strengthening public health and the healthcare workforce health partners can-do guide...

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StrengtheningPublicHealthandtheHealthcareWorkforce

ACan-DoGuideoftheOpenDoorCollectiveMay26,2019Edition

What’sInsideThisODCCan-DoGuidepresentswhyandhowU.S.adultbasicskillsprogramscancollaboratewith“healthpartners”–organizationsthatinvariouswayssupportpublichealthandhealthcarecareeropportunities.

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Itdescribeseighttypesofcollaborations,withexamplesofeachandlinkstocorrespondingorganizationsanddocuments:

1. Healthliteracyeducation;2. Healthcarecareer

preparation;3. Directhealthcareservices

toadultlearners;

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4. Basicskillssupportsforhealthcareproviderstohelpthembetterworkwiththeirclientsandemployees;

5. Health-friendlyadulteducationfacilities;

6. Publichealthservicelearning;7. Advocacyandplanning;8. Healthpartnershipsresearch.

Attheend,theguidesuggestsstepsthatadulteducationandhealthpartnerscantaketogetstartedoncreatingproductivecollaborations.

Appendicescontainanextensiveannotatedbibliographyofrelevantresourcesandlinkstoon-lineresourcescitedinthisguide.

WhatU.S.HealthPartnersandAdultBasicSkillsProgramsCanDoTogether

TheOpenDoorCollectiveODCisanationalnetworkofadulteducatorsandotherswhopromotehigh-qualityadultbasiceducationasatoolforpovertyreductionandforward-thinkingsocialandeconomicdevelopment.(Visitwww.opendoorcollective.org.)Welcome!

OpenDoorCollective “StrengtheningPublicHealth&theHealthcareWorkforce” 2

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Purpose:

This“Can-DoGuide”aimsatfacilitatingcollaborationsbetween“healthpartners”andadultbasicskillsprograms.Suchhealthcollaborationscanbenefitseveralstakeholdergroupsinvariouswaysandtakemultipleforms.Potentialstakeholders,benefits,andformsofcollaborationaredescribedinthesepages.

Audiences:

Thisguideiswrittenfortwoaudiences:“healthpartners”andadultbasicskillsprograms.

Healthpartnersaredefinedbroadlyasorganizationsandindividualsthathaveasaprimaryorsecondarygoaltheprotectionandimprovementofpublichealth.Thesecouldincludegovernmentalandnon-governmentalbodiesthat:

• providehealtheducation;• providedirecthealthcare

servicestoindividuals;• providetrainingand

employmentinthehealthcareindustry;

• set,support,monitor,andimplementhealthpolicies;

• createanddistributehealth-supportingproducts;

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Healthpartnerscanincludehealthadvocacygroups,preventivehealthservices(e.g.,exerciseandhealthyeatingprograms,communitygardens,anti-smokingefforts);directcareproviders(e.g.,FederallyQualifiedHealthCenters,individualhealthcareprofessionals,hospitalsandclinics,extended-careproviders);environmentalhealthprograms;healthcareindustrytrainingprogramsandemployersseekingwell-trainedemployees;companiesthatproduceandsellhealthyfoods,medications,andotherproducts;healthinsuranceproviders;laborunionspromotinghealthyworkplaces;andpublichealthresearchersandfunders.

Theterm“healthpartners”shouldbeviewedinaflexibleway.Theymightbeorganizationsthatincludehealthactivitiesaspartofalargermission.Forexample,aprimaryschoolmightincludehealtheducationinitscurriculumorayouthgroupmighthavevolunteersdohealthawarenessorfooddeliveryactivitiesaspartofitscommunityserviceprogram.

Adultbasicskillsprogramsarelocal,state,andnationalorganizationswhoseektostrengthenthebasicskillsadultsandout-of-schoolyouthneedforwork,family,andcivicroles.Theseskillsincludereading,writing,speaking,listening,numeracy,problemsolving,digitaltechnology,andotherfundamentalskills.Providersincludepublicorprivateagenciesinavarietyofinstitutionalsettings(e.g.,

community-basedorganizations,publicschools,communitycolleges,libraries,workplaces,laborunions,correctionalfacilities).Theyservediversepopulationschallengedbybasicskillslimitations.Thesecanincludeemployedworkersandunemployedjobseekers,oldercareer-changers,parentswhowanttosupporttheirchildren’slearninganddevelopment,out-of-schoolyouthandadults,peoplewithdisabilities,andcurrentandformerinmates.Immigrantsandrefugees(whocanhavevariouslevelsofEnglishfluencyandbasicskillsintheirnativelanguages)areamajorsegmentoftheadultbasicskillsstudentpopulation.

Thisdocumentisaimedatorganizationalleadersandothers.Inparticular,wehopetoreachhealtheducators,healthcareindustrytrainers,andFederally-QualifiedHealthCenters(thelastofwhichserveclientssimilartothosewhoenrollinadultbasicskillsprograms).Thesestakeholdershaveanaturalconnectiontoadultbasiceducationprograms.

Part1

Purpose&Audiences

INFORMATIONSOURCESThisdocumentdrawson:• aliteraturereviewofsources

fromthehealth,workforcedevelopment,andadulteducationfields;

• inputfromadulteducatorsandhealthstakeholders.2


Part2

WhyCollaborate?

Howcollaborationscanbenefitmultiplestakeholders

TheOpenDoorCollectiveisanationalnetworkofadulteducatorsandotherstakeholderswhosemissionistohelpadultbasicskillseducationprogramstoworkwithotherstakeholdergroupstoreducepovertyandincomeinequalityintheUnitedStates,especiallyfortheestimated36millionadultswhoarechallengedbybasicskillslimitations.Weseepublichealthandothersocietalissues(e.g.,criminaljusticereform,environmentalsustainability,improvingaccesstodigitalliteracyandtechnologies,immigrantintegration)asinterwovenwithemployabilityandjobsthatprovidefamily-sustainingwagesandbenefitsandapositiveworkenvironment.

Thisguidepromotescollaborationsbetweenhealthpartnersandadultbasicskillsprogramsthathavethesepotentialbenefits:

Foradultsandout-of-schoolyouthwhohavebasicskillslimitations(andpossiblytheirfamiliesandcommunities):

• Improvethehealthliteracyofthoseadultsandyouth,sotheycanmakeinformeddecisions(includinghealth-relatedfinancialdecisions)anduseeffectivehealthpracticesintheirfamily,work,andcommunityroles.

• Strengthenthoseindividuals’accesstoqualityhealthcareservices,sotheycanstayhealthyandbetterabletoattain,perform,retain,andadvanceinemploymentthatprovidesthem(andbyextensiontheirfamilies)withfamily-sustainingwagesandbenefits;

• Improvetheaccessofthoseindividualstocareerpathwayjobsinthehealthcareindustry;

• Engageadultlearnersandothersinservicelearningactivitiesthatsupportpublichealthwhilehelpingthoselearnersdevelopusefulbasicskillsandhealth-relatedknowledge.

Foradultbasicskillsprogramsandhealthcarepartners:

• Helpadulteducationfacilitiesadopt“health-friendly”practicesandproceduresthatcanbenefitthehealthofusers;

• Improveeducationprograms’abilitytorespondtocommunityhealthneedsandtherebystrengthentherelationshipsbetweentheprogramsandthecommunitiestheyserve;

• Improvehealthpartners’abilitytounderstandandrespondtotheneedsofclientsandemployeeswhohavebasicskillslimitations;

• Increasepublicawarenessandfinancialandin-kindsupportforadultbasiceducation,healthliteracy,healthcarejobtraining,andpublichealth. 3


• Basicskillslimitationscanreduceadults’abilitytolearnabouthealthissuesthatimpactthemandhealth-sustainingthingstheycandointheirworkplaces,homes,andcommunities.(Manypeoplewithlowerlevelsofbasicskillshavenothadaccesstoeducation,information,digitaltechnology,andsupportnetworksthatwouldhelpthemdevelopthebackgroundknowledgeandotherskillsneededtounderstandthecausesandpossibleresponsestohealthchallenges.)

• Occupationaltrainingprogramsdonotalwaysaccommodatelearnerswhohavelowerlevelsofbasicskills.Theyarethusblockedfromlearninghowtoprotecttheirhealthintheircurrentjobsand/ortomoveintonewjobsinthehealthcareindustry.

• Peoplewithlimitedbasicskillstendtohavelowerincomesthanthegeneralpopulation.Lower-incomepeoplearemorelikelytoliveandworkincommunitiesthataremoreimpactedbyhealthhazards(e.g.,pollution,unsafeconditions,lackofaccesstohealthyfoods)andlessabletoaffordhealthcare,technologies,medications,orotherresourcesortrainingthat

-Ipsum

Healthchallengesandopportunities

Peoplewhohavebasicskillslimitationsfacemany–ifnotall–ofthesamehealthchallengesasthegeneralpopulationdoes.Thesechallengesincludephysicalandmentalhealthproblemsexacerbatedbypoordiet,lackofexercise,riskybehaviors,exposuretotoxins(includingthroughsubstanceabuseandenvironmentalpollutants),limitedaccesstoqualityhealthcareandaffordablemedications,unsafeworkandlivingconditions,andexcessivestress.Atthesametime,therehasbeenagrowthinawarenessanduseofpreventivecarestrategiesandnewhealthcaretechnologies,procedures,andmedicationsthatcancountertheabovehealthchallenges.Therehasalsobeenagrowthinemploymentopportunitiesinthehealthcarefield,andmanyofthosejobsprovidelivingwages,benefits,andopportunitiesfortrainingandacareerpath.PeopleintheU.S.nowhavetheopportunitytoadopthealth-sustainingwaysoflivingandworking,However,itcanbemoredifficultforpeoplewithlimitedbasicskillstodosobecause:

helpthemavoidanddealwiththosehazards.

Peoplewithbasicskillslimitations–andtheirfamilies--arethusdisproportionatelynegativelyimpactedbyhealthchallenges.Thiscantranslateintoreducedhealth,employmentoptions,andabilitytomakeinformeddecisionsasconsumersandcitizens.Basicskillslimitationscanalsoreducetheabilityofadultsandout-of-schoolyouthtoattainandsucceedinrewardingjobsinthegrowinghealthcareindustry.

Toreduceandpossiblyeliminatetheseimpacts,weproposenewpartnershipsbetweenthehealthstakeholdersdescribedabove(whohaveexpertise,resources,networks,andotherassetstosupportpublichealthandhealthcareemployment),adultbasicskillsprograms,andtheadultsandcommunitiesthoseeducationprogramsserve.

(Forfurtherinformationontherelationshipofbasicskillstopublichealthandhealthcarecareers,seethereportscitedinthe”Type8:Healthpartnershipsresearch”sectionbelowandtheAppendix.)

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1. Healthliteracyeducation(p.6):Healthorganizationsandadulteducatorscancollaboratetohelpadultlearnerstounderstandhealth-relatedchallengestheyandtheirfamiliesandcommunitiesfaceandstrategiesandresourcestheymightuseintheirhomes,communities,andcurrentworkplacestoensuretheirhealth.

2. Healthcarecareerpreparation(p.8):Healthcareindustryemployers,laborunions,andtrainerscanworkwithadulteducatorstohelpadultlearnersunderstandhealthcarecareeroptionsandpreparefor,access,succeedin,andadvanceinjobsinthislarge,diverse,andgrowingindustry.

