21st century literacy : perceptions of and influences on year 6 teachers in Victorian classrooms

This paper presents a study of teachers’ perceptions of ‘21st century literacy’ practices and the dilemmas teacher face when these perceptions clash with the policies and the practices they feel are expected of them. Using narrative inquiry as its methodology, the paper presents 3 themes identified within the study, namely: ‘Teachers’ insights into 21st century literacy, ‘Teachers’ perceptions of necessary 21st century literacy skills for Year 6 students’ and ‘Influences on teachers’ literacy pedagogical decision-making and practice’. The narratives present two teachers’ perceptions (and misperceptions) of 21st century literacy, their pedagogical approaches, and how various factors influence their work. The paper considers how various factors influence teachers’ pedagogical practices, and highlights discrepancies between teachers’ professional beliefs and their practices based on external classroom influences. Narrative offers an insider’s view of how these discrepancies are lived out in two Victorian classrooms.

Rethinking difference in the iWorld: possibilities, challenges and ‘unexpected consequences’ of digital tools in literacy education

Within contemporary literacy classrooms, mobile touchscreen devices are occupying a more prominent place. For children who have disabilities or learning differences, such devices can offer increased participation and access and may also provide social capital to users. We share examples of how iPads and iPods were successfully used in classrooms by children who might be categorized as experiencing various challenges, as well as autobiographical examples we have experienced as parents of children with disabilities. Through these illustrations, we examine the possibilities of ‘new tools’ as well as challenges encountered in changing existing literacy practices.

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: applying current concepts to improve health services and reduce health inequalities

The concept of 'health literacy' refers to the personal and relational factors that affect a person's ability to acquire, understand and use information about health and health services. For many years, efforts in the development of the concept of health literacy exceeded the development of measurement tools and interventions. Furthermore, the discourse about and development of health literacy in public health and in clinical settings were often substantially different. This paper provides an update about recently developed approaches to measurement that assess health literacy strengths and limitations of individuals and of groups across multiple aspects of health literacy. This advancement in measurement now allows diagnostic and problem-solving approaches to developing responses to identified strengths and limitations. In this paper, we consider how such an approach can be applied across the diverse range of settings in which health literacy has been applied. In particular, we consider some approaches to applying health literacy in the daily practice of health-service providers in many settings, and how new insights and tools--including approaches based on an understanding of diversity of health literacy needs in a target community--can contribute to improvements in practice. Finally, we present a model that attempts to integrate the concept of health literacy with concepts that are often considered to overlap with it. With careful consideration of the distinctions between prevailing concepts, health literacy can be used to complement many fields from individual patient care to community-level development, and from improving compliance to empowering individuals and communities.

Gaps in understanding health and engagement with healthcare providers across common long-term conditions: a population survey of health literacy in 29 473 Danish citizens

OBJECTIVES: To (1) quantify levels of subjective health literacy in people with long-term health conditions (diabetes, cardiovascular disease, chronic obstructive pulmonary disease, musculoskeletal disorders, cancer and mental disorders) and compare these to levels in the general population and (2) examine the association between health literacy, socioeconomic characteristics and comorbidity in each long-term condition group.

DESIGN: Population-based survey in the Central Denmark Region (n=29,473). MAIN

OUTCOME MEASURES: Health literacy was measured using two scales from the Health Literacy Questionnaire (HLQ): (1) Ability to understand health information and (2) Ability to actively engage with healthcare providers.

RESULTS: People with long-term conditions reported more difficulties than the general population in understanding health information and actively engaging with healthcare providers. Wide variation was found between disease groups, with people with cancer having fewer difficulties and people with mental health disorders having more difficulties in actively engaging with healthcare providers than other long-term condition groups. Having more than one long-term condition was associated with more difficulty in engaging with healthcare providers and understanding health information. People with low levels of education had lower health literacy than people with high levels of education.

CONCLUSIONS: Compared with the general population, people with long-term conditions report more difficulties in understanding health information and engaging with healthcare providers. These two dimensions are critical to the provision of patient-centred healthcare and for optimising health outcomes. More effort should be made to respond to the health literacy needs among individuals with long-term conditions, multiple comorbidities and low education levels, to improve health outcomes and to reduce social inequality in health.

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.

Teacher research on literacy: turning around to students and technology

This chapter first reviews the evolution of teacher research that links inquiry to democracy, social justice, and educational change. It then examines key moves in teacher research in and on children's literacy education. The 'turn around' metaphor is utilized to emphasize our belief that teachers need to engage in research for their own well-being and that of their students and communities. Using the metaphor of teachers 'turning around' to students as researchers and to technology, the chapter explores productive directions for future teacher research, given the strengths of past research and opportunities of the present. The research in this chapter demonstrates that engaging in teacher research has the potential to change teachers' work and their subjectivities.

The e-health literacy framework: A conceptual framework for characterizing e-health users and their interaction with e-health systems

In current e-health research and development there is a need for a broader understanding of the capabilities and resources required for individuals to use and benefit from e-health services, i.e. their e-health literacy. The aim of
this study was to develop a new conceptualisation of e-health literacy with consideration of the experiences of a wide range of stakeholders and in alignment with current technologies. Concept mapping was used to generate a comprehensive and grounded model of e-health literacy. Concept mapping workshop participants included patients, health professionals and medical informatics experts. Eight workshops, carried out in Denmark and United Kingdom, generated 450 statements, separated into 128 clusters. Through an inductive structured analysis, seven domains were identified: 1. Ability to process information, 2. Engagement in own health, 3. Ability to engage actively with digital services, 4. Feeling safe and in control, 5. Motivation to engage with digital services, 6. Having access to systems that work, and 7. Digital services that suit individual needs. These empirically derived domains form an e-health literacy framework (eHLF) and provide new insights into the user’s ability to understand, access and use e-health technologies. The eHLF offers a framework for evaluating an individual’s or a population’s capacity to understand, use and benefit from technology to promote and maintain their health. Such a framework also provides a potential checklist for the development and improvement of e-health services.

Cultural adaptation and validation of the Health Literacy Questionnaire (HLQ): robust nine-dimension Danish language confirmatory factor model

Health literacy is an important construct in population health and healthcare requiring rigorous measurement. The Health Literacy Questionnaire (HLQ), with nine scales, measures a broad perception of health literacy. This study aimed to adapt the HLQ to the Danish setting, and to examine the factor structure, homogeneity, reliability and discriminant validity. The HLQ was adapted using forward-backward translation, consensus conference and cognitive interviews (n = 15). Psychometric properties were examined based on data collected by face-to-face interview (n = 481). Tests included difficulty level, composite scale reliability and confirmatory factor analysis (CFA). Cognitive testing revealed that only minor re-wording was required. The easiest scale to respond to positively was 'Social support for health', and the hardest were 'Navigating the healthcare system' and 'Appraisal of health information'. CFA of the individual scales showed acceptably high loadings (range 0.49-0.93). CFA fit statistics after including correlated residuals were good for seven scales, acceptable for one. Composite reliability and Cronbach's α were >0.8 for all but one scale. A nine-factor CFA model was fitted to items with no cross-loadings or correlated residuals allowed. Given this restricted model, the fit was satisfactory. The HLQ appears robust for its intended application of assessing health literacy in a range of settings. Further work is required to demonstrate sensitivity to measure changes.