Two resources may assist you in measuring and reporting on health literacy
rates:

1. If you contact Dr. Scott Murray, he could consult on the health literacy
survey that he used, and tied to the IALS/ALLS Adult Literacy and Life
Skills data set to make a compelling case for the correlations between low
health literacy and low health, economic stability, education, etc. He's at
baboon at rogers.blackberry.net. A list of his publications shows you the depth
of his scholarship to lend a seasoned statistician's eye to your survey:

http://library.nald.ca/research/browse/author?name=T.+Scott+Murray

2. A team of researchers at the University of Victoria have designed an
e-survey for teens to measure their ability to understand and use
information about their health. Contact Deborah Begoray (dbegoray at uvic.ca)
or Dr. Irv Rootman, the Exec Director of the Health and Learning Knowledge
Centre of the Canadian Council on Learning (irootman at telus.net) for
information or to test drive their model.

Marg Rose
Victoria, BC



"Life is 10% what you make it and 90% how you take it."
                                                                   ~Irving
Berlin

-----Original Message-----
From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov]On Behalf Of
healthliteracy-request at nifl.gov
Sent: Tuesday, June 10, 2008 5:41 AM
To: healthliteracy at nifl.gov
Subject: HealthLiteracy Digest, Vol 33, Issue 5


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Today's Topics:

   1. [HealthLiteracy 2060] Re: health literacy assessment survey
      (MSkewes at ria.buffalo.edu)
   2. [HealthLiteracy 2061] Re: Health Literacy Assessment Survey
      (Seubert, Douglas)
   3. [HealthLiteracy 2062] Adult Education Content Standards
      Discussion	begins Monday (David J. Rosen)
   4. [HealthLiteracy 2063] Re: Health Literacy Assessment Survey
      (Brach, Cindy (AHRQ))
   5. [HealthLiteracy 2064] Re: New current awareness resource	on
      healthliteracy resources (MSkewes at ria.buffalo.edu)
   6. [HealthLiteracy 2065] Universal Precautions Toolkit for
      Primary Care (DeWalt, Darren)


----------------------------------------------------------------------

Message: 1
Date: Fri, 6 Jun 2008 14:06:03 -0400
From: MSkewes at ria.buffalo.edu
Subject: [HealthLiteracy 2060] Re: health literacy assessment survey
To: The Health and Literacy Discussion List <healthliteracy at nifl.gov>
Message-ID:
	<OF5146F003.472A7F30-ON85257460.00633FCC-85257460.00637C3E at ria.buffalo.edu>

Content-Type: text/plain; charset="us-ascii"

Perhaps you can take a random sample of the population (using random digit
dialing or some other effective method of random sampling) and administer
the S-TOFHLA, REALM, NVS, or other measure of health literacy.  If random
sampling is done properly, you should be able to generalize from your
sample to the population of interest.  Just an idea!

Best,
Monica

Monica C. Skewes, Ph.D.
Postdoctoral Associate
Research Institute on Addictions
University at Buffalo
The State University of New York
1021 Main Street
Buffalo, New York 14203
716-887-2242 (phone)
716-887-2510 (fax)




"Janet Sorensen" <Jsorensen at afmc.org>
Sent by: healthliteracy-bounces at nifl.gov
06/06/2008 12:00 PM
Please respond to
The Health and Literacy Discussion List <healthliteracy at nifl.gov>


To
<healthliteracy at nifl.gov>
cc

Subject
[HealthLiteracy 2058]  health literacy assessment survey






Matt, if you or whoever replies to you would cc me (or possibly the whole
list if anyone else is interested), I'd greatly appreciate it. We're
working on assessing the health literacy of the Medicaid population in a
specific county in Arkansas, and I'd love to see some examples of this
kind of survey or other tools. Thanks!
Janet Sorensen
Arkansas Foundation for Medical Care

From: healthliteracy-bounces at nifl.gov [mailto:  ] On Behalf Of Matt Gayer
Sent: Thursday, June 05, 2008 5:19 PM
To: healthliteracy at nifl.gov
Subject: [HealthLiteracy 2053] Health Literacy Assessment Survey