3. Directhealthcareservicestoadultlearners(p.11):Healthcareproviderscanhelpadultlearners(andpossiblytheirfamilies)accesshealthcareservices(e.g.,healthscreenings,visualandauditoryexams)inthecommunityorattheadulteducationfacility.

4. Basicskillssupportsforhealthcareproviders(p.12):Adultbasicskillsprofessionalscanprovideculturalguidance,translation/interpreting,editing,andotherservicestohelphealthcarepartnerstobetterserveclientsandemployeeswhohavebasicskillslimitations.

Part3

HowHealthPartnersandAdultBasicSkillsProgramsCanCollaborateHealthliteracyeducationisoneofseveralwaysthathealthpartnerscanworkwithadultbasicskillsprograms.Butthereareothersaswell.Seethesummarybelow:

5. Health-friendlyeducationfacilities(p.14):Healthorganizationscanworkwithadulteducatorstomakeadultbasiceducationfacilitiesandproceduresmoresupportiveofthehealthofthefacilities’users(e.g.,throughservingofhealthyfoods,exerciseprograms,airqualitytechnologies,goodlighting,apsychologicallypositivestudyandworkenvironment).

6. Publichealthservicelearning(p.15):Involvingadultlearners(andpossiblytheirfamiliesandcommunities)andadulteducationstaffinhealth-relatedservicelearningactivitiescansupportpublichealthwhilehelpinglearnersdevelopusefulskills,knowledge,networks,andbehaviors.

7. Advocacyandplanning(p.15):Health-supportingorganizationsandadulteducatorscanconductjointawareness-raising,planning,advocacy,and/orfundraisingactivitiestosupportpublichealthandadultbasiceducation.

8. Healthpartnershipsresearch(p.18)todocumentandinformtheabove-describedcollaborations.

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Note:Noadulteducationprogramshouldfeeltheneedtopursuealloftheseeightformsofcollaboration.AsstatedinPart4onpage20,thoseinterestedintryinganyofthesepartnershipsneedtogothroughaplanningprocesstochoosecollaborationstrategiesthatareinsyncwiththeneedsandcapacitiesofthestakeholderstobeinvolved.Partnersmightstartwithamodestinitialjointeffort,learnfromit,andthenpossiblyexpanditand/oraddanadditionalcollaboration.Shownbelowareexamplesoftheseeighttypesofcollaboration.Wewelcomereaderstosendusmoreexamplestoincludeinfutureeditions.

Type1:Healthliteracyeducation

Forseveraldecades,theinter-relationshipsbetweenhealth,socio-economicstatus,education,andbasicskillshavebeencitedbyresearchers,practitioners,policymakers,andadvocatesforpublichealthandeducation.(Seethesourcescitedinthe“Type8:Healthpartnershipsresearch”sectionbelowandinAppendixA.)

Buildingon–andinforming--suchresearch,healthorganizationsandadulteducatorshavecollaboratedsincethe1990stocreatehealthliteracyprogramsforadultswithbasicskillslimitations.Theseprogramsusevarioustypesofcurriculatohelplearnersunderstand,prevent,andrespondtohealth-relatedchallengestheyandtheir

Examplesoftheeighttypesofcollaboration*

• TheChicagoCitywideLiteracyCoalitionoperatesanEmpowerment-BasedHealthLiteracyProjectforstudentsandinstructorsinprograms,withfundingfromtheChicagoCommunityTrust.Aparticipant-centeredHealthyCommunitiesUnitprovidessevenlessonplansonthemeslike“TalkingtoaDoctor,”“ATourofaFederallyQualifiedHealthcareCenter(FQHC),”“HeartDisease,”“Diabetes,”“MentalHealth,”“PersonalCare,”and“Obesity/DietManagement.”TheprogramhelpsstudentsandtheirfamiliesconnecttoaFederallyQualifiedHealthCenterandadoptandmaintainhealthybehaviors.

• ABCDMattapan(Massachusetts)usedaFirstLiteracyLabGranttodevelopa“TeachingESOLthroughCommunityGardening”curriculum.Thestudents–mostlyHaitianimmigrants–wantedtolearnmoreaboutgardeningintheU.S.Thecurriculumdevelopersworkedwithalocalurbangardeningprogram,CityGrowers,tocreateacurriculumshapedtostudents’needs.

families,communities,andco-workersmightface.Atthesametime,participantsdevelopvariouskindsofbasicskills(e.g.,reading,writing,speaking,listening,math,problem-solving,research),self-confidence,andsupportsystems.Learnersaretherebyequippedtousestrategiesandresourcesintheirhomes,communities,andcurrentworkplacestoensuretheirhealth.Thesechallengescanincludeenvironmentalhealthproblems(e.g.,toxinsinwater,air,soil,andhousing),communicableandnon-communicablediseases,andmentalhealthissues.

Herearesomeexamplesofhealthliteracypartnershipsthatuseavarietyofstrategiestohelpvariouslearnerpopulationsdealwitharangeofhealthneeds:

6*Mostoftheexamplespresentedinthisguidearelinkedtoanon-linesourceformoreinformation.TheselinksareshowninAppendixB.Ifalinkdoesn’twork,pleasecopyandpastetheURLintoyourwebbrowser.


Type1:Healthliteracyeducation(cont’d.)

• TheFloridaLiteracyCoalition’sHealthLiteracyInitiativeisastatewidegrantprogramadministeredbytheFloridaLiteracyCoalitionandfunded(fortenyears)bytheFloridaBlueFoundation(ofBlueCross/BlueShield).Itprovidestraining,resources,andfinancialsupporttoassistFloridaliteracy,ESOLandfamilyliteracyprograms–includingsomeinharder-to-reachruralareas--tointegratehealtheducationintotheircurricula.Usingaproject-basedlearningapproach,learnersvisithospitals,growfreshfoods,createcookbooks,andlearnfromguestspeakersandvideostodevelophealthknowledgewhilepracticingauthenticlanguage..

• YorkCorrectionalInstituteisaprisonforwomeninNiantic,CT.ItsYorkSchoolhelpsinmatesdevelopbasicskillsandoccupationalskills,preparefortheGED,andaccessspecialeducationandcollegecourses.Staffincludeteachers,counselors,alibrarian,andcorrectionalofficers.

Tohelpinmatesdealwithtraumaandstressesexperiencedintheprisonandpriorto

• ProLiteracy’sNewReaders’Presspublishes“HealthStories”(readings,audiorecordings,andteacherguides)tohelpadultsnavigatetheU.S.healthsystem.Topicsinclude“nutrition,”“allergies,”“injuries,”“firstaid,”and“foodsafety.”ProLiteracy’s“NewsforYou”isaclear-languagenewspaperforadultswithbasicskillslimitations.Health-relatedarticlesinclude“SomeKidsUseTooMuchToothpaste,”“DoctorsSayDon’tSpankKids,”“NowIsTimetoGetaFluShot,”and“FinalBanonTransFatGoesintoEffectinU.S.”

• ThePlymouth(Mass.)Public

LibraryhasaConsumerHealthResourceCenter,connectinghealthliteracywiththelibrary’sdigitalinclusionefforts.WithfundsfromtheNationalLibraryofMedicine’sNewEnglandRegion,thelibrarypurchasedspecifically-engineeredlaptopsandprinterstoallowresidentstosearchhealthinformationonMedlinePlus.govandrelatedsitesthroughtheNationalInstituteofHealth.Additionalfunding(forreadingmaterialsandotherresources)isprovidedbySouthShoreCommunityPartnersinPrevention.

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incarceration,theeducationstaffbegantoweavehealthtopicsintotheeducationprogram.Education,health,andcustodialstaffformedaWomen’sHealthandHealingCommitteewhichsetupanewartsprogramtoprovide“creativespacewhereinthestudents’griefmightbeexpressedsafely.”

Oneartprogram,called“Struggles,”isa“healing-through-writing”groupco-facilitatedbyasocialworkerandanadulteducationteacher.Writingandreadingaboutpersonalchallengeshasledtoimprovementsinparticipantattitudesandinterestinlearning,leadership,andliteracyskills.

• TheCommunityHealth

NetworkforNorthCentralMassachusettsawardsmini-grantstohelpcommunityorganizationsrespondtolocalpublichealthissues.A2018-2019grantwenttotheClintonAdultLearningCenterforcitizenshipclassesforimmigrantresidents.TheclassesfallundertheNetwork’sprioritiesof“access”and“racialjustice.”


Type1:Healthliteracyeducation(cont’d.)

• AVirginia-basedESOLinstructorandsocialworkgraduatestudentdevelopedahealthcurriculumforadultESOLstudentsthatusespicturestoriesandthelanguageexperienceapproachtoengagelearnersindiscussionofcommonhealthissuessuchas"Emergency,""ADoctor'sAppointment,"and"StressedOut."Italsoincludesresourcesfordealingwithmoresensitiveissues,includingdomesticviolence.

• TheQueensLibraryisalibrarysystemintheBoroughofQueensinNewYorkCityserving2.3millionpeoplein62locationsplussevenAdultLearningCentersandtwoFamilyLiteracyCenters.ItcirculatesamongthehighestnumbersofbooksandotherlibrarymaterialsintheU.S.Amongitsservicesisan“EnglishforYourHealth”webpagewhereEnglishlanguagelearnerscanaccesshealthinformation.TheLibraryalsooffersa“HealthLiteracyCurriculumforESOLLearners.”

Toseemoreexamplesofhealthliteracyprojectsandrelatedresearchandcurricula,goto“Type8:Healthpartnershipsresearch”andAppendixAlaterinthis

Type2:

HealthcarecareerpreparationHealthcareindustryemployers,laborunions,

andtrainerscanworkwithadulteducatorstohelpadultlearnersunderstandhealthcarecareeroptionsandpreparefor,access,succeedin,andadvanceinrewardingemploymentinthisgrowingindustry.Inadditiontopatient-carejobs(invariouslevelsofnursing,emergencyservices,patienttransportation,interpreting/translating,andtherapeuticandrehabilitationservices),theindustryofferscareersinmanytechnicalpositionsthatrequireknowledgeoftheinstallation,maintenance,anduseoftechnologies.Healthcarealsohasmanytypesofadministrativeandclericalpositions,maintenanceandsecurityjobs,andwastemanagement,transportation,anddietary/nutritionemploymentopportunities.Thesepositionsrangefromentry-leveltomore-advancedjobs.

Insomecases,thesepositionsarebeingfilledbyimmigrantswithlimitedEnglishproficiency,someofwhomaretrainedhealthcareprofessionalsintheirhomecountrieswhoneedtoupgradetheirEnglishskillsandtransferpreviouscertificationstotheU.S.Healthcarejobsaregrowing,inpartbecauseoftheagingoftheU.S.population(withmoreolderpeopleneedinghealthservices);theincreaseinpopulationswithvariouskindsofdisabilities;theretirementofexperiencedBabyBoomerhealthcareemployees;andthegrowthintechnologies,procedures,andmedicinesthatcanextendandimprovethelivesofpatients.Healthcarejobsarefoundinmanysettings(e.g.,hospitals,clinics,nursinghomes,facilitiesforveterans,laboratories,educationalinstitutions,workplaces,andcorrectionalfacilities)andservemanytypesofhealthcareneeds(e.g.,emergencycare,long-termresidentialcare,mentalhealth,physicalrehabilitation,

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Type2:Healthcarecareerpreparation(cont’d.)substanceabuse),andpatientpopulations(e.g.,children,seniors,peoplewithdisabilitiesorwhohavesufferedphysicaltrauma).

