Hi Bill and others.  I am  fascinated by the work of the young people in
their mapping of their communities.  I am also struck by your comment
about disparities. One of the things I found was that the study circle
format allowed teachers to really examine many issues, particularly the
issue of disparity.  They were able to read and examine research data
and other health information and talk about many issues. As a result of
those discussions, I found many teachers seized with a deeper awareness
of the nature of health disparities. Many saw  health literacy playing a
part in reducing some of those disparities. (of course they recognized
that changes in systemic conditions were also needed)
I am wondering whether the study circle format for health providers
could do the same -i.e. stimulate  health workers to a deeper
appreciation of the importance of health literacy in addressing
disparities. What do we think?
Winston


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Winston Lawrence Ed. D
Senior Professional Deveopment Associate,
Literacy Assistance Center
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New York, NY 10004
Tel: 212-803-3326
Fax: 212-785-3685
Email: winstonl at lacnyc.org

-----Original Message-----
From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov] On Behalf Of William Smith
Sent: Wednesday, June 21, 2006 6:57 AM
To: esltilla at gmail.com; The Health and Literacy Discussion List;
sfallsliteracy at yahoo.com
Subject: [HealthLiteracy 228] Re: Welcome to the discussion: Using
theHealthLiteracy Study Circles+

Hi. Nancy,

I won't say it's not a challenge.  I know what you are going through. 
Health professionals don't know about and often don't believe they have
a health literacy problem, especially the highest health professionals. 
I think it is more than denial.  It is a real disconnect with the real
world. They are pushed to be so efficient - given so little time with
patients and going through a major change in American health care that
they truly believe they are doing all that is possible.  And they may
be.,  We have to be sensitive to their reality too.  

My experience suggests an inside champion ( a respected physician)
helps a lot. A respected outsider who frames the problem as a U.S.
problem- a silent epidemic that is effecting everyone is also useful. 
This is particularly true with the elderly and they are often an
audience that doctors will understand are having a hard time
understanding.  

Youth mapping - why does it work?  It is not without problems and that
is one reason we have been reluctant to create a tool kit for anyone to
use it.  It is still dependent upon expert trainers who really
understand youth.  Some things that do matter in getting youth to take
it seriously. 

1.  They get paid and therefore they are treated like professionals. 
They are asked to dress like professionals in special T-shirts we
provide them.  
2. They work in teams of three so they get support from each other. 
3. During training we weed out the teens we know are not taking it
seriously, but this has to be done carefully, not to upset the sense
that the teens are gaining power over the process.
4.  The training is VERY skill  oriented.  No pep talks just practice
sessions- that they hate at first but get into with persistence.  I
remember one young women who just said she was not going to practice. 
Our trainer said -  "sure I understand"- but with a slight tone of "you
are letting the others down".  She sat out two rounds and then came back
on her own.  Teens have no idea why they do things.  Their bodies are
going through tremendous change they do not understand.  Sometime they
just need space to truly "get it together."
5. We use teens that are already in youth programs.  They are not the
"ggodie-goodies", but they have some experience with working with other
teens on projects.  Health literacy was like totally new to them.  You
think doctors are resistence -  the first time we explained the problems
people have with prescription labels one teen said: "Why don't they just
learn to read."  Later he had a conversation with his grandmother and
learned why. 
6. They are truly needed for the mapping to work.  This is not make
work with the adults doing all the hard stuff.  They have to come
through or let everyone down.  "Responsibility" has to be felt.  
7.  The training lasts only 2-3 days.  
8. By the time they are presenting - they are confident.  
9.  The press loves teens - they love to cover a story like this. 
10. Teens find real problems - and expose them.  If the problems are
not real the adults won't pay attention.  

Hopes this helps a bit.  Youth Mapping is no panacea - but we have been
amazed at what teens can accomplish.  The most amazing finding of the
Harlem teens was the discovery that in 50 square blocks in Harlem there
were "O" doctor's office, while just a few blocks away in Manhattan they
found 119 in a few blocks.  Talk about disparities.  

We are happy to talk to anyone interested in this.  We have been doing
youth mapping in Egypt and are brining some of our Egyptian kids
together with the U.S. kids....they hate it when I call them
kids..."Teens".  

Wm. Smith
Executive Vice President
Academy for Educational Development
1825 Connecticut Ave., NW
Washington, D.C. 20009

Organize policy until self-interest
does what justice requires.
Phone: 202-884-8750
Fax: 202-884-8752
e-mail: bsmith at aed.org
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