Health literacy : what is it and why is it important to measure?

This report summarizes the proceedings of the first Outcome Measures in Rheumatology Clinical Trials (OMERACT) Health Literacy Special Interest Group workshop at the OMERACT 10 conference. Health literacy refers to an individual’s capacity to seek, understand, and use health information. Discussion centered on the relevance of health literacy to the rheumatology field; whether measures of health literacy were important in the context of clinical trials and routine care; and, if so, whether disease-specific measures were required. A nominal group process involving 27 workshop participants, comprising a patient group (n = 12) and a healthcare professional and researcher group (n = 15), confirmed that health literacy encompasses a broad range of concepts and skills that existing scales do not measure. It identified the importance and relevance of patient abilities and characteristics, but also health professional factors and broader contextual factors. Sixteen themes were identified: access to information; cognitive capacity; disease; expression/communication; finances; health professionals; health system; information; literacy/numeracy; management skills; medication; patient approach; dealing with problems; psychological characteristics; social supports; and time. Each of these was divided further into subthemes of one or more of the following: knowledge, attitude, attribute, relationship, skill, action, or context. There were virtually no musculoskeletal-specific statements, suggesting that a generic health literacy tool in rheumatology is justified. The detailed concepts across themes provided new and systematic insight into what needs to be done to improve health literacy and consequently reduce health inequalities. These data will be used to derive a more comprehensive measure of health literacy.

Mobile texts and migrant audiences : rethinking literacy and assessment in a new media age

This article highlights the importance of rethinking literacy assessment in a digital and global world. Although pressures currently abound to narrow conceptions and practices of literacy, especially in an era of high stakes testing, digital multimodality and connectivity offer the potential for new ways of thinking, representing, and communicating, as well as new avenues for participating in relationships across social, geographic, and cultural difference. We explore the challenges of redesigning assessments so that they better take into account children's multiliterate capabilities. In so doing, we offer examples from our work in afterschool contexts that demonstrate how we have grappled with the complexities of assessment in new times.

Youth literacy development through applied learning and the national curriculum

The introduction of a national curriculum into Australian schools coincides with an increasing body of research emphasising the importance of completing Year 12 or its equivalent if young people are to achieve successful transitions beyond school. This research is reflected in Australian government policy targets to achieve secondary school completion rates to at least 90% by 2015. State governments across the country have also embraced these targets, with some states already achieving above this level thanks to innovative curriculum and pedagogical initiatives that are more attuned to applied ways of learning.

In this chapter we examine the challenges faced by school leaders and teachers as they re-conceptualise approaches to youth literacy development through applied learning pedagogy. We begin by exploring definitions and applications of applied learning and examining the relatively recent growth of applied learning in secondary schools. We discuss the impetus for using applied learning approaches to literacy development and consider the challenges manifest in the day-to-day professional practices of secondary school teachers who use applied learning to engage young people who may otherwise leave school early. We conclude by exploring tensions emerging from the use of applied learning approaches to youth literacy development in Australia and the new demands created by a national curriculum.

Assessing health literacy : a new domain for collaboration between language testers and health professionals

Health literacy, defined as an individual's capacity to process health information in order to make appropriate health decisions, is the focus of increasing attention in medical fields due to growing awareness that suboptimal health literacy is associated with poorer health outcomes. To explore this issue, a number of instruments, reported to have high internal consistency and strong correlations with general literacy tests, have been developed. However, their validity as measures of the target construct is seldom explored using multiple sources of evidence. The current study, involving collaboration between health professionals and language specialists, set out to assess the validity of the Rapid Estimate of Adult Literacy in Medicine (REALM), which describes itself as a “reading recognition” test that measures ability to pronounce common medical and lay terms. Drawing on a sample of 310 respondents, including both native and non-native speakers of English, investigations were undertaken to probe the REALM's validity as a measure of understanding the selected terms and to consider associations between scores on this widely used test and those derived from other recognized health literacy tests. Results suggest that the REALM is underrepresenting the health literacy construct and that the test may also be biased against non-native speakers of English. The study points to an expanded role for language testers, working in collaboration with experts from medical disciplines, in developing and evaluating health literacy tools.

Techno-literacy and learning in blended, multicultural course environments

For the last two decades, higher education institutions have been actively engaged in the use of online technology with the aim of transforming the way 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 learning purposes. Drawing on an ethnographic study of culturally diverse computing students and teachers within learning environments that blend online and face-to-face pedagogies, 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-literacy skills.

Literacy in early childhood and primary education : issues, challenges and solutions

Literacy in Early Childhood and Primary Education provides a comprehensive introduction to literacy teaching and learning. The book explores the continuum of literacy learning and children's transitions from early childhood settings to junior primary classrooms and then to senior primary and beyond. Reader-friendly and accessible, this book equips pre-service teachers with the theoretical underpinnings and practical strategies to teach literacy. It places the 'reading wars' firmly in the past as it examines contemporary research and practices. The book covers important topics such as assessment, multiliteracies, reading difficulties and diverse classrooms. Each chapter includes learning objectives, reflective questions and definitions of key terms to engage and assist readers. Written by an expert author team and featuring real-world examples from literacy teachers and learners, the book will help pre-service teachers feel confident teaching literacy to diverse age groups and abilities.

The role of health literacy and social networks in arthritis patients' health information-seeking behavior : a qualitative study

Background. Patients engage in health information-seeking behaviour to maintain their wellbeing and to manage chronic diseases such as arthritis. Health literacy allows patients to understand available treatments and to critically appraise information they obtain from a wide range of sources.

Aims. To explore how arthritis patients' health literacy affects engagement in arthritis-focused health information-seeking behaviour and the selection of sources of health information available through their informal social network.

Methods. An exploratory, qualitative study consisting of one-on-one semi-structured interviews. Twenty participants with arthritis were recruited from community organizations. The interviews were designed to elicit participants' understanding about their arthritis and arthritis medication and to determine how the participants' health literacy informed selection of where they found information about their arthritis and pain medication.

Results. Participants with low health literacy were less likely to be engaged with health information-seeking behaviour. Participants with intermediate health literacy were more likely to source arthritis-focused health information from newspapers, television, and within their informal social network. Those with high health literacy sourced information from the internet and specialist health sources and were providers of information within their informal social network.

Conclusion. Health professionals need to be aware that levels of engagement in health information-seeking behaviour and sources of arthritis-focused health information may be related to their patients' health literacy.

Growth in literacy and numeracy achievement : evidence and explanations of a summer slowdown in low socio-economic schools

The phenomenon of summer slide or setback has gained a great deal of attention in the USA. It is understood to account for as much as 80 % of the difference in achievement for students between low and high socio-economic families over their elementary schooling. In a mixed method longitudinal study of reforms in low socio-economic school communities in Victoria, Australia this phenomenon in the achievement growth of primary and secondary school students for both literacy and numeracy was identified. The longitudinal analysis of achievement data revealed decelerated growth during Terms 4 and 1, the spring and summer months in the Australian school calendar. In this article we present these findings and the reflections of Principals, literacy and numeracy leaders and coaches about these findings and their suggestions for action. We argue that reforming school practices during Terms 1 and 4 and developing a deeper understanding of students’ out-of-school learning and knowledge are essential for enhancing growth in achievement from September to March and for narrowing the achievement gap between marginalised and advantaged students. Further research of this phenomenon in the Australian context is needed.