Hello All-
  I am health literacy intern this summer at a county health department in
Missouri.  My first goal is to assess the current health literacy rate of
the county so we can identify strengths and weaknesses, then prepare an
implementation plan tailored to best fit the community.  In order to
assess current health literacy, I proposed that a survey of some sort
would probably be necessary in order to formulate our initial research.  I
have been able to thus far find any examples of such a
survey/questionnaire, and was wondering if anyone had used/created one or
knew from where I could find one.  I very much appreciate any help with
this as I prepare to begin the first steps in our new health literacy
program.  Thank you.
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Message: 2
Date: Fri, 06 Jun 2008 13:57:53 -0500
From: "Seubert, Douglas" <seubert.douglas at marshfieldclinic.org>
Subject: [HealthLiteracy 2061] Re: Health Literacy Assessment Survey
To: "healthliteracy at nifl.gov" <healthliteracy at nifl.gov>,
	"Jsorensen at afmc.org" <Jsorensen at afmc.org>,	"mcggayer at sbcglobal.net"
	<mcggayer at sbcglobal.net>
Message-ID: <200806061859.m56IxUft003265 at mailhost2.mfldclin.edu>
Content-Type: text/plain; charset="us-ascii"

If you really want to do a thorough survey to assess the health literacy of
a county population, there are probably many areas you'd need to cover in
your questionnaire.

The example of the Low Literacy Prevalence Calculator I mentioned in my
previous post is a good starting point. It looks at these key areas:

Percent over 65 years of age
Percent enrolled in Medicaid or other public assistance program
Percentage that are White
Percentage that are Black (African American)
Percentage that are Hispanic
Percentage that mainly speak a language other than English

So, you would want to collect demographic data on age, gender, race (would
asking about a person's primary language be part of race?). Considering
those enrolled in Medicaid or other public assistance programs is only one
aspect concerning income and poverty status. What the calculator does is
look at some of the BIG factors impacting literacy. (see my closing comments
below for more on this).

An example of a comprehensive health survey that covers many of these key
areas -- and has lots of sample questions -- is the California Health
Interview Survey conducted by the UCLA Center for Health Policy Research in
2007.  The results were just released in March 2008. You can view the entire
report here: http://www.chis.ucla.edu/pdf/CHIS2007_adult_q.pdf

For a "health literacy" survey, you might want to consider questions from
these areas:

SECTION A – DEMOGRAPHIC INFORMATION, PART I
Age
Gender
Ethnicity
Race
Marital Status

SECTION G – DEMOGRAPHIC INFORMATION, PART II
Country of Birth
Language Spoken at Home
Additional Language Use
Citizenship and Immigration
Child and Teen Selection
Paid Child Care, Cost
Educational Attainment

SECTION K – EMPLOYMENT, INCOME, POVERTY STATUS, FOOD SECURITY
Hours Worked
Income Last Month
Annual Household Income
Number of persons supported
Poverty level test
Food Availability in Household
Hunger

SECTION L - PUBLIC PROGRAM PARTICIPATION
TANF/CalWORKS
Food Stamps
Supplemental Security Income
WIC
Assets
Alimony/Child Support
Social security/Pension Payments

SECTION M – HOUSING, PARKS, TRANSPORTATION
Housing


OK, that's a lot of ground to cover! Most of this data is probably already
collected in your state and is available by county. Since we know some of
the BIG factors that impact literacy, we can conclude that they also effect
health literacy. Both, however, crossover into every part of our culture.
Asking someone's race, education level and employment status may not tell
you anything about their health literacy level. For that you almost need to
use one of the health literacy assessment tools like REALM or TOFHLA. I
suppose you could include some demographic questions and then as a few
questions specific to health literacy.

But as stated many times by many experts, health literacy fluctuates.
Stress, hearing bad news from a doctor, anxiety, exhaustion, and any number
of uncontrollable factors can effect understanding. How do you collect that
type of information in a survey?

