Using the Health Literacy Study Circles: June 19-23, 2006
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Preparation Materials: Overview, Article and Discussion Questions
Read the discussion below:
From: WinstonL@lacnyc.org
To: healthliteracy@nifl.gov
Date: Monday - June 19, 2006 9:26 AM
Subject: [HealthLiteracy 205] Re: Welcome to the discussion: Using theHealthLiteracy Study Circles+
Hello; I am Winston Lawrence. I am a Senior Professional Development
Associate at the Literacy Assistance Center in New York City. Over the
past three years, I have had the opportunity to pilot all three modules
of the health literacy study circles developed by NCSALL and Harvard
School of Public Health.
I have facilitated several study circles comprising teachers,
counselors, program managers and staff developers.. Currently I'm
involved in developing a health literacy initiative at the center,
building program capacity through the training of teachers and also
promoting partnerships between literacy programs and health care
agencies.
I too look forward to your contributions. I hope we can hear from all of
you on an issue that really impacts ESOL/ABE students - health literacy.
Winston
Winston Lawrence Ed. D
Senior Professional Deveopment Associate,
Literacy Assistance Center
32 broadway, 10th Floor
New York, NY 10004
Tel: 212-803-3326
Fax: 212-785-3685
Email: winstonl@lacnyc.org
From: soricoli@gse.harvard.edu
To: healthliteracy@nifl.gov
Date: Monday - June 19, 2006 10:08 AM
Subject: [HealthLiteracy 207] Re: Welcome to the discussion: Usingthe HealthLiteracy Study Circles+
Hello -
I am Lisa Soricone, a Research Associate at the National Center for the Study of Adult Learning
and Literacy (NCSALL). I have had the pleasure of working with Professor Rima Rudd of the Harvard
School of Public Health and Maricel Santos, now of San Francisco State College, on the creation of
the Study Circle+ Facilitator Guides. After three years of writing the guides, I had the
opportunity to facilitate a study circle with adult ESOL educators here in Boston this spring.
Winston and I are excited about this opportunity to connect with a larger group of adult education
and health professionals and look forward to hearing from you this week.
Lisa
Lisa Soricone
Research Associate
National Center for the Study of Adult Learning and Literacy
Harvard Graduate School of Education
Nichols House, 7 Appian Way
Cambridge, MA 02138
Phone: 617-495-1712
Fax: 617-495-4811
E-mail: soricoli@gse.harvard.edu
From: poledc@slu.edu
To: healthliteracy@nifl.gov
Date: Monday - June 19, 2006 1:09 PM
Subject: [HealthLiteracy 208] Re: Welcome to the discussion: Using theHealth Literacy Study Circles+
Thank you very much for your work with HALL. My responsibilities include
academic and community based training in Family Medicine and an AHEC Program
Office. I have reviewed the Circles + materials and the article in the Focus
on Basics newsletter.
We have been engaged with other partners in the region to understand the
issue and determine how to link the health community to the adult literacy
community and came up with a similar strategy, so we are excited to see the
"Health Literacy Circles +" resources/model. We have also engaged in efforts
to train providers in the region on the issue of health literacy to raise
awareness and are participating in discussion on how to implement a strategy
for skills based education sessions. We have also included clinical
vignettes in our Family Medicine clerkship with simulated low literacy
patients so the third-year medical students can gain hands-on experience
discussing the issues around literacy in a patient-provider situation.
Do you see the Health Literacy Circles + materials being made available for
others to pilot?
The Tables in the FOB article provide an excellent organizational framework
for integrating issues with necessary skills and teachable moments. Are
these something that we would be able to use as a guide in developing our
curriculum and community based efforts?
Thank you.
David Pole, MPH
Deputy Director, Division of Community Health Promotion
Saint Louis University School of Medicine
Deparment of Community and Family Medicine
(P) 314-977-8484
(F) 314-977-5268
poledc@slu.edu
From: soricoli@gse.harvard.edu
To: healthliteracy@nifl.gov
Date: Monday - June 19, 2006 2:09 PM
Subject: [HealthLiteracy 209] Re: Welcome to the discussion: Usingthe Health Literacy Study Circles+
David -
Thank you for your message. It is very exciting to hear about your efforts to connect the worlds
of health and adult education. Winston and I hope that colleagues who have extended the original
model of the study circle to include health professionals will share some of their experiences.
In developing the study circles, we fully intended that people would use the materials and run
study circles on their own -- indeed, that is why the product of our efforts is a Facilitator's
Guide for each of the three areas - access and navigation, chronic disease management, and disease
prevention and screening. So, we encourage you to use the materials and adapt them to your needs.