Tofillthesejobs,thehealthcareindustryoffersvariouslevelsandtypesoftrainingforjobseekersandincumbentworkers.Thesecanincludehealthcarecareerexplorationprogramstohelpjob-seekersunderstandcareeroptionstheymightpursueandhowtogoaboutdoingso.Insomecases,trainingforjobseekersorindividualscurrentlyemployedintheindustryintegratestheteachingofjob-specificbasicskills(e.g.,oralandwrittenEnglish,numeracy,computerskills,teamwork)intoalargercurriculumthatcoverstechnicalskillsandotherknowledgerequiredforparticularjobs.Herearesomeexamplesofsuchintegratedbasicskillsprogramsforarangeofhealthcarejobsandworkerpopulations.

• LaGuardiaCommunityCollege’sNewYorkCityWelcomeBackCenterisaresourceforinternationally-trainedhealthcareprofessionalswhowouldliketoenterthehealthcaresectorintheU.S.StaffguideparticipantsthroughtheNewYorkStatelicensingprocesssotheycanworkintheirprevioushealthcareprofessionsagainormovetoalternativecareersinhealthcarewhilepursuinglicensure.Membersreceivecasemanagementandsupportservicesandreferralstoeducational(includingEnglishforSpeakersofOtherLanguages),community,orprofessionalprogramsandorganizations,asneeded.ThisCenterservesindividualsintheNewYorkCityareaandispartoftheNationalWelcomeBackInitiative,anationalnetworkofsimilarcenters.

• ADayintheLifeisaseriesofcareerexplorationvideosdevelopedbyConnectEDandtheNationalCenterforCollegeandCareer.Severalofthevideosfocusonhealthcarecareers,includinghealtheducator,occupationaltherapist,dietician,andregisterednurse.Thesevideoscanbeusedasaresourceinacareerexplorationcurriculumforlearnerswithlimitedbasicskills.

• TheFloridaLiteracyCoalitionhaspublishedaclear-language“HealthCareers:AGuidetoFindingEntry-LevelJobsinHealthCare.”(Versionsareavailableforbothlearnersandteachers.)HalfofthetwentyfastestgrowingjobsinFloridaareinhealthcare.

• TheCambridge(Mass.)CommunityLearningCenteroffersa17-week,16-hours-per-weekCNATrainingProgramforresidentswishingtoworkasCertifiedNursingAssistantsandHomeHealthAides.TheCity’sDepartmentofHumanServicesalsosupportstheCambridgeBiomedicalCareersProgram,anintensive8-monthprogramtohelpresidents(manyofwhomareimmigrants)completeaCertificateinBiomedicalSciences,earncollegecredits,andmoveintoentry-leveljobsatlocalbiotechnologycompanies,labs,universities,andhospitals.ResidentscanalsotakefreeESOL,citizenship,GED-prep,job-readiness,andcollege-prepclassesattheCenter.

• CareerOneStopprovideson-lineresourcesthatcanbeintegratedintocareerexplorationactivitiesforlearnerswithbasicskillslimitations.Bysearchingfor“health”jobs,usersaretakentojobdescriptions,videos,andotherresourcesrelatedtohealthcarecareers.

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Type2:Healthcarecareerpreparation(cont’d.)

• UnionCounty(NJ)College(UCC)establishedanEldercareCareersProjectforlimited-English-proficientwomeninterestedinworkinginhomehealthaideandotherpatient-carepositions.Thisprojectwasapartnershipofthecollege’snon-creditdivision,localeldercareagencies,ashoppingmall(whichprovidedclassroomspace),anon-profitagencyservingtheHaitiancommunity,andtheMetLifeFoundationandtheInternationalLongevityCenter(whichprovidedfunding).UCCstaffdidbackgroundresearchabouttheEnglishskillsneededbyeldercareworkers,createdajob-relatedESOLcurriculum,recruitedstudents,conductedthreepilotclasses(forHaitianandSpanish-speakingwomen),andestablishedworkingrelationshipswithlocalnursingindustryemployers(toinformtheprogramandhelpgraduatesconnecttojobs).Thiscustomizedprogramproducedrealresultsforgraduates(e.g.,skillandknowledge,networks,credentials,jobs)andtheprojectpartners(e.g.,curricula,expertise,connections,andacareerpathwaymodelapplicabletootherindustries,jobs,skills,andworkerpopulations).

• TheNationalInstituteforLiteracyandtheCenterforLiteracy,Education,andEmploymentattheUniversityofTennesseeatKnoxvillecreateda“PreparingforCareersinHealthCare”curriculumtohelpadultlearnersdevelopthebasicskillsrequiredforarangeofhealthcarepositions.Learnerswouldstrengthentheirabilitytocommunicatewell,readcritically,applymathconceptsaccurately,solveproblems,workwellwithothers,andevaluateavarietyofjobsituations.ThesehealthcareskillsaligneddirectlywiththeEquippedfortheFuture(EFF)ContentStandards.TheCenterhopestoupdatethiscurriculumwhenfundingbecomesavailable.

• TheHealthcareCareerAdvancementProgram,fundedbytheU.S.DepartmentofLabor,supportedgreenjobsdevelopmentinthehealthcareindustry.Areportstates:“Frontlineworkershaveagreatdealtocontributetoimprovingenvironmentalsustainabilityoftheiremployers

andthehealthofworkersandpatients...Implementationwasaccomplishedthroughalabor/managementcollaborationbetweenunionlocalsand11employersinfourregionsthroughouttheUnitedStates.Theprojectdevelopedandimplementedamodeloftrainingandeducationforenvironmentalserviceworkersandotherfrontlinehealthcareworkersinhospitalsettingsthatsupportedsystemschangeandbuiltnewrolesfortheseworkers.ItempoweredthemtocontributetotriplebottomlineoutcomesinsupportofPeople(patients,workers,thecommunity),Planet(environmentalsustainabilityandalowercarbonfootprint),andProfit(costsavingsfortheinstitutions).Intheprocessworkersmoreclearlyarticulatedtheirimportantroleasapartofthehealthcareteamandlearnedhowtheycouldcontributetoimprovedpatientandworkerhealthandsafety.”

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Type3:DirecthealthcareservicestoadultlearnersHealthcareproviderscanhelpadultlearners(andpossiblytheirfamilies)accesshealthcareservices(e.g.,healthscreenings,visualandauditoryexams)inthecommunityorattheadulteducationfacility.• TheChelsea((Mass.)

IntergenerationalLiteracyProgram(ILP)isafamilyEnglishforSpeakersofOtherLanguages(ESOL)programsponsoredbytheChelseaPublicSchools.ILPstaffhavehadalong-terminterestinhealthandhealthliteracy.StudentsgotoahealthcenteroperatedinChelseabyMassachusettsGeneralHospital.TheILPisalsoamemberoftheHealthyChelseaCoalition.ILPparticularlyunderstandstheimportanceofenvironmentalhealthtoguardagainstdiseasesaffectedbytheenvironmentsuchaschildhooddiabetes,asthma,andcancer.Theorganizationisactiveingreenspaceandcommunitygardenprojects.

• AtAzusaCityLibraryin

California,adultliteracystaffestablishedHealthLiteracyLearning,apartnershipofthelibrary,theAzusaNeighborhoodWellnessCenter,andtheAzusaPacificUniversityTESOL

• Ina“HealthLiteracy

Fellowships”programsponsoredbytheNewYorkCityMayor’sOfficeofAdultLiteracy,medicalstudentswerepairedwithadultbasicskillsinstructorstohelpadultlearnersimprovetheirhealthliteracy.Intheprocess,themedicalstudentsdevelopedtheirownunderstandingofthehealthliteracychallengestheirpatientsmightfaceandstrategiesforreducingthosechallengesandimprovingcommunicationwiththeirpatients.

(TeachingEnglishtoSpeakersofOtherLanguages)Department.Theprogramisgroundedinthebeliefthatliteracyis"acatalysttotransformlives."Intwice-a-weeksessionsovereightweeks,participantsbuildEnglishlanguageskillswhiledevelopingknowledgeinhealth-relatedtopicssuchasnutrition,exercise,anddiseaseprevention.UniversityTESOLundergraduatesteachEnglishwhilenursingstudentsanswerparticipants’healthquestions,monitortheirbloodpressure,andtracktheirexercisethroughpedometersgiventoallparticipants.

• AmeriCorpsVolunteersprovidemanytypesofhealth-relatedservicestoat-riskpopulationsacrosstheU.S.,includingnutrition,exercise,environmentalhealth,substanceabuse,andotherprogramsforpeopleofallages.Inone,ProjectHealthAccessinAtlantahelps“communityclinicstoincreasethehealthoutcomesoftheuninsuredandunderinsured.Volunteersfacilitatehealtheducationoutreach,patientreferrals,andbenefitsenrollment.Membersserveinfreeclinicsandvariousnon-profitsintheMetro-Atlantaarea.”

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Type4:BasicskillssupportsforhealthcareprovidersAdultbasicskillsproviderscanprovideculturalguidance,translation/interpreting,editing,stafftraining,andotherservicestohealthcareproviderstohelpthembetterserveclientsandemployeeswhohavebasicskillslimitations.

• LiteracyforLifeinWilliamsburg,VirginiaoperatestheHEAL(HealthEducationandLiteracy)Programforadultswithlimitedbasicskills.HEALusesatwo-prongedapproachto(1)helpmedicalproviderstounderstandhowtheycanbetterserveadultswithlowbasicskillsand(2)helpthreelevelsofadultlearnerstounderstandhowtheycanmoreeffectivelynavigatethehealthcaresystem.Topicsincludeemergencyservices,prescriptionlabelsandpreventivecare.

• WisconsinHealthLiteracyisadivisionofWisconsinLiteracy,Inc.andworkswithinthestateandbeyondtoraiseawarenessofhealthliteracyandpromoteclearcommunicationbetweenthosewhogiveandthosewhoreceivehealthcareservices.Programsandservicesimpacthealthoutcomes,patientexperience,chronicdiseasemanagement,transitionsofcare,access,andcost.WHLprovidesconsultation,training,plainlanguagedocumentreviewandwebsitetestingforhospitals,clinics,publichealthdepartments,healthinsurers,andotherorganizations.

“ImprovingtheHealthLiteracyofHospitals:ACollaborativeGuideforLiteracyOrganizations.”

•SanFranciscoStateUniversityhasofferedagraduatecoursetitled“SeminarinImmigrantLiteracies”designedtofosterpartnershipsbetweenfront-linehealthcareprofessionalsandadulteducationproviders.Participantsdeveloptheirabilitiestoworktogethertohelpimmigrantadultsdealwiththeirneeds–inpersonalhealthand

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Specialinitiativesfocusonimprovingmedicationcompliance,reducingopioidabuse,improvingrefugeeandimmigranthealth,improvingAlzheimer’shealthoutcomes,reducinginappropriateemergencyroomuse,andincreasingconsumerengagementintheirhealthcare,easier-to-readmedicationlabelsinpharmacies,andabiennialnationally-recognizedHealthLiteracySummit(withattendeesin2017from29statesand2foreigncountries.Freecopiesareavailableof


Type4:Basicskillsservicesforhealthcareproviders(cont’d.)

