Individuals with chronic low back pain have greater difficulty in engaging in positive lifestyle behaviours than those without back pain : an assessment of health literacy

Background: Despite the large volume of research dedicated to understanding chronic low back pain (CLBP), patient outcomes remain modest while healthcare costs continue to rise, creating a major public health burden. Health literacy - the ability to seek, understand and utilise health information - has been identified as an important factor in the course of other chronic conditions and may be important in the aetiology of CLBP. Many of the currently available health literacy measurement tools are limited since they measure narrow aspects of health literacy. The Health Literacy Measurement Scale (HeLMS) was developed recently to measure broader elements of health literacy. The aim of this study was to measure broad elements of health literacy among individuals with CLBP and without LBP using the HeLMS.
Methods: Thirty-six community-dwelling adults with CLBP and 44 with no history of LBP responded to the HeLMS. Individuals were recruited as part of a larger community-based spinal health study in Western Australia. Scores for the eight domains of the HeLMS as well as individual item responses were compared between the groups.
Results: HeLMS scores were similar between individuals with and without CLBP for seven of the eight health literacy domains (p > 0.05). However, compared to individuals with no history of LBP, those with CLBP had a significantly lower score in the domain ‘Patient attitudes towards their health’ (mean difference [95% CI]: 0.46 [0.11- 0.82]) and significantly lower scores for each of the individual items within this domain (p < 0.05). Moderate effect sizes ranged from d = 0.47-0.65.
Conclusions: Although no differences were identified in HeLMS scores between the groups for seven of the health literacy domains, adults with CLBP reported greater difficulty in engaging in general positive health behaviours. This aspect of health literacy suggests that self-management support initiatives may benefit individuals with CLBP.

Computer games – pushing at the boundaries of literacy

The need to expand traditional, print-based versions of literacy to also incorporate attention to multimodal forms of text and literacy in the English curriculum is now well established. Much can be learnt about students and their literacy practices from the exploration of their engagement with digital culture – particularly videogames – from their out-of-school lifeworlds. However, the emerging set of skills and competencies or, the ‘new’ literacies and literacy practices associated with multiple and ever-emerging genres generated through information and communications technologies, present challenges in terms of how they might be conceptualised as literacy (or not) and how the multiple dimensions entailed in gameplay are increasingly a part of what it means to be literate in the 21st century. Drawing on two case studies of classroom work, the paper describes approaches to conceptualising the complexity of digital texts and their access, production and distribution and the opportunity to create spaces where students could interact, socialise and learn in both the real and virtual world. Dimensions such as play, interactivity, action, movement and time raise challenging questions about the limits and possibilities of constructing games and gameplay as texts and literacy practices that push the boundaries of literacy.

Research methodologies in creative practice : literacy in the digital age of the twenty first century - learning from computer games

Literacy remains one of the central goals of schooling, but the ways in which it is understood are changing. The growth of the networked society, and the spread of Information and Communications Technologies (ICT), has brought about significant changes to traditional forms of literacy. Older, print based forms now take their place alongside a mix of newer multi-modal forms, where a wide range of elements such as image, sound, movement, light, colour and interactivity often supplant the printed word and contribute to the ways in which meaning is made. For young people to be fully literate in the twenty-first century, they need to have clear understandings about the ways in which these forms of literacy combine to persuade, present a point of view, argue a case or win the viewers’ sympathies. They need to know how to use them themselves, and to be aware of the ways in which others use them. They need to understand how digital texts organise and prioritise knowledge and information, and to recognise and be critically informed about the global context in which this occurs. That is, to be effective members of society, students need to become critical and capable users of both print and multimodal literacy, and be able to bring informed and analytic perspectives to bear on all texts, both print and digital, that they encounter in everyday life.

This is part of schools’ larger challenge to build robust connections between school and the world beyond, to meet the needs of all students, and to counter problems of alienation and marginalisation, particularly amongst students in the middle years. This means finding ways to be relevant and useful for all students, and to provide them with the skills and knowledge they will need in the ICT-based world of the Twentyfirst century. With respect to literacy education, engagement and technology, we urgently need more information as to how this might be best achieved.

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.

Using information and communication technologies to consult with patients in Victorian primary care : the views of general practitioners

Information and communication technologies such as email, text messaging and video messaging are commonly used by the general population. However, international research has shown that they are not used routinely by GPs to communicate or consult with patients. Investigating Victorian GPs’ perceptions of doing so is timely given Australia’s new National Broadband Network, which may facilitate web-based modes of doctor-patient interaction. This study therefore aimed to explore Victorian GPs’ experiences of, and attitudes toward, using information and communication technologies to consult with patients. Qualitative telephone interviews were carried out with a maximum variation sample of 36 GPs from across Victoria. GPs reported a range of perspectives on using new consultation technologies within their practice. Common concerns included medico-legal and remuneration issues and perceived patient information technology literacy. Policy makers should incorporate GPs’ perspectives into primary care service delivery planning to promote the effective use of information and communication technologies in improving accessibility and quality of general practice care.