Also, keep in mind these studies:

Evidence does not support clinical screening of literacy --- According to a
recent article in the Journal of General Internal Medicine, clinical
screening for literacy is not recommended: "Limited health literacy is a
significant risk factor for adverse health outcomes. Despite controversy,
many health care professionals have called for routine clinical screening of
patients' literacy skills. Whereas brief literacy screening tools exist that
with further evaluation could potentially be used to detect limited literacy
in clinical settings, no screening program for limited literacy has been
shown to be effective. Yet there is a noted potential for harm, in the form
of shame and alienation, which might be induced through clinical screening.
There is fair evidence to suggest that possible harm outweighs any current
benefits; therefore, clinical screening for literacy should not be
recommended at this time."
http://www.ncbi.nlm.nih.gov/pubmed/17992564?ordinalpos=5&itool=EntrezSyst
 em2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


Patients' shame and attitudes toward discussing the results of literacy
screening --- Health care providers must recognize the potential shame
patients might experience as a result of literacy screening.
http://www.ncbi.nlm.nih.gov/pubmed/18030638?ordinalpos=7&itool=EntrezSystem2
.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


AND MOST INTERESTING OF ALL --- Brief report: screening items to identify
patients with limited health literacy skills: According to this study, one
screening question, "How confident are you filling out medical forms by
yourself?" was accurate in detecting limited and limited/marginal health
literacy skills.
http://www.ncbi.nlm.nih.gov/pubmed/16881950?ordinalpos=1&itool=EntrezSystem2
.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_R
A&linkpos=3&log$=relatedarticles&dbfrom=pubmed

According to this study, researchers were able to accurately predict which
patients had low health literacy skills by asking one question. The results
were just as accurate had they used REALM or TOFHLA. So maybe your survey
only needs one question????

The idea of a survey for a large population seems like a lot of effort and
expense, especially since NAAL already did that for you. We know the BIG
factors that impact literacy, and they carry over into health literacy
(race, language spoken, education level, employment status) and you should
already have access to this information for your county.

A survey won't measure those uncontrollable things that effect us all day to
day. Who among us hasn't experienced a time when we didn't understand what
someone was telling us (for any of the various reasons I already mentioned).
If you give me the TOHFLA test I'd do really well. Or if I took the NAAL
survey (http://nces.ed.gov/NAAL/sample_results.asp) right now I'd score in
the proficient range. Under stress I wouldn't do as well.

So, think about using the data already available to you. Create a
demographic profile of your county population. List out the BIG factors.
Estimate how many people might have low literacy. Use more of your time and
energy for educating health care organizations and social services in your
community about the need to communicate clearly. Consider the "universal
design" concept. Everyone benefits from clear, simple communication.

Doug Seubert
Quality Improvement & Care Management
Family Health Center/Community Heath Access

Marshfield Clinic
1000 N Oak Avenue
Marshfield, WI 54449
www.marshfieldclinic.org/quality

(715) 387-5096 (1-800-782-8581 ext. 75096)
seubert.douglas at marshfieldclinic.org


------Original Message------
From:	"Matt Gayer" <mcggayer at sbcglobal.net>
Date:	Thu Jun 05, 2008 -- 09:12:38 PM
To:	healthliteracy at nifl.gov
Subject:	[HealthLiteracy 2053]  Health Literacy Assessment Survey

Hello All-
    I am health literacy intern this summer at a county health department in
Missouri.  My first goal is to assess the current health literacy rate of
the county so we can identify strengths and weaknesses, then prepare an
implementation plan tailored to best fit the community.  In order to assess
current health literacy, I proposed that a survey of some sort would
probably be necessary in order to formulate our initial research.  I have
been able to thus far find any examples of such a survey/questionnaire, and
was wondering if anyone had used/created one or knew from where I could find
one.  I very much appreciate any help with this as I prepare to begin the
first steps in our new health literacy program.  Thank you.

----------------------------------------------------
National Institute for Literacy
Health and Literacy mailing list
HealthLiteracy at nifl.gov
To unsubscribe or change your subscription settings, please go to
http://www.nifl.gov/mailman/listinfo/healthliteracy
Email delivered to seubert.douglas at marshfieldclinic.org




------------------------------

Message: 3
Date: Sat, 7 Jun 2008 18:16:07 -0400
From: "David J. Rosen" <djrosen at comcast.net>
Subject: [HealthLiteracy 2062] Adult Education Content Standards
	Discussion	begins Monday
To: The Assessment Discussion List <assessment at nifl.gov>,	The Adult
	English Language Learners Discussion List	<englishlanguage at nifl.gov>,
	The Family Literacy Discussion List <familyliteracy at nifl.gov>,	The
	Health and Literacy Discussion List <healthliteracy at nifl.gov>,	The
	Learning Disabilities Discussion List <learningdisabilities at nifl.gov>,
	diversity at nifl.gov,	The Adult Literacy Professional Development
	Discussion List	<professionaldevelopment at nifl.gov>, 	The Technology
	and Literacy Discussion List <technology at nifl.gov>,	The Workplace
	Literacy Discussion List <workplace at nifl.gov>
Message-ID: <400CCBA2-EDA0-47AF-A425-C601C0A8AB3E at comcast.net>
Content-Type: text/plain; charset="windows-1252"