• HealthLiteracyNZhelpsNewZealandhealthcareproviderstobetterserveindividualswithbasicskillslimitations.“Wehelphealthorganizations...lookathealthliteracyfromtheperspectiveofreducingcomplexityandotherbarrierstoaccessaswellasbuildingworkforcecapabilityandimprovinginformationtohelpindividualsandfamiliesbetterunderstandandmanagetheirhealth.Wewanttosupportthegrowthofahealthliteratehealthsectortoachieveimprovedhealthoutcomesforallcommunities--wherehealthliteracyiscentraltodesignanddelivery,workforcedevelopment,andcommunicationwithindividualsandfamilies.“Projectshaveincludedhelpingpublichealthagenciesbettercommunicatewithfamiliesaboutrheumaticfeverpreventionandtreatment,preparingaguidebookthatshowshealthcareorganizationshowtouseasystem-wideapproachtobetterservingclients,improvingcommunicationswithkidneydonorsandrecipients,andhelpingcommunitypharmacistsbettercommunicatewithclients.

Forthehealthcareproviders,projectstaff(a)raisedtheirawarenessofhealthliteracy,(b)trainedmedicalproviders(includingmedicalstudents)onstrategiestousewhenservingpatientswithbasicskillschallenges,and(c)enhancedpartnershipsbetweenhealthcareandadultbasiceducationproviders.

• Visualaidesforhealthcommunications:PeoplewhogrewupinotherculturesmighthavelimitedexposuretosymbolsorabstractillustrationsthatU.S.-bornadultsarefamiliarwith.Relianceonsuchvisualrepresentationscanthusblockratherthanenhanceunderstandingofthehealthconceptsandinformationthathealthprofessionalswanttoconvey.Conversely,photosofindividualswho“looklike”theintendedaudiencecanhelplearnerstoidentifyandconnectwiththeintendedmessages.

otherareasoftheirlives(e.g.,theworkplace,thecommunity).Intheprocess,thegraduatestudentshavecometosee“literacy”notas“readingandwriting”inatraditionalsense.Ratherliteracy(or“basicskills”)isseenasamixofskillsthatimmigrantsusetonavigatetherangeofchallengesandopportunitiestheyfaceinvariouscontextstheyliveandworkin.

• TheMayor’sOfficeofAdultEducationandtheLiteracyAssistanceCenterinNewYorkCitycarriedoutafive-yearhealthliteracyinitiativeinthemid-2000sdesignedto(1)helpadultlearnersstrengthentheirabilitiestodealwithhealth-relatedissuesand(2)helphealthcareprovidersunderstandhowtheycanbetterserveadultswhohavelimitedbasicskills.

13


Type5:Health-friendlyeducationfacilities

Healthorganizationscanworkwithadulteducatorstomakeadultbasiceducationfacilitiesandproceduresmoresupportiveofthehealthofusersofthosefacilities.Thesesupportscouldincludeservingofhealthyfoods,exerciseprograms,psychologicallypositivestudyandworkenvironments,andsanitationandhygieneprocedures.SofarinourresearchwehavefoundonlyafewexamplesofsuchconceptsbeingimplementedinU.S.adultbasicskillsprograms.(ThepsychologicalsupportsprovidedtostudentsintheYorkSchooldescribedunder“healthliteracyeducation”aboveisoneexample.)

However,thereissignificantworkbeingdoneintheU.S.andothercountriestopromotethe“healthyschool”conceptattheK-12level.HerearesomemodelsforU.S.adultbasiceducationprogramstoconsider:

• HealthySchoolsNetworkisanationalnon-profit

organizationthatfostersschoolsashealthyenvironmentsforlearningandworking.Theorganizationpromotes“collaborativeresearchandpolicydevelopmentandadvancedsystemicreformsin...(1)environmentalpublichealthservicesforchildrenatriskorwithsuspectedexposuresatschool;(2)child-safepoliciesforhousekeepingandpurchasing(targetingindoorairpollutants,mercury,pesticidesandothertoxicsandpromotingtheuseofgreenandhealthy/saferproducts);and(3)child-safestandardsforschooldesign,construction,andsiting.”

• ThePublicHealthLawCenteratMitchellHamlineSchoolofLawprovidesinformationonpublicpolicyrelatedto“FoodatSchools”andotherpublichealthissues(e.g.,“activeliving,”“tobaccocontrol.”)

• PeaceCorpsVolunteersincountriesaroundtheworldsometimesspecializeinpromoting“healthyschools.”Dependingontheneeds,resources,andinterestsattheirschoolsandcommunities,theymight--withhelpofteachers,parents,andothercommunitymembers--teachhealthclassesandhavestudentscarryouthealthprojects;helpimprovethefoodsavailabletochildrenatschool(viaschoolgardens,healthysnackandlunchoptions,cookingclasses);improveschoolsanitation(wastemanagement,handwashingstations,toilets)andwatersupplies;instituteexerciseprograms;andprovidechild-protectionservices).

14


Type6:Publichealthservicelearning

Adultlearners(andpossiblytheirfamiliesandcommunities)andadulteducationstaffcanengageinservicelearningactivitiesthatsupportpublichealthwhilehelpinglearnersdevelopusefulskills,knowledge,networks,andbehaviors.Examples:• TheCambridge(Massachusetts)Community

LearningCenterhaspartneredwiththeCambridgeHealthAlliancetotrainsomeofCCLC’sEnglishforSpeakersofOtherLanguages(ESOL)learnerstoserveascommunityhealthadvisors.ThestudentsprovidemeaningfulserviceonanimportantissuewhilepracticingtheirEnglish.CHAseesthisasaneffectivewaytogethealthpromotionactivitiestothelinguisticallydiversecommunitiesitserves.SomeparticipantsarealsointerestedinworkinginhealthcareandseethisasanopportunitytoimproveboththehealthknowledgeandEnglishtheywouldneed.Theadvisorscreatehealtheducationactivitiescustomizedtotheircommunitiesandtheirownstrengths.Oneadvisor(aformernurseinherhomecountry)providedhealthactivitiesinherchurch.Anotherorganizedhealthscreeningsandinformation-sharingforparticipantsina“Hoops‘N’Health”men’sbasketballprogram.

• TheMassachusettsDepartmentofEducation’sAdultandCommunityLearningServicesforseveralyearssupported“communityhealthprojects”createdandcarriedoutbybasicskillsprogramsandtheirstudents.MassAAL(Mass.AllianceforAdultLiteracy,thestatewideadultlearnerleadershiporganization)organizedanannualhealthconferencewherestudentsfromthefundedprogramspresentedtheirprojects.

Type7:Advocacyandplanning

Health-supportingorganizations,adulteducators,andadultlearnerscanconductjointawareness-raising,advocacy,planning,andfundraisingactivitiestosupportpublichealthandadultbasiceducation.Herearesomeexamplesatclassroom,city,state,andnationallevels:• TheChangeAgentisabiannualmagazinefor

adulteducatorsandlearnerspublishedbytheNewEnglandLiteracyResourceCenteratWorldEducation.Thislow-costteachingresourcefeatureswritingsbyadultlearnersthathighlightthewaysthatlearnerscanbeagentsofchangeintheirownlivesandintheircommunities.Eachissueexploresadifferenttopicthroughstudentwriting,newsarticles,opinionpieces,classroomactivities,poems,graphics,andcartoons.Publichealthisfocusedondirectlyintheissuestitled“Health:TheBigPicture,””AllAboutFood,”“StayingSafeinaToxicWorld,““PrisonsandJustice,”and“HealthandLiteracy.”Healthcarecareersarediscussedin“CareerPathways,”“GoodJobs,NotJustAnyJobs,”and“Immigration.”“Health”isalsotouchedoninarticleson“ClimateChange,”“Hair,”“Transportation,”“Technology,”and“DemocracyinAction.”Freesamplematerialsareavailable.

• TheSanDiegoCouncilonLiteracyworkedwiththeCommunityHealthImprovementPartners(acoalitionoftwelveagencies)tocreateacommunityhealthliteracyinitiativeinthe2000s.Plannersbeganbylisteningtoadultlearnersintwofocusgroups.Thelearnersexpressedtheirfrustration–andangerandembarrassment–abouttheexperiencestheyandfamilymembershadwiththehealthcaresystem.Manylearnersdescribedhealthcarepersonnelwhoseemedunwillingorunabletorespectfullylisten15


Type7:Advocacyandplanning(cont’d.)

rationalefor…collaborationbetweenthefieldsofhealthcareandadulteducation,and…thevalueofadulteducators’expertisenthiscollaboration.”

• Interagencybodiesinseveralstateshaveincreasedsupportforhealthliteracyservices.Thesebodiesdrewontheinterest,expertise,networks,funding,andotherresourcesoftheirmemberorganizations.Newopportunitiesforcross-agencycommunication,con-textualizedcurricula,anddeliverymethodsemerged.

InMassachusettsStudentHealthTeamscomposedoftrainedadultbasicskillsstudents,servedashealthresourcestotheircommunities.Theyusedpeerteaching,drama,musicandarttohelpfellowcommunitymemberstobetterunderstandanddealwithhealthissues.Adultlearnersalsoidentifiedstepsadulteducationprogramscantaketomakethemselvesmoreconducivetolearningforstudents. InGeorgia,healthliteracyteamsfacilitatedactivitiesinhealthcentersandothernon-ABEsettings,reachingpeoplewhomightnotattendadultbasicskillsprograms.

tobeidentifiedinthefirstphaseofactivities;(8)forumsforhealthcareprofessionals,adultlearners,andadulteducatorstoshareideasandinformation;and(9)developmentofdiversemediatosupporthealthliteracy

• “TheEmergenceofHealthLiteracyasaPublicPolicyPriority:FromResearchtoConsensus.”ThisarticlefromtheNewYorkCityMayor’sOfficegivesan“...overviewoftheconsensusreachedfromtheresearchonliteracyandhealth,thengoesontodescribetheadulteducationcommunities’strengthsinpedagogy,environmentandaccessto‘abroadcohortofadultswithsignificanthealthproblemsandpooraccesstoservices.’Itexplainshowthismakesadulteducationprogramswell-suitedtohelpthepublichealthsystemtoimprovethepublic’shealthliteracy.Thoughwrittenin2004,theauthor’sconceptofhealthliteracymatcheswellwiththecurrentunder-standing,andhispredictionsforwhatfutureresearchmayshowhaveproventobeontarget…givesawell-rounded

andrespondtotheirneeds.Healthcareagencydocuments(e.g.,intakeforms,consentforms)wereindecipherable.Butthelearnersalsosuggestedsolutionstotheseproblems,includingtheuseofinterpretersinhealthcaresettingsandhealth-relatedactivitiesaspartofadultbasicskillscurricula.

Plannersalsoconsultedhealthcareproviders,someofwhomwerealreadyinvolvedinhealthliteracyactivities.Theyrecommendedusingexistinghealtheducationmaterials,curricula,andnetworksratherthancreatingsomethingnewfromscratch.Communityhealthpromoterswerealsointerviewed,andtheyprovidedinsightsintothehealth-relatedchallengesandstrategiesofthecounty’sSpanish-speakingresidents.