Beginning the search for core principles underpinning literacy development in the early years

Providing opportunities for all people to become literate is now a global imperative (World Bank 2008). There are many and varied reasons underlying this emphasis including global, national, community and personal perspectives (Friere & Macedo 2000) and countries world-wide are investing more money into their early childhood programs and the development of associated policies (Oberhuemer 2005). From a socio-cultural view, literacy development is emergent, ongoing (Cook-Gumperz 2006) and multifaceted (New London Group 1999). Literacy involves far more than reading and writing and encompasses listening, speaking and critical thinking (Department of Education, Science and Training 2005, Luke & Freebody 1997). Literacy is not merely a curricular area, but an important empowering life skill (Harrison 2012, Friere & Macedo 2000). It seems logical then, to search for and identify if there are core principles underpinning early years literacy development.In seeking to identify core principles for emergent literacy development, the study reported here adopted Wiersma & Jurs' (2005) 'Four Step' Historical Research methodological approach involving the identification of a research problem, collection and evaluation of source materials, synthesis of information from the source materials and finally, the analysis, interpretation and the formulation of conclusions. The historical research approach requires creative interpretation (Keastle 1988) and is valued for its effectiveness in sourcing ideas, enlightening current debates, empowering decision-making (Stricker 1992) and influencing policy formation (Wiersma & Jurs 2005).This study involved analysis of Early Years Language and Emergent Literacy Research from the past decade, sourced via education and social sciences databases, as well as information gathered from correspondence with Australian government departments, their websites and policies. The findings from a synthesis of these data sources led to the identification of nine core principles viewed as underpinning children's emergent literacy development. Interested in exploring the relevance and application of these principles to the field of early childhood in Australia, additionally, the researcher has embarked upon a mapping exercise that reveals how the recently introduced Early Years Learning Frameworks align with these principles. Furthermore, in recognition of the importance of the early years as a crucial time in a child's literacy development (Cook-Gumperz 2006, Raban & Nolan 2005, Hall, Larson & Marsh 2003), it is argued that these literacy principles will be valuable to the development of a range of educational tools to be used by Pre-service and practicing Early years educators.

Focus group discussions of literacy assessment and world wide web-based reading intervention

Focus groups provide a means for participants in research to take on a greater role in the evaluation of the research and planning of its various stages. The role and outcomes of focus groups conducted with participants in a World Wide Web Project in literacy assessment and intervention are reported. Thirteen individuals with severe communication impairments participated in one of three focus groups. The groups were held after an assesment of reading skills and a trial period of intervention as part of the Web Project. The aim of the focus groups was to obtain feedback from participants about their involvement in the project and to discuss strategies for the next stage of the intervention. The focus groups offered a forum for participants to talk about what they did and did not like about the assessment and trial intervention. The discussions provided information about issues of both a practical and emotional nature that might have otherwise been unavailable to the researchers. Brainstorming of strategies provided valuable input for the next stage of the project and involved both the researchers and participants in a form of participatory action research.

Development and implementation of Taiwan's child health literacy test

Objectives: The aims of this study were to develop Taiwan's Child Health Literacy Test and to undertake a nation-wide survey in order to determine the current status of Taiwanese sixth graders' health literacy, and to understand the association between health literacy, healthy behavior, and health status. absp Methods: Taiwan's Child Health Literacy Test was developed through the process of concept clarification, a qualitative pilot, a development pilot, and a field test. In the field test, 162,609 sixth graders (56.9%) from 2,235 schools (83.3%) nationwide completed the questionnaire. We also collected the students' dates of birth, BMIs, self-reported health and healthy behaviors. absp Results: The final test consisted of 32 questions with item discrimination of 0.55-1.89 and item difficulty of-1.7-0.41 according to IRT; Cronbach's a was 0.87. Based on this information, the test was deemed appropriate for basic health literacy screening among children. Nation-wide, the average score for sixth graders' health literacy was 23.97 points (total score 32 points), with a correct rate of 74.9%. Those who were "good" in self-reported health scored highest in health literacy (M = 24.29). Health literacy was significantly positively related to healthy behavior (r = .25, p< .05), and negatively to risky behavior (r =-.28, p< .05). absp Conclusions: This study was the first curriculum-based child health literacy test developed from the viewpoints of both teachers and pupils in Taiwan through a rigorous procedure. The nationwide survey results may serve as a reference for decision-makers at the national health education level.

Towards an understanding of ‘Digital Literacy(ies)’

This report is concerned with the conceptualisation and definition of digital literacy in the context of Australian higher education. It draws on a diverse literature in proposing a working definition of digital literacy to inform the Deakin University Library in its work with the University’s faculties.

This report forms the first of a two-stage review. The second stage of the review is focused on identifying good practice in digital literacy. The findings of the second stage of the review are encompassed in a companion report titled: What is good practice in the development, assessment and evaluation of digital literacy for graduate employability?