Colleagues,

Beginning Monday, June 9th, and continuing through Friday, June 20th,
on the National Institute for Literacy Special Topics list, we will
discuss the implementation of state adult education content
standards. Experts from several states will talk about the
opportunities and challenges they have experienced as they work with
teachers, administrators and others who are developing curriculum,
and designing and teaching lessons that reflect their state's content
standards. Our guests include: Miriam Kroeger, from Arizona; Raye
Nell Spillman, from Louisiana; Karen Lisch Gianninoto, from Maryland;
Judy Franks, from Ohio; Pam Blundel, from Oklahoma; Philip Anderson,
from Florida; and Federico Salas, from Texas. You will find
background information on all of our guest experts below. I hope you
will join us for this discussion. I hope you will also forward this
announcement to your colleagues who may be interested!

To subscribe to the discussion, go to:

http://www.nifl.gov/mailman/listinfo/specialtopics

You can unsubscribe later by going to the same web page or, if you
prefer, you can stay subscribed for the next discussion.

Adult Education Content Standards Warehouse

Sponsored by the U.S. Department of Education, the Adult Education
Content Standards Warehouse "provides access to materials for
developing, aligning, and implementing adult education content
standards in the areas of English language acquisition, mathematics,
and reading. On this site you can find content standards from a
variety of states and organizations; learn about the process of
developing standards in A Process Guide for Establishing State Adult
Education Content Standards; and find field resources on professional
development and national and international standards." The web site
address is:

http://www.adultedcontentstandards.ed.gov/


Background on Discussion Guests

Philip Anderson started his English teaching career in 1974 as a
Peace Corps volunteer in the Dominican Republic.  English teaching
was a sideline to his main project of helping farmers groups with pig
raising projects.  After Peace Corps, Phil continued to live in the
Dominican Republic as a pastor for small church groups, and he
continued to teach English to adults who wanted to emigrate to the
U.S.  In 1986, he returned to the states to finish college at UC
Davis.  With a MS in community development, Phil went to Haiti in
1991.  There, Phil taught woodworking at a vocational school, taught
English, managed a large soil conservation project (not all at the
same time)!  In 1995, Phil returned to the states, and became a part-
time adult ESOL instructor at night for Palm Beach county in Belle
Glade, Florida.  In 1998, he joined the adult ESOL program at South
Florida Community College, where he was department chair from
2000-2004.  Since 2004, Phil has worked at the Florida Department of
Education.  There Phil manages EL Civics state leadership grants and
provides technical assistance trainings to adult ESOL instructors
statewide.

Pam Blundell has been involved in Oklahoma's development and
implementation of content standards since 2002-2003 when the state
held its first discussions around the possibility of introducing the
Equipped for the Future (EFF) teaching and learning system to the
field. Pam was given the task of overseeing the state's first EFF
pilot project in 2003-2004. During the EFF pilot year, the state
decided to expand the EFF training and officially adopt EFF content
standards statewide. At that time, Pam was asked to coordinate this
long-term process. Pam has continued to be directly involved in the
implementation and oversight of the integration of content standards
into the adult education classroom. This process has involved the
development of new tools and training processes and most recently,
leading the state's Standards-In-Action (SIA) team. Prior to coming
to the state, Pam worked as an adult education teacher integrating
EFF standards into instruction.

Judy Franks is currently on staff at the Ohio Literacy Resource
Center as a Literacy Projects Coordinator. She was involved
originally with the Equipped for the Future (EFF) Standards-based
System Reform Initiative, coordinating the Ohio Research Field Sites
and training as a Certified State Facilitator. Judy has had
experience developing and working with the standards at the program,
state, and national levels. As a veteran instructor of training and
development courses, Judy's background in adult basic education since
1992 includes family literacy, GED classroom instruction and the
development of a workforce training program.