Thisresearchwasfedintoareportwhichledtothecreationofacountyhealthliteracyinitiativewithninecomponents:(1)ahealthliteracytaskforcetoguidethecounty’sefforts;(2)healthliteracycurriculatobeusedinhealthandbasicskillsprograms;(3)awebsitemakinghealthliteracyresourcesavailable;(4)trainingforhealthcareproviders;(5)awareness-raisingactivities;(6)apilotprograminwhichtrainedvolunteersworkinhealthcaresettingsasadvocatesforlow-literatepatients;(7)marketingeffortstobetargetedataudiences 16


Type7:Advocacyandplanning(cont’d.)

• “WisconsinPromisingPracticesProgram,

EnglishforHealth:ProgramSummary”describespromisinghealtheducationactivitiesforEnglish-language-learnerWisconsinresidents.ThereportwasissuedIn2010bytheWisconsinDivisionofHealthandtheUniversityofWisconsinPopulationHealthInstitute,withfundingfromtheWisconsinPartnershipProgram.ItwaswrittenbytheExecutiveDirectoroftheLiteracyNetworkofDaneCounty.

• TheNationalActionPlantoImproveHealthLiteracywaspublishedin2010bytheU.S.DepartmentofHealthandHumanServices.Itpresentstwocoreprinciplesandsevengoalsfor“engagingorganizations,professionals,policymakers,communities,individuals,andfamiliesinalinked,multi-sectorefforttoimprovehealthliteracy.”

17


Type8:Healthpartnershipsresearch

BeginninghereandcontinuingintheAppendixisasamplingofthreedecadesofresearchactivitiesrelatedtothepracticeandpolicyofhealthliteracyeducationandhealthcarecareertraining.Theseactivitiesaretypicallycarriedoutbycross-disciplinaryteamsfromtheadultbasiceducationandpublichealthfields.• TheHealthandAdultBasic

EducationIssuesGroupoftheOpenDoorCollectiveissuedtwo“MakingtheCase”papersin2017(forhealthprofessionalsandadulteducators)thatpresentargumentsforandexamplesofpartnershipsbetweenthesetwostakeholdergroups,toImprovethehealth,educationalopportunities,andeconomicwell-beingofindividualswithlowerlevelsofbasicskills.TheGrouphasalsodevelopedalistofresourcesandafactsheetrelatedto“healthliteracyandABE.”

• “GreeningU.S.AdultBasicSkillsEfforts:WhatEco-PartnersandAdultEducatorsCanDoTogether”isanOpenDoorCollectiveCan-DoGuidethatprovidesexamplesofenvironmentaleducationactivitiesforhealthissueslikepollutionandnutrition(e.g.,communitygardens).

• PennsylvaniaStateUniversity’sInstitutefortheStudyofAdultLiteracyconductsresearchonvariousaspectsofadultbasicskillseducation,includinghealthliteracy.One2015studyofdatafromtheProgramfortheInternationalAssessmentofAdultCompetencies(PIACC)showedthathigherliteracylevelscorrelatestronglywithhigherlevelsofself-reportedhealth.ToseethisandotherPSUresearchrelatedtoPIACC,visitthePennStatelinksinAppendixB.Thereyoucanalsofindalinkto“AddressingtheHealthLiteracyNeedsofAdultEducationStudents,”a2013Practitioner’sGuidepublishedbyPSU’sGoodlingInstituteforResearchinFamilyLiteracy.

• “WhyEducationMatterstoHealth:ExploringtheCauses”isa2015issuebrieffromtheCenteronSocietyandHealthatVirginiaCommonwealthUniversitydescribinghoweducationcanimpactaperson’shealth--andviceversa.VCUresearchersalsowrote“UnderstandingtheRelationshipBetweenEducationandHealth,”anacademicarticlesummarizingfindingsfromaliteraturereviewandcommunityhealthprojectshowingthepotentialofeducationasatoolforpublichealthusinga“socio-ecological”healthmodel.

• TheCentersforDiseaseControlandPreventionhasawebpagethatshowshowhealthcareproviderscanbuildcommunityhealthimprovementpartnershipswithotherstakeholders.

18


Type8:Healthpartnershipsresearch(cont’d.)

• “SmallStepstoHealthandWealth”isa2013publicationofRutgersUniversity’sNewJerseyAgriculturalExperimentStation.“Thisprogramisdesignedtomotivateconsumerstoimplementbehaviorchangestrategiesthatsimultaneouslyimprovetheirhealthandpersonalfinances.”

• “LowHealthLiteracyandHealthOutcomes:AnUpdatedSystematicReview”isa2011reviewofresearchonhealthliteracyintheU.S.Itfoundthatlowhealthliteracyisassociatedwithpoorerhealthoutcomesandpooreruseofhealthcareservices.

• TheNationalInstitutesofHealthoperateanon-linePubMedsystemthathousesarticlesonhealthliteracyforadultswithlimitedbasicskillswithtitleslike“ESLParticipationasaMechanismforAdvancingHealthLiteracyinImmigrantCommunities.”

• “Research-BasedHealthLiteracyMaterialsandInstructionGuide–BeginningandIntermediateABEandESLLevels”isa2009jointeffortoftheU.S.DepartmentofEducation,NationalInstituteforLiteracy,andNationalInstituteofChildHealthandHumanDevelopment.

• “ExpectingtheBest”isa

2009healthandwellnesscurriculumforESOLlearnersdevelopedbyfacultyattheUniversityofNorthCarolinaandpublishedbytheCenterforLiteracyStudiesattheUniversityofTennesseeatKnoxville.Itfocusesontwotopics–nutritionandnavigatingthehealthcaresystem–thatwereidentifiedasprioritiesbyESOLlearnersandhealthcarepatientswithlimitedEnglishproficiency.

SeeAppendixAforadditionalresearch-relatedresources.AppendixBcontainslinksrelatedtotheexamplesinPart3ofthisGuide.

• LINCS(LiteracyInformationand

CommunicationSystem)isanon-lineprofessionaldevelopmentserviceprovidedbytheU.S.DepartmentofEducation’sOfficeofCareer,Technical,andAdultEducation.Itssearchableresourcecollections,on-linecoursesandwebinars,anddiscussiongroupsprovideadulteducators,adultlearners,andotherswithopportunitiestobuildexpertiseandnetworksonmanyaspectsofadultbasiceducation.Topicsincludehealthliteracyeducationandhealthcarecareertraining.

• “HealthInformationLiteracyOutreach:ImprovingHealthLiteracyandAccesstoReliableHealthInformationinRuralOxfordCounty,Maine”:This2010articleaboutahealthliteracycurriculumdevelopedforaruralNewEnglandcommunitywaspublishedinTheJournalofConsumerHealthontheInternet.

• “Let’sSmile:ABookaboutDentalHealth”isa2009dentalhealthresourceforparentsdevelopedbytheGoodlingInstituteforFamilyLiteracyatPennsylvaniaStateUniversity.

19


Howadultbasiceducationorganizationscangetstarted

a. Reviewyouroptions.Withinput(wherefeasible)fromotheradulteducationprovidersandhealthorganizationsatstateornationallevels,identifywhichoftheabovecollaborationswithhealthorganizationsmightbeagoodmatchandpriorityforyou.

b. Draftsomeinitialgoalsandplans.Assessyouradulteducationorganization’sstrengthsandlimitationsandthehealthneedsofyouradultlearnersandtheircommunities.Setsomeprimaryandsecondary(short-andlonger-term)goalsanddevelopaninitialdraftplanforhowyouandyourpartnersmightmeetthosegoals.

Forexample,ifyouwouldliketointroduceorexpandhealtheducationactivitiesforyouradultlearners,clarify:

• Howmanylearnersmightparticipate.• Thetypesofhealthissuesthelearnersare

dealingwithandhaveaninterestinlearningabout.

• Thetypesofinstructionalactivitiesthatwouldbeagoodmatchforyourlearnersandstaff(e.g.,computer-basedactivities,project-basedlearning,guestpresentations,videos,sitevisits).

Part4

HowtoGetStarted

1

Youhavenowseensomewaysthatadultbasiceducationandhealthorganizationscanworktogether.Butnowwhat?Howdoyoudecidewhetherandhowtopursueoneormoreoftheseoptions?Herearesomesuggestions.

• Wheresuchactivitiesmightfitintoyourcurrentprogram’slargercurriculum,schedule,facilities,instructorteam...

• Howyouwouldintegratebasicskillsdevelopmentwiththeproposedhealthtopicsandactivities.

• Potentialhealthpartnersyoumightworkwithandquestionsyou’dliketoaskthem.

c. Identifyandreachouttoappropriatehealthorganizationstoexplorewhetherandhowyoumightformashort-termand/orlonger-termpartnership.Consultstate-levelandlocal-levelhealthagenciesandnetworksanduniversity-basedhealthprogramsto...• Reviewoptionsforcollaborationdescribed

earlierinthisguideandthedraftplansyou’vecomeupwithsofar.

• Askforfeedbackfromthosehealthorganizationsaboutyourdraftplanandappropriatehealthpartnersyoumightworkwith(i.e.,thosewhosemissions,expertise,andotherresourcesmatchyourinterests).

• Clarifyhowyouradulteducationorganizationmightbenefitthehealthorganizationsyouareconsidering(e.g.,byhelpingthemserveanimportantsegmentofthecommunityorworkforce).

• Identifypotentialnextsteps,responsibilities,andquestionstoconsiderasyoumoveforward.20

2


a. Reviewyouroptions.Withinputfromotherhealthorganizationsat

stateornationallevels,asfeasible,identifywhichoftheabove-describedcollaborationswithadulteducationorganizationsmightbeagoodmatchandapriorityforyou.

b. Draftsomeinitialgoalsandplans.Consideringyourhealthorganization’s

strengthsandlimitationsandthehealthneedsofthecommunitiesyoucurrentlyworkwith,setsomeprimaryandsecondary(short-andlonger-term)goalsforcollaborationswithadulteducationorganizations.Developaninitialdraftplanforhowyouandadulteducationpartnersmightmeetthosegoals.

Forexampleifyouwouldliketointroduceorexpandhealtheducationand/orhealthcarecareerexplorationactivitiesforadulteducationstudents,clarify:

• Howmanylearnersyoumightbeabletoserve.

• Thetypeofinstructionyoumightprovide.• Whatyou’dneedtoknowfrompotential

adulteducationpartnersaboutwheresucheducationalactivitiesmightfitintotheircurrentprogram’slargercurriculum,schedule,facilities,instructorteam...

Part4:HowtoGetStarted(cont’d.)

c Identifyandreachouttoappropriate

adulteducationorganizations(SeetheNationalLiteracyDirectoryathttps://www.nld.org.)toexplorewhetherandhowyoumightformashort-termand/orlonger-termpartnership.Consultstate-levelandlocal-leveladulteducationagenciesandnetworksanduniversity-basedadulteducationprogramsto...

• Reviewtheoptionsforcollaboration

describedearlierinthisguideandthedraftplansyou’vecomeupwithsofar.

• Askforfeedbackfromthoseadulteducationorganizationsaboutyourdraftplanandappropriateadulteducationorganizationsyoumightworkwith(i.e.,organizationswhosemissions,expertise,andotherresourcesmatchyourinterests).