Of course, we hope that you will give appropriate credit/citations to NCSALL for any elements of
the study circle that you use.
The Tables contained in the first section of each facilitator guide that outline health tasks,
materials, and skills are very useful for enhancing our understanding of the links between health
and adult basic education (including ESOL). We found these tables essential in keeping our own
work focused. By all means, feel free to use them to guide your curriculum development and other
activities. Citing the original source, of course. = )
My colleagues at Harvard, particularly Professor Rima Rudd, and I would be very happy to learn
about your work in adapting the study circles. Feel free to contact me down the road as you work
with the study circle materials.
All the best in your continued exciting work,
Lisa
From: kabeall@comcast.net
To: healthliteracy@nifl.gov
Date: Monday - June 19, 2006 2:31 PM
Subject: [HealthLiteracy 210] Re: Welcome to the discussion: Usingthe Health Literacy Study Circles+
Hi David,
The health literacy study circles+ are available free for download on the
NCSALL Web site. Here are the links.
Skills for Health Care Access and Navigation: http://www.ncsall.net/?id=891
Skills for Chronic Disease Management:
http://www.ncsall.net/index.php?id=1058
If you'd like to order print copies, go to http://www.ncsall.net/?id=674.
Another HALL resource that you might find helpful is the Health Literacy
Public Health Forums: Partners for Action at http://www.ncsall.net/?id=899.
We hope that you find these training materials helpful and would love to get
your feedback on their usefulness.
Kaye
Kaye Beall
Outreach Coordinator/NCSALL Dissemination Project
World Education
4401 S. Madison St.
Muncie, IN 47302
Tel: 765-717-3942
Fax: 208-694-8262
kaye_beall@worlded.org
http://www.ncsall.net
From: WinstonL@lacnyc.org
To: healthliteracy@nifl.gov
Date: Monday - June 19, 2006 4:34 PM
Subject: [HealthLiteracy 214] Re: Welcome to the discussion: Using theHealthLiteracy Study Circles+
Hi David: Thanks . It is certainly great to hear of your work in the
Department of Family and Community Medicine. One area that you raised is
that of partnering with community based agencies. You indicated that you
have been involved in linking health providers and literacy agencies.
I'd like to hear some more about this if you can. In New York City, as
I have worked with adult literacy programs, partnering has been a key
element of the project. We believe that partnerships provide a
wonderful opportunity for adult literacy students to increase their
health literacy. It allows adult students to become more familiar with
key elements of the health care system and ultimately enable them to
more readily access health services. What have your partnerships look
like? Who are the key people that were/are involved. Also, are there
others like David who have been doing similar things?
From: poledc@slu.edu
To: healthliteracy@nifl.gov
Date: Monday - June 19, 2006 4:58 PM
Subject: [HealthLiteracy 215] Re: Welcome to the discussion: Using theHealth Literacy Study Circles+
Thank you for reply comments - in response to Julie's original questions
I am in an academic medical center environment teaching medical students
from perspective of Community and Family Medicine as well as general health
professions recruitment and retention to improve access to quality care,
particularly in medically underserved areas.
In a health education setting:
Q: What challenges do you find when teaching health information, medication
instructions, or at-home management of conditions?
A: There is such heavy emphasis clinical skills training and content, that
patient-provider communications training are just becoming aware of and
working to incorporate more topics on health literacy and cultural
competency into the curriculum. We have worked on an Inter-professionals
curriculum committee headed by our College of Allied Health Professionals at
SLU and they have done some excellent work.
As and AHEC Program Office, we sponsored a CME session in January of this
year with the AMA Train-the-Trainer program on Health Literacy and had 42
providers from the medical academic, residency programs, community
providers, community based agencies, and policy makers. Our goal was to
increase awareness and provide a training that enabled people to implement
materials in their own disciplines.
We have also worked further within our Family Medicine clerkship to have
sample patients and students around a "medications brown-bag" and students
must identify patient as being low literacy as well as determine different
was to address understanding of medications.
In another course - an 8 week clinical training experience, we have provided
academic discussions on the issue of health literacy, disparities, barriers
to accessing care and cultural competency and then have discussion with
students following their clinical encounters where we ask them to report
back how these factors related to specific patients - we are finding that it
challenges their thinking, stereotyping and assumptions, then comes the
learning.
Q: How do you adapt when working with speakers of other languages, or others
who seem less comfortable with text, charts, tables, etc.?
A: We have strong community resources here in Saint Louis on working with
medical interpreters and training interpreters. Our goal will be to train
medical students on how to access and use these resources. Additionally, to
bring up the issue that the barrier may be two-fold, the non-English
language AND literacy. A patient who does not speak English may also not be
literate in their own language so just having and interpreter may not solve
the problem if do not address literacy as well.
