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      Adult Basic Education: Community Health Partnerships and Health Disparities

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          Abstract

          Background:

          Adult Basic Education (ABE) is the national system that offers adults with low literacy and/or limited English with educational services in reading, writing, math, technology, and communications from basic levels to high school equivalency, with specialty programs in transition to community colleges and family literacy.

          Brief Description of Activity:

          To show the role of ABE in increasing health literacy in low literate and/or limited English populations through partnership with community health organizations (CHOs).

          Implementation:

          This article was developed through a collaborative thought process over a period of 8 months with experts from the field of ABE in development of health literacy within low literate and/or limited English populations. It describes the research that links low literacy and/or limited English with poor health, and introduces how ABE and CHOs have addressed these issues together. It also introduces research on the impact on learners of integrating health into ABE.

          Results:

          ABE learners have consistently shown a strong interest in learning about health for themselves and their families, and health content energizes ABE instruction. Learners report improvements of basic health knowledge, their confidence communicating with health care professionals, enhanced self-efficacy, and intention to make changes in such health behaviors as diet and tracking blood pressure. Partnerships between ABE programs and their local CHOs strengthen the teaching/learning process and can be mutually beneficial. ABE provides access to hard-to-reach populations, a safe learning environment, and teaching expertise. CHOs provide health expertise, preventive health screenings, and access to treatments.

          Lessons Learned:

          The link between low literacy and poor health is no longer disputed. ABE programs and many CHOs share a common mission and commitment to serving vulnerable populations. Stronger partnerships between these organizations should be viewed as a viable strategy for addressing health disparities. A coordinated effort of community health centers across the nation is required to meaningfully respond to health disparities as a national social issue. [ HLRP: Health Literacy Research and Practice. 2019;3(Suppl.):S1–S7.]

          Plain Language Summary:

          This article introduces ABE and the role this system plays in improving health literacy within populations with low health literacy and/or limited English populations. It details the educational services the system provides, how health content has been integrated into instruction, the impact on learners, and how partnerships between ABE programs and community health services strengthen the work.

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          Most cited references6

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          The Arc of Health Literacy.

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            ESL participation as a mechanism for advancing health literacy in immigrant communities.

            A reliance on the conceptualization of health literacy as functional skill has limited researchers' views of the adult English-as-a-second-language (ESL) context as a site for health literacy interventions. To explore the contributions of alternative views of literacy as social practice to health literacy research, the authors examined teacher survey data and learner outcomes data collected as part of a multiyear collaboration involving the California Diabetes Program, university researchers, and adult ESL teachers. The survey results (n=144 teachers) indicated that ESL teachers frequently model effective pedagogical practices that mediate social interaction around health content, the basis for acquiring new literacy skills and practices. In the classroom pilot (n=116 learners), the majority of learners reported they had learned about diabetes risk factors and prevention strategies, which affirmed existing healthy behaviors or prompted revision of unhealthy ones. About two thirds of the learners reported sharing preventive health content with members of out-of-school social networks. This study represents a first step in research efforts to account more fully for the mechanisms by which social interaction and social support facilitate health literacy outcomes in ESL contexts, which should complement what is already known about the development of health literacy as functional skill.
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              Integrating Health Literacy and ESL

              Adult Hispanic immigrants are at a greater risk of experiencing the negative outcomes related to low health literacy, as they confront cultural and language barriers to the complex and predominately monolingual English-based U.S. health system. One approach that has the potential for simultaneously addressing the health, literacy, and language needs of Hispanics is the combination of health literacy and English as a second language (ESL) instruction. The purpose of the project was to evaluate the feasibility of using ESL instruction as a medium for improving health literacy among Hispanic immigrants. Objectives included the development, implementation, and evaluation of an interdisciplinary health literacy/ESL curriculum that integrates theories of health literacy and health behavior research and practice, sociocultural theories of literacy and communication, and adult learning principles. This article describes the curriculum development process and provides preliminary qualitative data on learners' experiences with the curriculum. Results indicate that the curriculum was attractive to participants and that they were highly satisfied with both the format and content. The curriculum described here represents one example of an audience-centered approach designed to meet the specific health and literacy needs of the Hispanic population on the U.S.-Mexico border. The combination of ESL and health literacy contributed to a perceived positive learning experience among participants. Interdisciplinary approaches to health literacy are recommended.
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                Author and article information

                Journal
                Health Lit Res Pract
                Health Lit Res Pract
                HLRP
                HLRP: Health Literacy Research and Practice
                SLACK Incorporated (Thorofare, NJ )
                2475-6024
                2474-8307
                July 2019
                03 October 2019
                : 3
                : 3 Suppl
                : S1-S7
                Author notes

                Marcia Drew Hohn, EdD, is a Literacy and Health Consultant. Winston Lawrence, EdD, is a retired Health Literacy Director, Literacy Assistance Center, New York City. Julie McKinney, MS, is a Health Literacy Consultant. David J. Rosen, EdD, is the President, Newsome Associates. Maricel G. Santos, EdD, is a Professor of English, Department of English, San Francisco State University. Rob Sheppard, MA, is the Director, Quincy Asian Resource Center. Gregory Smith, MS, is the Executive Director, Florida Literacy Coalition, Inc. Alexandra Ziskind, MSW, is a Program Associate, Chicago Citywide Literacy Coalition.

                Address correspondence to Marcia Drew Hohn, EdD, Literacy and Health Consultant, 6 Pioneer Circle, Andover, MD 01810; email: mdrewhohn@ 123456aol.com .

                Disclosure: The authors have no relevant financial relationships to disclose.

                Article
                10.3928_24748307-20181125-01
                10.3928/24748307-20181125-01
                6857767
                31773083
                eb0c7e9f-d67a-448e-bb6f-afe44ea81dd8
                © 2019 Hohn, Lawrence, McKinney, et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International ( https://creativecommons.org/licenses/by-nc/4.0). This license allows users to copy and distribute, to remix, transform, and build upon the article non-commercially, provided the author is attributed and the new work is non-commercial.

                History
                : 05 April 2018
                : 19 September 2018
                Categories
                Best Practice

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