Karen Lisch Gianninoto's involvement with the Maryland Content
Standards for Adults ESL/ESOL began when she was working part-time as
an ESL instructor. She "was one of the teachers complaining from the
field that we needed standards". As a full time high school teacher,
she knew how helpful standards were in guiding instruction. Not long
after, she was appointed to the ESL Workgroup that developed the
content standards document.

Four years ago, she became the ESL Specialist for the Maryland State
Department of Education. When she took the position, she was
"grateful the content standards were finished. Little did I know that
my work was just beginning. Over the past four years, the content
standards have been revised three times, the ESL content standards
have been implemented in all of Maryland's programs, state trainers
have completed a training process, and a training manual was
completed. Yet, there is more to learn about standards. Maryland has
been most fortunate to participate in the CAELA and SIA Projects
funded through OVAE. These projects have helped Maryland refine our
training and provided instructors with the tools to understand
content standards."

Miriam Kroeger has been involved in Adult Education as a volunteer,
teacher, coordinator, administrator and specialist since 1972 and in
Arizona since 1978. She has taught adult English learners and adults
studying for their secondary school credential at a variety of
locations including elementary and secondary schools, community
colleges, jails, and prisons; she works with K-12 and adult
educators, and has visited teachers throughout the state of Arizona.
Miriam has served on state, regional and national committees; on the
boards of the Arizona Association for Lifelong Learning, the Mountain
Plains Adult Education Association and Arizona Teachers of English to
Speakers of Other Languages. She has been on national working groups
involved with adult education standards and teacher development and
was an original team member in the development and implementation of
Arizona's Standards for Adult Learners. She was also a member of the
Standards Specialist/Resource Teachers team that assisted programs
and instructors in the implementation of the standards. As an
Education Program Specialist in the Arizona Department of Education,
Adult Education Services unit during the past six years, one of her
responsibilities was to spearhead the revisions to the Reading,
Writing, Math, Science, Social Studies and ELAA (ESOL) Arizona Adult
Education Standards. These revisions were published in December 2007,
and the training process in understanding and utilizing the standards
continues.

Federico Salas-Isnardi is Assistant State Director of Adult Education
in Texas.  He oversees the Professional Development System in the
state.  He has worked for 20 years in the field of adult Education as
an ESL and GED instructor, professional developer, curriculum writer,
and program administrator.  He has trained adult educators for over
18 years on topics ranging from language acquisition to
individualized professional development planning, and from cross-
cultural communication and multicultural awareness to educational
leadership.

Between 2004 and 2007, Federico represented the state office of adult
education in the AE Content Standards Project team that adopted the
standards and wrote the benchmarks for Texas AE Content Standards
document.  In that capacity he worked with the project staff and
observed the work of the standards writers.  He also helped
articulate the vision of the state in regards to the adoption
process.  During the first two years of the project, Federico was the
state?s liaison to the National Adult Education Content Standards
Consortium.

Raye Nell D. Spillman has worked in the Louisiana State Department of
Education, Office of School and Community Support, Adult and Family
Literacy Services for four years. Ms. Spillman holds an undergraduate
degree from Louisiana State University in the field of education. She
has taught in the K-12 public education system and served on numerous
committees to advance the education of children and adults. After the
approval and adoption of The Louisiana Adult Education Content
Standards in October 2006, Ms. Spillman was instrumental in
introducing the standards to adult education instructors across the
state in collaboration with the Louisiana Association for Public,
Community and Adult Education. The following summer, Louisiana
applied for and was one of six states accepted to participate in
OVAE's Standards-in-Action (SIA) project. Ms. Spillman headed the
Louisiana team who accepted their charge to pilot test training
materials for implementing adult education standards use in the
classroom. Again this year, Ms. Spillman and the Louisiana team are
looking forward to participating in Part 2 of the Standards-in-Action
project.

David J. Rosen
National Institute for Literacy
Special Topics Discussion Moderator
Djrosen at comcast.net




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Message: 4
Date: Mon, 9 Jun 2008 13:51:21 -0400
From: "Brach, Cindy (AHRQ)" <Cindy.Brach at ahrq.hhs.gov>
Subject: [HealthLiteracy 2063] Re: Health Literacy Assessment Survey
To: "The Health and Literacy Discussion List"
	<healthliteracy at nifl.gov>
Message-ID:
	<04B4EF9F9E334C48903C284C4B16A19708A1F891 at AVN3VS004.ees.hhs.gov>
Content-Type: text/plain; charset="iso-8859-1"

Nikki Lurie at RAND and A.I.R. (the contractor that conducted the NAAL) are
developing a geographic health literacy estimator using NAAL health literacy
data. I believe they will have a working model for one state this summer,
and plan to expand it further pending additional funding.