• Clarifyhowyourhealthorganizationmightbenefittheadulteducationorganizationsyouareconsidering(e.g.,byhelpingthemrespondtothehealthneedsofanimportantsegmentofthecommunityorworkforce).

• Identifypotentialnextsteps,responsibilities,andquestionstoconsiderasyoumoveforward.

Howhealthorganizationscangetstarted

21


Inconclusion...

Wethankandsalutethemanypeopleresponsiblefortheinnovativehealthactivitiesdescribedinthisguide.We’velearnedalotfromyourworkandbeeninspiredbyit.

Buildingontheseexamples,forward-thinkingsupportersofpublichealth,healthcarecareers,andadultbasiceducationnowhaveopportunitiestomakeadifferenceonthevitally-important,overlappingissuesofpublichealth,workforceandeconomicdevelopment,adultbasiceducation,andsocialjustice.

Bycollaboratinginwell-planned,meaningfulways,healthandadulteducationpartnerscantargettheirresourcestocommongoalswhilealsobuildingtrustingrelationshipsforthefuture.

Wewelcomeyourthoughtful,informed,andpatientleadershipatthistimeofchallenge--andopportunity.

Wesalutethemanypeople

WrittenanddesignedbyPaulJurmo(www.pauljurmo.info)withresearchandeditinghelpfromMarciaHohn,DavidRosen,JulieMcKinney,JanetIsserlis,BarbaraKrol-Sinclair,DenaGiacometti,JoseCruz,SusanReid,RobSheppard,GregSmith,AaronKohring,CynthiaPeters,JenniferThompson,EmmaBroderick,SamanthaBailo,andEricJurmo.AndthankstotheLiteracyInformationandCommunicationSystem(www.lincs.ed.gov)andFocusonBasicsforprovidingaccesstosomeofthedocumentscitedhere.

22


Andhomehealthaidesarepronetoinjuringthemselvesfromimproperliftingtechniques.)(Seetruckdriverexamplesat

• TakingChargeofYourHealthwasamaternityandchildhealthprogramdevelopedinPhiladelphiainthe2000sbytheUniversityofPennsylvaniaSchoolofMedicineandtheCenterforLiteracy.Theprojecttookalearner-centered,problem-solvingapproachtohelplow-incomewomenwhowerebothchallengedbylimitedliteracyskillsandatriskofpoormaternityhealthtoidentifyanddealwithpotentialhealthproblemsforthemselvesandtheirchildrenduringpregnancyandafterward.Theresearchteammonitoredactivitiesandrevisedthemodeltofocusonindividualized,home-basedinstructionratherthanonamoretraditionalclassroom-basedmodel.Theinstructors

“traditional”(non-integrated)literacyandESOLinstruction.

• UnionCounty(NewJersey)Collegedevelopedanumberofcareerpreparationprogramsforvariousindustries(e.g.,retail,homehealthcare,transportation/logistics/distribution),jobs,andworkerpopulationsfrom2005to2010.Eachprogramintegrateddevelopmentofbasicskills(asdefinedbyEquippedfortheFutureinitiativeoftheNationalInstituteforLiteracy)withdevelopmentoftechnicalknowledgeandskills.Severalofthecurriculaincludedexplorationofworkplacehealthissuesfacedbyparticularworkers,usingon-linesourcesandotherinformation.(Forexample,truckdriversareatriskofpoordiet,relianceonstimulants,exposuretohazardousmaterials,repetitivestresssyndrome,sleepdeprivation,trafficaccidents,andimproperliftingofheavyobjects.

-Ipsum

• TheBigelow(Mass.)PublicLibraryhasofferedhealthandwellnessclassesunderaHealthLiteracyGrantfromCommunityHealthNetworkArea9.TheLibrary’swebsiteprovideslinkstoon-lineresourcesrelatedtoquittingtobaccouse,activeliving,mentalhealth,accessingandusinghealthrecords,healthybehaviorsforkids,andresourcesavailablefromtheNationalInstitutesofHealthandNationalLibraryofMedicine.

• “TestingtheImpactof

HealthLiteracyinAdultLiteracyandFamilyIntegratedFamilyApproachPrograms”(a2008studybytheInstituteforHealthResearchandPolicyattheUniversityofIllinoisatChicago)comparestheimpactsonlearners’literacyskillsof“integratedfamilyliteracy”and

APPENDIXAMoreExamplesofHealthPartnershipsResearch

SourcesBigelow:http://bigelowlibrary.org/health/resources/

TestingtheImpact:https://www.ihrp.uic.edu/study/testing-impact-health-literacy-adult-literacy-and-integrated-family-approach-programs

UnionCountyCollege:http://www.pauljurmo.info/pauljurmo/Writings_files/TLD%20Ready%2010-4-09.pdf A1


• TheLiteracyAssistanceCenterofNewYorkCityoperatedacitywidehealthliteracyinitiativefrom2003to2010.Thiswasapartnershipbetween75adultbasiceducationprogramsand35communityhealthcenters,withfundingfromprivatefoundationsandtheNewYorkStateDepartmentofEducation.ItsgoalwastoincreasethehealthknowledgeofABE/ESOLstudents,promotelearnerinvolvementwithhealthissues,andconnectthemtohealthservices.Activitiesincludeddevelopmentofahealthliteracycurriculum,network-buildingandresource-sharingacrossorganizations,programevaluationresearch,andstudenttoursofhealthcenters.

Andseearelated2008webcast,“AdvancingHealthLiteracy:MeetingtheNeedsofAdultLearners,”organizedbytheNationalInstituteforLiteracyandresearchersattheUniversityofPennsylvania,UniversityofIllinoisatChicago,andRutgersUniversity.Panelistsdiscussthedefinitionofhealthliteracy,statisticsandresearchonthegrowingneedforhealthliteracy,aswellasmodelsandstrategiesforincreasinghealthliteracyamongadultlearners.

• “LINCSRegionalHealthSummits”isacollectionofPowerPointspresentedbyspeakersatthreehealthliteracysummitssponsoredbytheNationalInstituteforLiteracyin2008.

-Ipsum

learnedaboutthemanyobstaclesthesenewmothersfacedincaringforthemselvesandtheirfamilies.Thisprovidedinsightaboutwhymanyadultlearnersfinditdifficulttopersistinclassroom-basededucationprograms.Theprogramalsodemonstratedthechallenges(e.g.,theextratimerequiredtoprepareindividualizedlessonsandtotraveltostudents’homes,thestressofwitnessingandtryingtorespondtothemanydifficultiesthatthevulnerablestudentsfaced)thatahome-based,individualizedprogrampresentedtoadulteducationteachers.

APPENDIXA

SourcesTakingCharge:Read“TakeChargeofYourHealth”athttp://ncsall.net/fileadmin/resources/fob/2008/fob_9b.pdf

AdvancingHealthLiteracy:https://lincs.ed.gov/webcasts/health08/webcast0916.html

LINCS:https://lincs.ed.gov/professional-development/resource-collections/profile-320

LiteracyAssistanceCenter:https://issuu.com/hice_newsletters/docs/literacyharvest A2


workplacehealthandsafetyrights.Thecurriculumuseslearner-centeredactivitiesthatengagestudentsindiscussion,elicitandbuildontheirexperiencesandencouragecriticalanalysisandstrategies.Teacherscanusetheselessonstocreateaparticipatorycurriculumwithstudents,inwhichteachersandstudentsanalyzeissuesthattheyhaveidentifiedtogether,anddevelopstrategiestoaddressthem.”

• “BringingHealthLiteracyResearchtoPractice”:This2005article“exploreshowresearchinformspracticeandwhatconstitutesevidencewhenlookingforevidence-basedmaterialsinanewfieldsuchashealthliteracy.”Thearticledefinessomebasic

three“healthliteracystudycircles”designedtoenableadulteducationteachershelptheirlearnersdealwithspecifichealthchallenges.

• “FamilyHealthandLiteracy:A

GuidetoEasy-to-ReadMaterialsandWebSitesforFamilies”wasproducedbyWorldEducationincollaborationwiththeNationalInstituteforLiteracywithsupportfromtheMetLifeFoundation.

• TheMassachusettsWorkerEducationRoundtable,astatewidenetworkofunion-affiliatedtrainingprograms,publisheda“WorkplaceHealthandSafetyESOLCurriculum”in2005.It“...isdesignedtohelpESOLstudents(EnglishforSpeakersofOtherLanguages)learnaboutandexercisetheir

-Ipsum

APPENDIXA

• TheNationalCenterfortheStudyofAdultLearningandLiteracyissued“HealthLiteracyinAdultBasicEducation:DesigningLessons,Units,andEvaluationPlansforanIntegratedCurriculum.”Developedin2007inpartnershipwiththeHealthandAdultLiteracyandLearningInitiativeatHarvardUniversityandNewYorkCity’sLiteracyAssistanceCenter,thedocumentshowsteachershowtoassesslearnerhealthliteracyneedsanddevelopandevaluaterelevantactivitiestohelpadultswhohavebasicskillslimitationstonavigatehealthsystemstoensuregoodhealth.Alsoavailablearedescriptionsof

Sources

NationalCenter:https://www.hsph.harvard.edu/healthliteracy/practice/training/

FamilyHealth:http://www.ruralfinanceandinvestment.org/sites/default/files/1170175024376_family_health_literacy_manual.pdf

MassWorkerEd:https://www.umass.edu/roundtable/projects/Health-Safety-ESOL.pdf

A3


• Healthcareprofessionals,adulteducators,andadultlearnersinIllinoiscollaboratedinthe2000’sonaprojectwhichdevelopedandfield-testednewhealthliteracyresourcesforuseinadultbasicskillsprograms.Theteamstartedbycreatinganewcurriculumthatwasmoresystematicinthecontentandinstructionalmethodologythantheloosecollectionofhealth-relatedlessonsthatmostadulteducationprogramshadbeenusinguntilthen.Adultlearnerswereaskedforinputasthecurriculawererolledout.Thecontextualizedlessonsmergedthelearningofpersonalhealth-relatedskillsand

navigatinghealthcaresystems.Theresultsofthisstudyweresubsequentlydisseminatedwidelyandfueledinterestandactioninhealthliteracyeducationforadultswithlimitedbasicskills.(Readthe2008article“ASecondLookattheHealthLiteracyofAmericanAdultsandtheNationalAssessmentofAdultLiteracy.”)“HealthLiteracyofAmerica’sAdults:Resultsfromthe2003NationalAssessmentofAdultLiteracy”Isa2007webinarbytheNationalInstituteforLiteracyinwhichamedicalprofessionalandanadultlearnerleadersharetheirinsightsaboutthehealthliteracyneedsofU.S.adultswhohavebasicskillschallenges.AlsoseethereportwiththesametitleissuedbytheNationalCenterforEducationalStatisticsin2006.

-Ipsum

APPENDIXA

typesofresearchthathavebeendoneandadultliteracypracticesthatarebeingusedorconsidered.Suchbibliographiescouldalsobeusedinstudycirclesforadultliteracypractitioners.Thiscouldbeagoodstartingpointtoexplorewhatconstitutesevidence-basedhealthliteracypractices.