The literature reviewed for the current report was conducted in late 2012 and draws on internal university policy documents, various national and international documents and literacy frameworks, previous reviews of the topic, and journal articles that are concerned with conceptualising information on digital literacy for higher education.

The report concludes by identifying the various factors and stakeholders that influence how digital literacy is conceptualised at Deakin University and proposes a working definition of digital literacy as a graduate learning outcome.

'Just dance' with digital literacy

In a rapidly changing higher education environment, Deakin University’s promise is to offer “brilliant education where the students are ‐ and where they want to go”. Targets set for learning, teaching and research, have significant implications across the University. Collaboration at all levels of the organization is core to achieving goals that deliver value to the student community.

The Library is charged with delivering one of the University's eight graduate learning outcomes, Digital Literacy, with initiatives required to build staff capability and contribute to student learning. Deakin University defines Digital Literacy as using technologies to find, use and disseminate information.

This paper provides an analysis of a case study in which liaison librarians collaborated with science academics to develop innovative digital literacy activities and assessment tasks for undergraduate units related to ‘Judging Reliability and Accuracy of Information’.

The case study reveals that engaging students in meaningful learning activities and assessment tasks creates dynamic and powerful learning experiences for first and second year students. In addition, the leadership that the liaison librarians demonstrate in activities that capitalise on problem based learning, elements of gaming, peer assessment, and new ways of communicating has prompted open conversations and collaborations with academics about further opportunities.

Development of a conceptual model of cancer caregiver health literacy.

Caregivers play a vital role in caring for people diagnosed with cancer. However, little is understood about caregivers' capacity to find, understand, appraise and use information to improve health outcomes. The study aimed to develop a conceptual model that describes the elements of cancer caregiver health literacy. Six concept mapping workshops were conducted with 13 caregivers, 13 people with cancer and 11 healthcare providers/policymakers. An iterative, mixed methods approach was used to analyse and synthesise workshop data and to generate the conceptual model. Six major themes and 17 subthemes were identified from 279 statements generated by participants during concept mapping workshops. Major themes included: access to information, understanding of information, relationship with healthcare providers, relationship with the care recipient, managing challenges of caregiving and support systems. The study extends conceptualisations of health literacy by identifying factors specific to caregiving within the cancer context. The findings demonstrate that caregiver health literacy is multidimensional, includes a broad range of individual and interpersonal elements, and is influenced by broader healthcare system and community factors. These results provide guidance for the development of: caregiver health literacy measurement tools; strategies for improving health service delivery, and; interventions to improve caregiver health literacy.

Responses and relationship dynamics of men and their spouses during active surveillance for prostate cancer: health literacy as an inquiry framework

BACKGROUND: Early stage prostate cancer patients may be allocated to active surveillance, where the condition is observed over time with no intervention. Living with a cancer diagnosis may impose stress on both the men and their spouses. In this study we explore whether the scores of and verbal responses to a Health Literacy Questionnaire can be used to identify individuals in need of information and support and to reveal differences in perception and understanding in health related situations within couples. METHODS: We used the nine-domain Health Literacy Questionnaire (HLQ) as a framework to explore health literacy in eight couples where the men were on active surveillance for prostate cancer progression. Scores were calculated for each domain for both individuals. For each couple differences in scores were also calculated and related to the informants' self-reported experiences and reflections in relation to participating in an active surveillance program. Also an inductive analysis was performed to identify themes in the responses and these themes were compared to those of HLQ. RESULTS: The men tended to score higher than their spouses. There was no consistent relation between scores and the reported experiences and reflections. However, some interesting patterns emerged, e.g. in two of the three couples with the largest within couple differences in HLQ scores, responses revealed discrepancies in how the men and their spouses perceived their situation. Also, three themes emerged which related to six of the HLQ domains, i.e. involvement of spouses and other people around the men; support from and interaction with healthcare professionals; and use of the Internet for information retrieval. CONCLUSIONS: Using the HLQ as an interview framework provided insight into the differences within couples and provided new perspectives on their experiences, including their contact with health professionals and the patient-spouse interaction when dealing with prostate cancer. The HLQ used as a dialogue tool may be an adjunct to assist healthcare providers to understand the need for support and information of men with prostate cancer on active surveillance and the dynamics within couples.

Development of a measure of health literacy for caregivers of people with cancer

Caregivers play a key role in supporting people with cancer. Little is known about challenges that caregivers might have when finding and understanding health information, making health-related decisions, and navigating the healthcare system. Using an innovative mixed-methods approach, the study developed and evaluated a tool to measure cancer caregiver health literacy.

The importance of digital literacy in the knowledge era

 Digital literacy is an essential skill in the knowledge era. This research found that occupational therapists recognise the importance of digital literacy and are willing to use digital technologies yet barriers exist. Improving digital literacy is a shared concern, to be addressed at the individual, institutional, professional and societal levels.