Cindy Brach
Center Delivery, Organization, and Markets
Agency for Healthcare Research and Quality
540 Gaither Road
Rockville, MD 20850
301-427-1444
fax: 301-427-1430
Cindy.Brach at ahrq.hhs.gov

________________________________

From: healthliteracy-bounces at nifl.gov on behalf of Seubert, Douglas
Sent: Fri 6/6/2008 2:57 PM
To: healthliteracy at nifl.gov; Jsorensen at afmc.org; mcggayer at sbcglobal.net
Subject: [HealthLiteracy 2061] Re: Health Literacy Assessment Survey




If you really want to do a thorough survey to assess the health literacy of
a county population, there are probably many areas you'd need to cover in
your questionnaire.

The example of the Low Literacy Prevalence Calculator I mentioned in my
previous post is a good starting point. It looks at these key areas:

Percent over 65 years of age
Percent enrolled in Medicaid or other public assistance program
Percentage that are White
Percentage that are Black (African American)
Percentage that are Hispanic
Percentage that mainly speak a language other than English

So, you would want to collect demographic data on age, gender, race (would
asking about a person's primary language be part of race?). Considering
those enrolled in Medicaid or other public assistance programs is only one
aspect concerning income and poverty status. What the calculator does is
look at some of the BIG factors impacting literacy. (see my closing comments
below for more on this).

An example of a comprehensive health survey that covers many of these key
areas -- and has lots of sample questions -- is the California Health
Interview Survey conducted by the UCLA Center for Health Policy Research in
2007.  The results were just released in March 2008. You can view the entire
report here: http://www.chis.ucla.edu/pdf/CHIS2007_adult_q.pdf

For a "health literacy" survey, you might want to consider questions from
these areas:

SECTION A - DEMOGRAPHIC INFORMATION, PART I
Age
Gender
Ethnicity
Race
Marital Status

SECTION G - DEMOGRAPHIC INFORMATION, PART II
Country of Birth
Language Spoken at Home
Additional Language Use
Citizenship and Immigration
Child and Teen Selection
Paid Child Care, Cost
Educational Attainment

SECTION K - EMPLOYMENT, INCOME, POVERTY STATUS, FOOD SECURITY
Hours Worked
Income Last Month
Annual Household Income
Number of persons supported
Poverty level test
Food Availability in Household
Hunger

SECTION L - PUBLIC PROGRAM PARTICIPATION
TANF/CalWORKS
Food Stamps
Supplemental Security Income
WIC
Assets
Alimony/Child Support
Social security/Pension Payments

SECTION M - HOUSING, PARKS, TRANSPORTATION
Housing


OK, that's a lot of ground to cover! Most of this data is probably already
collected in your state and is available by county. Since we know some of
the BIG factors that impact literacy, we can conclude that they also effect
health literacy. Both, however, crossover into every part of our culture.
Asking someone's race, education level and employment status may not tell
you anything about their health literacy level. For that you almost need to
use one of the health literacy assessment tools like REALM or TOFHLA. I
suppose you could include some demographic questions and then as a few
questions specific to health literacy.

But as stated many times by many experts, health literacy fluctuates.
Stress, hearing bad news from a doctor, anxiety, exhaustion, and any number
of uncontrollable factors can effect understanding. How do you collect that
type of information in a survey?

Also, keep in mind these studies:

Evidence does not support clinical screening of literacy --- According to a
recent article in the Journal of General Internal Medicine, clinical
screening for literacy is not recommended: "Limited health literacy is a
significant risk factor for adverse health outcomes. Despite controversy,
many health care professionals have called for routine clinical screening of
patients' literacy skills. Whereas brief literacy screening tools exist that
with further evaluation could potentially be used to detect limited literacy
in clinical settings, no screening program for limited literacy has been
shown to be effective. Yet there is a noted potential for harm, in the form
of shame and alienation, which might be induced through clinical screening.
There is fair evidence to suggest that possible harm outweighs any current
benefits; therefore, clinical screening for literacy should not be
recommended at this time."
http://www.ncbi.nlm.nih.gov/pubmed/17992564?ordinalpos=5&itool=EntrezSyst
 em2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


