a team of teachers introduced a one-to-one computing program and worked to renew their literacy assessment practices, this article discusses how each of the seven affordances are enacted in the assessment practices in a years five and six primary school classroom. The findings from this research project show that educational technologies have the potential to enable new approaches to teaching, learning, and assessment that better align with the needs of twenty-first century literacy learners. The findings alsosupport approaches to formative assessment that value print and multimodality and engage students in more flexible and differentiated ways. They can enable teachers and students to be re-positioned as designers, knowledge producers, and collaborative learners. The seven affordances provide a framework that holds rich possibilities for teacher learning and planning as prompts to support reflection on formative assessment practices, critique habitual practices, and considernew opportunities.

Literacy, technology and the economics of attention

This article is based on a project aimed at generating practical suggestions based on research findings about how new technologies might be used to enhance L1 literacy attainment in disadvantagedsettings. The project involved designing,implementing and researching an innovative approach to curriculum and pedagogy using new digital technologies in language and literacy education within classroom settings involving small groups of "disadvantaged'' learners. The paper reports activity and findings from one of four study sites. It focuses on four Grade 9 boys seen by their teachers as troublemakers and at risk of failing in English. The researchers draw on current conceptual and theoretical work associated with the emergence of an Attention Economy theory to design a collaborative activity around constructing a website, and to identify and analyse positive literacy learning outcomes associated with the pedagogical approach taken. The authors show how this new perspective on attention informs a critique of conventional approaches to school organization and classroom learning, and how it can be used to envisage alternative approaches to understanding and teaching students who display literacy learning difficulties at school.

‘Computer games can get your brain working’: student experience and perceptions of digital games in the classroom

There is considerable enthusiasm in many quarters for the incorporation of digital games into the classroom, and the capacity of games to engage and challenge players, present complex representations and experiences, foster collaborative learning, and promote deep learning. But while there is increasing research documenting the progress and outcomes of game-based learning, relatively little attention is paid to student perceptions and voice. In order to effectively target game-based learning pedagogy, it is important to understand students' previous experience, if any, of the use of games in the classroom, and what they made of these. In this paper, we present findings from a survey of 270 primary and secondary school students in Year Levels 4–9 (aged 9–14) in 6 Queensland schools at the start of a 3-year Australian Research Council project researching the use of digital games in school to promote literacy and learning.

Shifting practices and frames: literacy, learning and computer games

Digital culture and the online world have profound implications for contemporary notions of literacy, learning and curriculum. The increasing integration of digital culture and technologies into young people’s lives reflects the energy and excitement offered by online worlds. Online forms of text and communication are shaping students’ experience of the world, including expectations and experiences about learning and literacy. While print literacies remain important, for schools to prepare students to participate in critical and agential ways in the contemporary and future world, they need also to teach them to be fully literate in digital and multimodal literacies, and at ease and in control in the online world. Computer games, and other forms of digital games, teach and exemplify multimodal forms of literacy. Schools can capitalize on their potential and work with them productively. Doing so however, entails recognizing the messy complexity of schooling, and the practicalities of classroom lives. This chapter reports on a three year project in five schools concerned with literacy and computer games, and discusses the important role of teachers as on-the- ground leaders in pioneering new conceptions of literacy, and of curriculum change, and the importance of school structures and support to enable such change to happen.

Writing, English and digital culture

In their out-of-school lives, young people are immersed in rich and complex digital worlds, characterised by image and multimodality. Computer games in particular present young people with specific narrative genres and textual forms: contexts in which meaning is constructed interactively and drawing explicitly on a wide range of design elements including sound, image, gesture, symbol, colour and so on. As English curriculum seeks to address the changing nature of literacy, challenges are raised, particularly with respect to the ways in which multimodal texts might be incorporated alongside print based forms of literacy. Questions focus both on the ways in which such texts might be created, studied and assessed, and on the implications of the introduction of such texts for print based literacies.

This paper explores intersections between writing and computer games within the English classroom, from a number of junior secondary examples. In particular it considers tensions that arise when young people use writing to recreate or respond to multimodal forms. It explores ways in which writing is stretched and challenged by enterprises such as these, ways in which students utilise and adapt print based modes to represent multimodal forms of narrative, and how teachers and curriculum might respond. Consideration is given to the challenges posed to teaching and assessment by bringing writing to bear as the medium of analysis of, and response to, multimodal texts.

Re-envisioning literacy instruction with adolescents: multiliteracies, multimodality and new technologies

Engaging students' lifeworlds and the concerns of their communities in globalised, semiotic and information societies is imperative in New Times. As youth continue to exhibit their proficiency with new literacies emerging from Internet communication technologies (leTs), education-particularly curriculum and instruction-remains largely focused around monomodal, print-only literacy practices, often ignoring students' hybrid multiple voices. This paper reports on two curricular interruptions to the progressive reading and writing workshop that acknowledged adolescents' engagement with digital technologies and their new multimodalliteracy practices in a year eight public classroom within a small urban academy of technology.

Re-envisioning teacher education in the new media age: multiliteracies, multimodality and internet communication technologies

Multiliteracies pedagogy and research (New London Group, 1996) addresses the range of literacies needed by diverse students to effectively negotiate the increasing multimodality of texts, both inside and outside of schools. Yet, few university teachers understand how youth are able to express themselves, their experiences and lives, in new, empowering and perception-shifting ways as designers in the 21st century. Several theorists (Bruce, 2000; Lemke, 1998; Luke, 2000; Bolter, 1998; Glister, 1997) argue literacy education must be reconceptualised to recognize the importance of teaching and supporting multimedia literacy in a world where internet communication technologies (ICTs) incorporate all semiotic resources. Expression through multiple media and more recently hypermedia—is common to youth—but has often been demonized by historically logocentric approaches to teaching and assessment by privileging print, over all other forms of expression (Albright & Walsh, 2003; Lemke, 1998; McCloud, 1993). As digital media becomes more pervasive in a post-typographic world, tertiary education will need to engage with its representational resources for acquiring traditional school literacy and knowledge. This paper reports on initiatives in Multiliteracies instruction for both pre-service and in-service teachers to more adequately attend to the multisemiotic landscapes of students’ changing worlds in New Times (Hall, 1996).