Literacy, Learning, and Health: Research Report
This descriptive study examines the relationships between literacy, learning and health among adult learners in the United Kingdom. Note that the UK term for adult learners is “adult literacy, language and numeracy (ALLN) students”.
The specific research questions were:
- What are the literacy, language and numeracy demands placed upon people in health-care settings?
- What are the difficulties ALLN students experience when accessing health-related information and when dealing with texts such as registration or consent forms?
- What strategies do they use to overcome these?
- How do ALLN students find out about any health matters that concern them? What sources of information do they use –for example do they read magazines and/or watch TV or do they use the internet?
- What are teachers’ and students’ perceptions of and experiences with health as a topic for ALLN?
The research involved a variety of methods, including quantitative surveys, classroom observation, and in-depth interviews with teachers and students. The report describes in detail the ways that adult learners were found to manage the health care system, and the ways in which adult education programs can help to improve health literacy among these learners. Although the study was done in the UK, many of the findings will be applicable to adult education and the health care system in the U.S.
This resource is important in part because it offers an international perspective on health literacy and adult learners, and in part because the findings can be generalized in many ways to U.S. learners and what they need from the literacy field and the health field in order to stay healthy. Also, the report treats health literacy in a broad sense, acknowledging the social and community context in addition to specific skills and abilities. Using this broad concept to explore many hidden aspects of the challenges of health literacy for adult learners, it discovers and shares many practical recommendations on what we can do to help.
The United Kingdom has a national health system in place, which is very different from the U.S. health system. Additionally, they have developed national curricula as a result of their Skills for Life strategy. Thus, for U.S. health literacy and adult education researchers this report provides evidence of how health literacy challenges differ and are similar across different socio-political contexts. For example, we have challenges as literacy folks to do real research in health literacy due to the limitations of hippa. The same limitations are cited in this study with “hippa” replaced by “the Trust.” Similarly, the levels of the learner reading levels are described differently; however, the issues and problems are the same.
For UK readers, the report offers a qualitative understanding of both barriers and bridges to using health literacy in that context as well as how health is and can be further employed within adult education settings. And despite the systemic differences, the patients/clients/learners in this study are very similar to those with whom we do research in the U.S.
In concluding, the report summarizes the findings from the study on literacy, learning and health. The authors discuss how literacy and ESOL students deal with the demands of the health-care system and how adult basic education classes can play a role in improving health literacy.
Importantly for the field of health literacy overall, a key finding is that while, indeed, the health system is “highly textually-mediated” (there are a lot of print materials to navigate) – people do not depend solely on somebody’s reading and writing skills to successfully find, understand, evaluate, communicate and use health information. This points out a shortcoming in many traditional print based approaches to health literacy. The authors found that health literacy is a shared construct – that resides not only in individuals but also families, neighborhoods, and social networks.
By and large, the authors characterize health literacy as activities people do in relation to their health. They took a broad perspective on these activities including personal contexts and use of social networks. Thus, health literacy is not simply a matter of ‘parroting’ a correct knowledge answer but is about the basis for informed behavior change – about using understanding for action.
This is the type of research we could use more of. Perhaps too many studies in the U.S. at least have focused on what happens when health literacy is not present. This work begins to identify how people actually do use the health literacy skills they do have to navigate the health system in the United Kingdom.
Practical recommendations from this report include the following:
- Adult basic education programs create learning units involving their students in researching their own reading and writing activities relating to health. Students, then, follow their interests and can identify successful strategies.
- Teachers need to be aware of the potentially sensitive nature of health topics – perhaps relying on common illnesses versus individualized conditions.
- Students can map their own network of resources for accessing health and health information.
- Focus on improving assertiveness and confidence with students – role playing is a suggested strategy.
- Let students explore how readable printed health information materials are as a class exercise.
- Consider grouping students by life experience or health status when exploring health issues to improve health literacy.