• “TheNationalAssessmentofAdultLiteracy”wasconductedbytheNationalCenterforEducationalStatisticsintheearly2000s.Itincluded28questionsthatfocusedon“healthliteracy.”Thesequestionslookedattheabilityofparticipantstoapplybasicskillstoparticularhealthproblems,preventingthoseproblems,and

Sources

BringingHealthLiteracy:https://docplayer.net/2019948-Bringing-health-literacy-research-to-practice.html

NationalAssessment:https://nces.ed.gov/naal/

ASecondLook…http://ncsall.net/fileadmin/resources/fob/2008/fob_9b.pdf

HealthLiteracyofAmerica’sAdultswebinar:https://lincs.ed.gov/webcasts/NAALhealth/webcast0829.html

NationalCenterforEducationalStatistics:https://nces.ed.gov/pubs2006/2006483.pdfA4


comfortwiththeU.S.healthsystem.Theresearchersrecommendedstrategiesthatadulteducationpolicymakersmighttaketohelpadulteducatorscustomizeservicestothevaryingneedsofdifferentlearnergroups(e.g.,thosewithvariouslevelsofliteracyandEnglishfluency,thosemotivatedbyparticularlearningobjectives,thosewithmoreorlessexposuretotheU.S.healthcaresystems.)

• “LiteracyandHealthinAmerica”:This2004report“...explorestherelationshipbetweenliteracyandhealthbyre-examiningdatafromtwolarge-scalesurveysofadultliteracyconductedbytheEducationalTestingService(ETS)fortheU.S.

assessedatthebeginningandendoftheclasses.Theresearchindicatedthatstudentsintheintegratedhealth-literacyclassestendedtoincreasetheirhealthknowledgesignificantlyandtheirliteracyskillssomewhatsignificantlyasaresultofparticipation.Neitherthehealthnorliteracyskillsofthecontrolgroupshowedasmuchgain.

Theresearchersconcludedthatcarefully-organizedcurriculafocusingonclearandrelevant,contextualizedlearningobjectives(onhealthandothertopicsofinteresttolearners)aremorelikelytoproducegainsinstudentliteracyskillsandcontentknowledgethanless-focusedcurricula.Thisisespeciallytrueforlearnerswithhigherlevelsofbasicskills.GainswerelowestforlearnerswithlowlevelsoffluencyinEnglishwhotendedtohavelessfamiliarityand

-Ipsum

APPENDIXA

knowledgewiththedevelopmentofvariousbasicskills.

Theresulting42-hourcurriculumwasthenfield-testedinmorethan50adultbasicskillsprogramsaroundthestate.Allparticipatingteachersweregivenanorientationtothepurposesoftheproject,whilesomereceivedadditionaltrainingintheusesofthepilotcurriculumandothersweretrainedinanon-health-relatedcurriculum.Thetwodifferentcurriculawerethenfield-testedwithlearnersfromvariousliteracyskilllevelsinrandomly-selectedsites.

Studenthealthknowledgeandliteracyabilitieswere

Source

HealthcareProfessionals(frompreviouspage):Read“HealthLiteracyCurriculumWorksforAdultBasicEducationStudents”athttp://ncsall.net/fileadmin/resources/fob/2008/fob_9b.pdf

A5


• “Literacy,Learning,andHealth:ResearchReport:”This2008studyfromtheUnitedKingdomexamines(1)theliteracy,languageandnumeracydemandsplaceduponpeopleinhealthcaresettings;(2thedifficultiesadultbasicskillsstudentsexperiencewhenaccessinghealth-relatedinformationandwhendealingwithhealthcaredocuments;(3)strategiestheyusetoovercomethesechallenges;(4)howandwhereadultlearnersaccessrelevanthealthinformation;and(5)teachers’andstudents’perceptionsofandexperienceswithhealthasatopicforadultbasicskillseducation.

literacyskillsofat-riskorvulnerablepopulationgroups,anddemonstratehowhealth-relatedliteracyisconnectedtohealthstatus,wealth,andcivicengagement.”

ProjectSHINEESLHealthUnits“...aredesignedtoimprovetheESLstudent’scapacitytointeractindifferenthealth-relatedenvironments.Theunitsemployrole-playing,speakingpractice,andwrittenexercisesalongwithreal-worldexamples.”Topicsincludecommunicationsusedinadoctor’soffice;inanemergencyroom;whendealingwithhighbloodpressure,diabetes,andheartdisease;touseappropriateexercise,nutrition,andstressmanagement;andtounderstandproperusesofmedicines.Developedin2008bytheIntergenerationalCenteratTempleUniversity.

-Ipsum

APPENDIXA

DepartmentofEducation:theNationalAdultLiteracySurvey(NALS)andtheInternationalAdultLiteracySurvey(IALS).Respondentsinthelarge-scaleassessmentswereaskedtoperformdifferentliteracytasksbasedonavarietyofhealth-relatedmaterials.Researchersanalyzedperformanceresultsforthesespecifichealth-information-relatedtasks,andusedtheinformationtocreateanewHealthActivitiesLiteracyScale(HALS),whichwasthenlinkedtotheNALSdatabase.Theassessmentsurveysalsogatheredextensivebackgroundinformationaboutrespondents'demographicandsocioeconomiccharacteristics,aswellastheirhealthstatus,literacypractices,andcivicparticipation.UsingthisinformationalongwiththenewHALSscale,theauthorsestimatethedistributionofliteracyonhealth-relatedtasksamongU.S.adults...describethehealth

Sources

LiteracyandHealthinAmerica(frompreviouspage):http://www.ets.org/Media/Research/pdf/PICHEATH.pdf

ProjectSHINE:http://springinstituteeslstudents.pbworks.com/f/Beg+Talk+to+Doctor+-+Unit+1.pdf

Literacy,Learning,andHealth:http://www.nrdc.org.uk/?p=278 A6


• ToReachtheFirstRungandHigher:BuildingHealthcareCareerLadderOpportunitiesforLow-SkilledDisadvantagedAdults:This2005reportbytheCouncilforAdvancementofAdultLiteracydrawsonanin-depthreviewofsixexemplarycareerladderprogramsofferedinvariousinstitutionalsettings:aunion,ahospital,acommunity-basedorganization(CBO),andthreecommunitycollegesinpartnershipwithanarrayofmedicalcenters.Theprogramsareprofiledindepthandthepapercontainsideasandsuggestionsforinstitutionsthatmaywanttoeithercreateanewhealthcarecareerprogramforlow-skilled,disadvantagedworkersorimproveexistingprograms.

APPENDIXA

• In“AMaturingPartnership”in2002,RimaRuddcitesonereport,issuedtoCongressin1998,which...“focusedspecificallyonsocioeconomicstatusandhealth...Thisreportofferedevidencefromaccumulatedstudiesthathealth,morbidity—therateofincidenceofadisease—andmortalityarerelatedtosocioeconomicfactors.Forexample,lifeexpectancyisrelatedtofamilyincome.So,too,aredeathratesfromcancerandheartdisease,incidencesofdiabetesandhypertension,anduseofhealthservices.Furthermore,deathratesforchronicdisease,communicablediseases,andinjuriesareinverselyrelatedtoeducation:thosewithlowereducationachievementaremorelikelyto

dieofachronicdiseasethanarethosewithhighereducationachievement.Inaddition,thosewithlessthanahighschooleducationhavehigherratesofsuicide,homicide,cigarettesmoking,andheavyalcoholusethandothosewithhighereducation.Theloweryourincomeoreducationalachievement,thepooreryourhealth.Thus,linksbetweencriticalhealthoutcomesandincome/educationarewellestablished.”

Sources

ToReachtheFirstRung:http://www.caalusa.org/publications.html#health

AMaturingPartnership:http://ncsall.net/fileadmin/resources/fob/2002/fob_5c.pdf

A7


inparticipatorypractices)andtocreatealibraryofteachingandlearningmaterialstheyandotherscoulduse.Aboutonequarterofteachersalsosaidthattheactivitieshelpedthemdevelopmoretrustingrelationshipswiththeirstudents.Manyinstructorsalsofoundthatstudentsdevelopedpositiverelationshipswithotherstudents,teamwork,othersocialskills,andaninterestincontinuingtheirlearningthattheycoulduseinworkandotherroles.Andmanystudentsalsoenhancedtheirunderstandingofandabilitytodealwithhealthissues.

• “IntegratingHealthandLiteracy:AdultEducators’Experience”summarizedanexploratorystudyonthetopicofhealthliteracyeducationforU.S.adultswithbasicskillslimitations.WrittenbyresearchersattheHarvardSchoolofPublicHealthandpublishedin1998bytheNationalCenterfortheStudyofAdultLearningandLiteracy,itexamined“theexperienceofadulteducatorsinMassachusettswhointegratedahealthunitintoadulteducationclassesthatfocusedonreading,writing,andcommunicationskilldevelopment.”

Theresearchersfoundthat,whilehealthcanbeamotivatingthemetofocusbasicskillsdevelopmenton,thistopichadnotyetbeensystematicallystudied.Thereportsummarizedwhat

teacherssaidaboutthepotentialoutcomesofintegratedhealthliteracyinstruction,thetypesandskillneedsoflearnerstheyworkedwith,andwhyandhowtheteachersincorporatedhealthlessonsintotheircurricula.Instructionalactivitiestendedtoemphasizeactivelearningthroughproject-basedactivities(e.g.,writingofcookbooks,presentationsbylearnersonhealthtopicstovariousaudiences),discussion,androleplays.

Teacherssaidthatstudentsdevelopedmultipletypesofbasicskillsthroughtheseactivities,includingcriticalthinkingreading,listeningandspeaking,research,notetakingandessaywriting.Teachersalsosawthisexperienceasusefulwaysforthemtodeveloptheirownteachingskills(especially

Source

IntegratingHealthandLiteracy:http://ncsall.net/fileadmin/resources/research/rep5.pdf

A8

APPENDIXA


• TheAdultPerformanceLevelStudy(carriedoutbytheUniversityofTexasatAustinin1977)wasoneofthefirstattemptstodefineadultliteracyperformancelevels,developassessmentinstrumentstomeasurethem,andtousethoseinstrumentstoassessthefunctionalcompetenceofarepresentativesampleoftheU.S.adultpopulation.1500subjectsweretestedfortheirabilitytoperformbasicskillstasksinfiveareas:(1)occupation-relatedknowledge,(2)consumereconomics,(3)governmentandlaw,(4)health,and(5)communityresources.Resultswerereportedforthefiveareasfortheover-allmeasureofcompetenceandalsofortheskillareasofreading,writing,computation,andproblemsolving.

• TheMassachusettsDepartmentofEducation’sAdultandCommunityLearningServicesdevelopeda“CurriculumFrameworkforHealth”in1991.Itguidedtheintegrationofhealtheducationwithadultbasicskillsinthisearlyperiodofthehealthliteracyfield.

• TheHighlanderResearchandEducationCenterinTennesseeconductedaparticipatoryactionresearchprojectwithmembersoftwocommunitiesimpactedbyenvironmentalhazards.Residentslearnedhowtocollectandassessinformationandthentakelegalactiontosolveproblemsthathadmajorimplicationsfortheirhealth.)

Sources

EmpowermentHealthEducation:https://eric.ed.gov/?id=ED425342

MassDept.ofEducation:http://www.doe.mass.edu/acls/frameworks/health.pdf

HighlanderResearch:Read“Knowing,Learning,Doing…”athttp://www.ncsall.net/index.html@id=479.htmland“CommunityintheClassroom…”athttps://files.eric.ed.gov/fulltext/ED386357.pdf.