Patients' shame and attitudes toward discussing the results of literacy
screening --- Health care providers must recognize the potential shame
patients might experience as a result of literacy screening.
http://www.ncbi.nlm.nih.gov/pubmed/18030638?ordinalpos=7&itool=EntrezSystem2
.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


AND MOST INTERESTING OF ALL --- Brief report: screening items to identify
patients with limited health literacy skills: According to this study, one
screening question, "How confident are you filling out medical forms by
yourself?" was accurate in detecting limited and limited/marginal health
literacy skills.
http://www.ncbi.nlm.nih.gov/pubmed/16881950?ordinalpos=1&itool=EntrezSystem2
.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_R
A&linkpos=3&log$=relatedarticles&dbfrom=pubmed

According to this study, researchers were able to accurately predict which
patients had low health literacy skills by asking one question. The results
were just as accurate had they used REALM or TOFHLA. So maybe your survey
only needs one question????

The idea of a survey for a large population seems like a lot of effort and
expense, especially since NAAL already did that for you. We know the BIG
factors that impact literacy, and they carry over into health literacy
(race, language spoken, education level, employment status) and you should
already have access to this information for your county.

A survey won't measure those uncontrollable things that effect us all day to
day. Who among us hasn't experienced a time when we didn't understand what
someone was telling us (for any of the various reasons I already mentioned).
If you give me the TOHFLA test I'd do really well. Or if I took the NAAL
survey (http://nces.ed.gov/NAAL/sample_results.asp) right now I'd score in
the proficient range. Under stress I wouldn't do as well.

So, think about using the data already available to you. Create a
demographic profile of your county population. List out the BIG factors.
Estimate how many people might have low literacy. Use more of your time and
energy for educating health care organizations and social services in your
community about the need to communicate clearly. Consider the "universal
design" concept. Everyone benefits from clear, simple communication.

Doug Seubert
Quality Improvement & Care Management
Family Health Center/Community Heath Access

Marshfield Clinic
1000 N Oak Avenue
Marshfield, WI 54449
www.marshfieldclinic.org/quality

(715) 387-5096 (1-800-782-8581 ext. 75096)
seubert.douglas at marshfieldclinic.org


------Original Message------
From:   "Matt Gayer" <mcggayer at sbcglobal.net>
Date:   Thu Jun 05, 2008 -- 09:12:38 PM
To:     healthliteracy at nifl.gov
Subject:        [HealthLiteracy 2053]  Health Literacy Assessment Survey

Hello All-
    I am health literacy intern this summer at a county health department in
Missouri.  My first goal is to assess the current health literacy rate of
the county so we can identify strengths and weaknesses, then prepare an
implementation plan tailored to best fit the community.  In order to assess
current health literacy, I proposed that a survey of some sort would
probably be necessary in order to formulate our initial research.  I have
been able to thus far find any examples of such a survey/questionnaire, and
was wondering if anyone had used/created one or knew from where I could find
one.  I very much appreciate any help with this as I prepare to begin the
first steps in our new health literacy program.  Thank you.

----------------------------------------------------
National Institute for Literacy
Health and Literacy mailing list
HealthLiteracy at nifl.gov
To unsubscribe or change your subscription settings, please go to
http://www.nifl.gov/mailman/listinfo/healthliteracy
Email delivered to seubert.douglas at marshfieldclinic.org





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Message: 5
Date: Fri, 6 Jun 2008 14:00:03 -0400
From: MSkewes at ria.buffalo.edu
Subject: [HealthLiteracy 2064] Re: New current awareness resource	on
	healthliteracy resources
To: The Health and Literacy Discussion List <healthliteracy at nifl.gov>
Message-ID:
	<OF499CDBED.5CDDBCDA-ON85257460.0062D759-85257460.0062EF61 at ria.buffalo.edu>

Content-Type: text/plain; charset="utf-8"

I agree!  This is fantastic!  Thanks so much.

