Gaining Health Literacy Through Adult Education

“Working with students in adult education classes represents an important opportunity to reach out directly to people who face health disparities. Helping students to develop skills that can be applied to a health context is an important step toward improving outcomes for our students and families.” (Soricone et al.)

by Dr. Dana L. Ladd

Healthy People 2030 (n.d.) defines health literacy as, “the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others” (Health.gov). Health literacy skills help people navigate all aspects of the healthcare system—making an appointment, wayfinding in a hospital, taking medications safely, reading and filling out consent forms, understanding nutrition labels, prevention and screening, and managing chronic health conditions. The underlying skills people need to perform these healthcare demands include reading, writing, listening, speaking, numeracy, and the ability to critically analyze information.

Though having health literacy skills is important, only 12 percent of adults in the United States have health literacy proficiency (National Center for Education Statistics, 2006). Anyone can be at risk for having low health literacy, but risk factors for having low health literacy include: age (over 65), race (other than White), education level (below high school), income level (at or below poverty), language/cultural background (first language other than English), and health status (those reporting low health status).

Adult educators can play an integral role in addressing the health disparities of adult learners by integrating curriculum that improves adult learners’ health literacy skills. 

Working with students in adult education classes represents an important opportunity to reach out directly to people who face health disparities. Helping students to develop skills that can be applied to a health context is an important step toward improving outcomes for our students and families. (Soricone et al.) 

Adult educators already focus on teaching literacy and numeracy skills to adult learners. Adult educators can incorporate lessons on completing health forms, making appointments, and navigating a health appointment. Numeracy education can incorporate training to help adults understand how to read food labels and understand portion sizes, understand medication dosages and instructions, and understand health risks. 

Communication and information literacy are both important health literacy skills for patients to possess. The skills below focus on improving adult learners’ communication and information literacy skills which can benefit adult learners and improve their ability to make informed decisions about their health. 

Adult learners should develop communication skills so they can communicate clearly with their health care providers. Adult learners should be encouraged to ask healthcare providers questions about all aspects of their health. The Institute for Healthcare Improvement (2021) encourages patients to ask their healthcare providers three important questions: 

•  What is my main problem?; 
• What do I need to do?; and 
• Why is it important for me to do this? 

Tools and documents designed by health literacy experts can be found at Ask Me 3: Good Questions for Your Good Health | IHI – Institute for Healthcare Improvement. Similarly, the Agency for Healthcare Research and Quality (n.d.) encourages patients to ask questions about their health and provides example questions patients can ask, and contains a free question builder toolkit on its website. Adult learning instructors can also access free materials and videos on the website to use during healthcare communication instructional sessions. 

Nothing has highlighted the need for critical evaluation skills more than the infodemic brought on by the massive amount of information being circulated about COVID-19 and vaccines. Adult learners need the ability to evaluate health information in order to learn how to identify misinformation.

“Adult educators can teach learners how to assess health information for credibility using the following evaluation criteria: authorship, accuracy, bias, and currency.”

 Educators can use Evaluating Internet Health Information: A Tutorial from the National Library of Medicine (medlineplus.gov), a free evaluating health information tutorial, to teach learners to evaluate health information before using it to make health decisions. Adult learners may also improve adult learners’ evaluation skills by having learners practice their evaluation skills to critically evaluate health websites for reliability.

In addition to evaluating consumer health information, adult learners should also know where they can access reliable consumer health information. Patients need access to reliable health information written at a level they can read and understand so they can make decisions about their health. MedlinePlus.gov provides consumer-level health information written in easy-to-read language and provides audiovisual material. The site is also beneficial for those whose first language is a language other than English. MedlinePlus provides health information in many languages on a variety of topics. Adult learners can access MedlinePlus to find health information on a variety of topics. Educators can provide adult learners with a demonstration of the MedlinePlus website and emphasize it as a place for free, reliable health information.

Having health literacy skills is important for everyone so they can navigate the healthcare system and make informed decisions about their health. The communication and information skills outlined above, along with enhancing literacy and numeracy training to focus on health-related tasks, can help adult learners improve their health literacy skills. The National Center for the Study of Adult Learning and Literacy (Sorcione et al., 2007) provides a guidebook, Health Literacy in Adult Basic Education that contains a more comprehensive list of skills and suggestions for integrating health literacy into the adult learning curriculum. This guidebook provides additional skills that are important for adult learners and includes lesson plans to teach many of these skills. By integrating these health literacy skills into the adult learning curriculum, adult educators can effectively work to decrease health disparities by improving the health and well-being of adult learners.

References

Agency for Healthcare Research and Quality. (n.d.). AHRQ Toolkit Questions are the Answer. Questions Are the Answer | Agency for Healthcare Research and Quality (ahrq.gov)

Healthy People 2030. (n.d.). Healthy people 2030: Building a healthier future for all. Retrieved March 7, 2021 from Healthy People 2030 | health.gov.

Institute for Healthcare Improvement. (2021). Ask Me 3: Good Questions for Your Good Health. Ask Me 3: Good Questions for Your Good Health | IHI – Institute for Healthcare Improvement

MedlinePlus (2020, March 6). Evaluating Internet health information tutorial. Retrieved March 1, 2021 from Evaluating Internet Health Information: A Tutorial from the National Library of Medicine (medlineplus.gov).

National Center for Education Statistics. (2006). The health literacy of America’s adults: Results from the 2003 national assessment of adult literacy. U.S. Department of Education. https://nces.ed.gov/pubs2006/2006483.pdf

Soricone, L., Rudd, R., Santos, M., & Capistrant, B. (2007). Health literacy in adult basic education: Designing lessons, units, and evaluation plans for an integrated curriculum. HALL/NCSALL.  healthliteracyinadulteducation.pdf(harvard.edu).

Dana L. Ladd M.S., Ph.D., AHIP is the Health and Wellness Librarian at the Virginia Commonwealth University (VCU) Medical Center Health and Wellness Library and is an associate professor on the faculty of VCU Libraries. Dr. Ladd has worked in libraries for more than twenty years and has extensive consumer health information, health literacy, and plain language communication experience. She manages the daily operations of the Health and Wellness Library; supervises and trains staff; provides consumer health information services for patients, their family members, and the public; and teaches health information classes.