AdultPerformanceLevel:https://eric.ed.gov/?id=ED185113A9

• “EmpowermentHealthEducationinAdultLiteracy:AGuideforPublicHealthandAdultLiteracyPractitioners,PolicyMakersandFunders.”This1997LiteracyLeadersFellowshipProgramReport(writtenbyMarciaDrewHohnfortheNationalInstituteforLiteracy(1)describestheproblemofhealthliteracyforpopulationswithlowliteracylevels;(2)summarizesaparticipatoryactionresearchprojectinwhichstudenthealthteamshelpedfellowadultlearners;(3)presentslessonslearnedandguidelinesforanempowermentmodelofhealthliteracyeducation;and(4)providesrecommendationsforpolicymakersandfunders.

APPENDIXA


p.6:Chicago:.http://www.chicagocitywideliteracy.com/programs/health-literacy/

p.6:ABCDMatapan:https://firstliteracy.org/gardening-as-a-theme-for-teaching-esol/#

p.7:FloridaLiteracyCoalition:https://floridaliteracy.org/literacy_resources__teacher_tutor__health_literacy.html.Seestudentprojectsathttps://floridaliteracy.org/health_literacy_student_projects.html.

p.7:YorkCorrectionalInstitute:Read“Struggles:WritingasHealing”and“ReflectionsontheWomen,Violence,andAdultEducationProject”athttp://ncsall.net/fileadmin/resources/fob/2002/fob_5c.pdf.

p.7:CommunityHealthNetwork:https://www.leominsterchamp.com/news/20190209/chna-9-announces-2018-19-mini-grant-awards

p.7:ProLiteracy’s“HealthStories”:https://www.newreaderspress.com/health-stories

“NewsforYou”:https://www.newreaderspress.com/about

p.7:Plymouth:https://www.plymouthpubliclibrary.org/blog/2017/05/08/literacy-program-at-plymouth-public-library/

p.8:VirginiaESOLpicturestories:http://www.cal.org/caela/esl_resources/Health/healthindex.htmlReadKateSingleton’sarticleathttp://ncsall.net/fileadmin/resources/fob/2002/fob_5c.pdf

p.8:QueensLibraryhealthwebpage:http://www.queenslibrary.org/services/health-info/english-for-your-health.Queenshealthcurriculum:http://www.queenslibrary.org/services/health-info/english-for-your-health/teacher-beginner-level

p.9:FloridaLiteracyCoalitionhealthcarecareersguideforlearners:https://lincs.ed.gov/professional-development/resource-collections/profile-1073andcurriculumforteachers:https://lincs.ed.gov/professional-development/resource-collections/profile-1074.

p.9:CambridgeCNAcourse:https://www.cambridgema.gov/~/media/Files/DHSP/CLC/ClcCNA.pdf?la=enBiomedicalprogram:https://www.cambridgema.gov/DHSP/programsforadults/biomedicalprogram

p.9:CareerOne-Stop:https://www.careeronestop.org/Videos/NewCareerVideos/new-career-videos.aspx

p.9:LaGuardiaWelcomeBack:https://www.laguardia.edu/ce/pages/career-skills-and-training/wbcenter/andNationalWelcomeBack:https://www.wbcenters.org

p.9:ADayintheLife:https://lincs.ed.gov/professional-development/resource-collections/profile-1005

Continuedonnextpage

APPENDIXBLinkstoSourcesCitedinthisGuide

B1


p.10:UnionCountyCollege:http://www.pauljurmo.info/pauljurmo/Writings_files/Eldercare%20Final%20Report%20UCC%2012-6-09.pdf

p.10:NationalInstituteforLiteracy:https://eff.clee.utk.edu/preparing_for_careers_in_healthcare.html

p.10:HealthCareerAdvancement:(Read“Front-LineWorkerEngagement:GreeningHealthCare,ImprovingWorkerandPatientHealth,andBuildingBetterJobs”athttps://www.ncbi.nlm.nih.gov/pubmed/23896075

p.11:ChelseaILP:https://www.ilpchelsea.comandHealthyChelsea:http://healthychelsea.org

p.11:AzusaLibrary:https://www.ci.azusa.ca.us/1247/Health-Literacy

p.11:AmeriCorps:Athttps://www.nationalservice.gov/programs/americorps/join-americorps/americorps-searchscrolldownandsearchforhealth-relatedtopics.

p.11:HealthLiteracyFellowships:(Read“HealthLiterateDoctorsandPatients”athttps://www.worlded.org/WEIInternet/inc/common/_download_pub.cfm?id=16590&lid=3

p.12:LiteracyforLife:Visithttps://vimeo.com/94471388toseeavideoaboutHEAL.

p.12:WisconsinHealthLiteracy:Visithttp://wisconsinliteracy.org/health-literacy/index.html.Downloadacopyof“ImprovingtheHealthLiteracyofHospitals:ACollaborativeGuideforLiteracyOrganizations”athttps://wisconsinliteracyorg.presencehost.net/file_download/6ffa0837-5949-4cc0-9e9b-bf5cbee3981f

pp.12-13:SanFranciscoState:Read“PartnersinTraining:ACross-DisciplinaryApproachtoPreparingAdultLiteracyPractitionersandHealthProfessionals”athttp://ncsall.net/fileadmin/resources/fob/2008/fob_9b.pdfP.13:Mayor’sOffice:Read“HealthLiterateDoctorsandPatients”athttp://ncsall.net/fileadmin/resources/fob/2008/fob_9b.pdf

p.13:VisualAids:Read“TheRoleofVisualsinCommunicatingHealthInformationtoLow-LiterateAdults”athttp://ncsall.net/fileadmin/resources/fob/2008/fob_9b.pdf

p.13:HealthLiteracyNZ:https://www.healthliteracy.co.nz

p.14:HealthySchools:http://www.healthyschools.org/Who-We-Are/

p.14:PublicHealthLaw:https://publichealthlawcenter.org/topics/healthy-eating/food-schools

p.14:PeaceCorps:ForanexamplefromGuatemala,visithttps://www.k4health.org/toolkits/pc-wash/peace-corps-guatemalas-healthy-schools-project

p.15:CambridgeCLC:Read“LiteracyStudentsasHealthAdvisors”athttp://ncsall.net/fileadmin/resources/fob/2008/fob_9b.pdfandvisithttps://www.cambridgema.gov/DHSP/programsforadults/communitylearningcenter

p.15:ChangeAgent:https://changeagent.nelrc.org/about/Getfreesamplematerialsathttps://changeagent.nelrc.org/in-the-classroom/lesson-packets/Continuedonnextpage

APPENDIXB

B2


pp.15-16:SanDiego:Read“CollaboratingfortheHealthofSanDiegoCounty”athttp://ncsall.net/fileadmin/resources/fob/2008/fob_9b.pdf

p.16:EmergenceofHealthLiteracy:http://www.nyc.gov/html/adulted/downloads/pdf/article.pdf

pp.16-17:InteragencyBodies:Read“Literacy,Health,andHealthLiteracy:StatePolicyConsiderations”athttp://ncsall.net/fileadmin/resources/fob/2002/fob_5c.pdfAlsoread“PartnershipsinNorthCarolina,Wisconsin,andNewYork”for2008casestudiesofthreeplanningmodelsathttps://www.worlded.org/WEIInternet/inc/common/_download_pub.cfm?id=16590&lid=3

p.17:WisconsinPromisingPractices:https://www.dhs.wisconsin.gov/minority-health/prompractices/englishforhealth.pdf

p.17:NationalActionPlan:https://health.gov/communication/initiatives/health-literacy-action-plan.asp

p.18:HealthandABE:Visitthe“ODCPapers”and“Resources”pagesathttp://www.opendoorcollective.org

p.18:GreeningAdultBasicSkills:http://www.opendoorcollective.org/workforce-basic-skills-resources.html

p.18:WhyEducationMatters:https://societyhealth.vcu.edu/work/the-projects/why-education-matters-to-health-exploring-the-causes.html

p.18:UnderstandingtheRelationship:https://www.ahrq.gov/professionals/education/curriculum-tools/population-health/zimmerman.html

p.18:PennStateresearchrelatedtoPIACC:https://ed.psu.edu/isal/research#Findings_from_PIAAC

Tosee“AddressingtheHealthLiteracyNeedsofAdultEducationStudents,”a2013Practitioner’sGuidepublishedbyPSU’sGoodlingInstituteforResearchinFamilyLiteracy,visithttps://ed.psu.edu/goodling-institute/professional-development/pracitioner-guide-4/view

p.18:CentersforDiseaseControl:https://www.cdc.gov/chinav/case/index.html

p.19:SmallSteps:https://njaes.rutgers.edu/sshw/

p.19:LowHealthLiteracy:https://annals.org/aim/article-abstract/747040/low-health-literacy-health-outcomes-updated-systematic-review

p.19:NationalInstitutesofHealth:Toviewasamplearticle,“ESLParticipationasaMechanismforAdvancingHealthLiteracyinImmigrantCommunities,”gotohttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250043/

p.19:LINCS:https://www.lincs.ed.gov

p.19:HealthLit’cyInfoOutreach:https://healthliteracyleadership.files.wordpress.com/2012/03/kurtzrossi.pdf

p.19:Let’sSmile:https://ed.psu.edu/goodling-institute/family-literacy-resources/lets-smile-book-final

p.19:Research-BasedHealthLiteracyMaterials:www.lincs.ed.gov/health/health

p.19:ExpectingBest:https://lincs.ed.gov/professional-development/resource-collections/profile-345

APPENDIXB

B3


p.1:Chicagoist.com:https://chicagoist.com/2017/03/24/hundreds_march_to_decry_gop_healthc.phpp.3:U.S.Dept.ofVeteransAffairs:https://www.washingtondc.va.gov/features/Regaining_Independence.asp

p.4:RockyMountainPoison&DrugCenter:https://www.rmpdc.org/pharmaceuticals/medical-information-inquiries.html

pp.8&9:LeonZernitskyFineArt:https://www.leonzernitsky.com

p.10:waggl.com:https://www.waggl.com/healthcare/

p.11:eyerx.com:https://www.eyerx.com/the-big-e-and-more-vision-testing-explained/

p.12:KaiserHealthNews:https://khn.org/news/efforts-to-instill-empathy-among-doctors-is-paying-dividends/

p.14:top:parkwayfamily.org:http://www.parkwayfamily.org/events/walking-club/

p.14:bottom:TheLunchLady:http://thelunchlady.ca/apples-infographic/

p.16:KeithHaringFoundation:http://www.haring.com/kh_foundation/

p.17:top:U.S.NatLibraryofMed: https://circulatingnow.nlm.nih.gov/2013/11/21/quit-smoking-its-only-logical/

p.17:bottom:BostonUniversitySchoolofMedicine:https://www.bumc.bu.edu/busm/2018/03/14/bumc-students-organize-walkout-in-support-of-enough-gun-violence-prevention/

p.18:pinterest.com:https://www.pinterest.com/pin/72690981463975975/

p.22:UnitarianUniversalistFellowshipofMankato:https://uumankato.com/connections/food-not-bombs/

APPENDIXCPhotoCredits

C1

strengthening public health and the healthcare workforce health partners can-do guide...

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