Monica

Monica C. Skewes, Ph.D.
Postdoctoral Associate
Research Institute on Addictions
University at Buffalo
The State University of New York
1021 Main Street
Buffalo, New York 14203
716-887-2242 (phone)
716-887-2510 (fax)




"Davies, Nicola" <NDavies at dthr.ab.ca>
Sent by: healthliteracy-bounces at nifl.gov
06/06/2008 11:08 AM
Please respond to
The Health and Literacy Discussion List <healthliteracy at nifl.gov>


To
"The Health and Literacy Discussion List" <healthliteracy at nifl.gov>
cc

Subject
[HealthLiteracy 2057] Re: New current awareness resource on healthliteracy
resources






Julie,
What a wonderful resource! Excellent start to a Friday morning!

Cheers
Nicola
-----Original Message-----
From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov]On Behalf Of Esparza, Julia M.
Sent: Friday, June 06, 2008 6:58 AM
To: The Health and Literacy Discussion List
Subject: [HealthLiteracy 2054] New current awareness resource on
healthliteracy resources

Friends,

I would like to announce the recently created Health Literacy Alerts
http://healthliteracyalerts.blogspot.com.  This resource is to try to
capture studies, reports and other information regarding health literacy
in one place.  This was created as a companion resource to my LSUHSC-S
Medical Library Evidence Alert.   You can use a feed reader to know when
the site is updated or you can bookmark the page and return to it often.
If I see resources mentioned online I will post those as well.  It won?t
be able to gather everything published but it will at least give us one
way to try to stay on top of the literature.  Most of the resources will
NOT be available free since most are reports in journals.  Your library
will need to have access to the journal or you might have to ask to
receive the resource via interlibrary loan.  The focus will be on health
literacy and not general literacy.  I just wouldn?t have time to cover all
the literature published in general literacy.  If you see a resource
please let me know and I can make an entry for it.

Please let me know if you have any questions.

Julie

Julie Esparza
Clinical Medical Librarian
LSU Health Sciences Center - Shreveport, LA

LSUHSC-S Medical Library Evidence Alert
http://lsuhsc-sevidencealert.blogspot.com
Health Literacy Alerts
http://healthliteracyalerts.blogspot.com

318-675-4179
318-675-5442 Fax
jespar at lsuhsc.edu
 ----------------------------------------------------
National Institute for Literacy
Health and Literacy mailing list
HealthLiteracy at nifl.gov
To unsubscribe or change your subscription settings, please go to
http://www.nifl.gov/mailman/listinfo/healthliteracy
Email delivered to mskewes at ria.buffalo.edu

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Message: 6
Date: Mon, 9 Jun 2008 15:53:20 -0400
From: "DeWalt, Darren" <darren_dewalt at med.unc.edu>
Subject: [HealthLiteracy 2065] Universal Precautions Toolkit for
	Primary Care
To: "The Health and Literacy Discussion List"
	<healthliteracy at nifl.gov>
Message-ID:
	<ADBAFA5ADB37AE409553D3F7B2F8F9B30290B2AB at medexch.med.unc.edu>
Content-Type: text/plain; charset="us-ascii"

Dear Colleagues,



We are developing a Health Literacy Universal Precautions toolkit for
use in primary care practices.  Therefore, we are looking for a broad
range of tools that can be used by practices to help patients get the
most out of their health care.  This includes but is not limited to:



1.       Staff training to improve cultural or literacy sensitivity and
patient communication & education

2.       Strategies for serving patients with low literacy or cultural
differences

3.       Strategies for practices to link with literacy or cultural
resources provided in the community



Please reply with any questions or if you have a tool that may be useful
to include. If you have a tool, please let us know the name of the tool,
how it is used, and what it costs.



How to Reply: Email: vhawk at med.unc.edu or fax: 919 966-1739 ATTN:
Victoria Hawk, HL Toolkit Mgr.



When to Reply: by June 16, 2008.



What to Include in Your Reply: In addition to information about tools,
please include contact information: Name, Organization, Phone, Fax,
Mailing Address and Email.



We look forward to hearing from you.



Sincerely,



Darren



Darren A. DeWalt, MD, MPH

Assistant Professor of Medicine

Division of General Internal Medicine

5039 Old Clinic Building, CB#7110

Chapel Hill, NC  27599

Campus Office: 919-966-2276, ext 245

Sheps Center Office: 919-966-0926

fax: 919-966-2274



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End of HealthLiteracy Digest, Vol 33, Issue 5
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