Q: What literacy skills do patients need to enhance in order to understand
necessary medical information more clearly?
A: Your grids around info, skills and then lessons is a great model. We
will discuss that and see how to adapt for our needs.
Real issues around navigation of system and the ability to utilize support
services to get there, transportation, getting prescriptions once they have
been ordered.. Here in St. Louis there is also recent personal history for
many patients around racial access to services and discrimination. So
building trust to work together is a big factor. The Regional Health
Commission in Saint Louis has done a great job bringing together members of
the community to identify issues and priorities. Now we need to turn the
recommendations into initiatives and programs that address the needs.
Also, access to service sites other than the ER that are open when people
need them or are available to access, ie, after working hours so do not need
to miss work to address health needs.
David Pole, MPH
Deputy Director, AHEC Program Office
Saint Louis University School of Medicine
Deparment of Community and Family Medicine
(P) 314-977-8484
(F) 314-977-5268
poledc@slu.edu
From: kpomeran@gwu.edu
To: healthliteracy@nifl.gov
Date: Monday - June 19, 2006 9:52 PM
Subject: [HealthLiteracy 217] Re: Welcome to the discussion: UsingtheHealth Literacy Study Circles+
A group in Washington, DC called Health Information Partners, organized
about 2 years ago to unite medical and public health practitioners,
librarians and adult educators to address disparities in access to usable
online health information.
We have focused primarily on training adult learners and others who are
novice computer users how to use the Internet effectively to learn about
health. Much of our focus is on HIV, diabetes, hypertension, and
community resources. We use web sites such as MedlinePlus and Healthy
Roads Media for gateway sites and AVERT, whatudo, and AIDSInfoNet for HIV
info.
We also give health talks and host professional development workshops on
health literacy. We are funded by the National Library of Medicine.
As we enter our next phase of planning and implementation, we plan to work
on introducing more health topics into adult education programs. I am so
delighted to learn of your work and this discussion; it is just what we
need to develop here.
Our web site, http://connectforhealth.gwu.edu, provides a basic training
curriculum, a list of our partners, and a monthly schedule of events. Our
GWU public health students have created more topic-specifc training
modules on diabetes, disabilities, and living with HIV.
I am also interested in hearing how people work to engage learners in
health advocacy, especially regarding the fight against HIV. Some of our
most rewarding experiences have been to watch people develop into
advocates and teachers, but we need so many more.
thanks, karyn
Karyn L. Pomerantz, MLS, MPH
Partners for Health Information | Health Information Partners
GW School of Public Health & Hlth Services
2175 K St., NW #716 | Washington, DC 20037
202/416-0408 (voice), 202/416-0433 (fax)
kpomeran@gwu.edu connectforhealth.gwu.edu
From: BSMITH@smtp.aed.org
To: healthliteracy@nifl.gov
Date: Tuesday - June 20, 2006 7:09 AM
Subject: [HealthLiteracy 218] Re: Welcome to the discussion: Using theHealthLiteracy Study Circles+
Hi, all.
My name is Bill Smith and I was privilege to be one of the committee
members on the Institute of Medicine's report, Health Literacy: A
Prescription to End the Confusion. I have been doing health education,
health communication and social marketing for years and it was eye
opener to take a health literacy frame for the problems so many people
face in dealing with our health system.
I got excited about doing something about it after the Committee ended
and we adapted a AED program called Youth Mapping to the Health Literacy
topic. Youth Mapping was originally developed as a way to give high
school kids in disadvantaged settings the opportunity to develop
computer, public speaking and data collection skills.
We worked with the IOM, Pinelas County Fla. and Harlem N.Y. to develop
a Youth Mapping of Health Literacy program. There is information about
it on our web site www.aed.org under Youth programs if you are
interested in more details.
Having youth present the problem to local hospital staff and community
leaders was a real eye opener and may be helpful as many of you look for
ways to make health literacy more real to decision-makers in your
community.
Wm. Smith
Executive Vice President
Academy for Educational Development
1825 Connecticut Ave., NW
Washington, D.C. 20009
Phone: 202-884-8750
Fax: 202-884-8752
e-mail: bsmith@aed.org
From: JuneW3963@aol.com
To: healthliteracy@nifl.gov
Date: Tuesday - June 20, 2006 10:06 AM
Subject: [HealthLiteracy 220] Re: Welcome to the discussion: Using theHealth Lite...
Dear Colleagues:
I have been enjoying the discussion thus far and would like to add my perspective as an adult educator and facilitator of at least four study circles in the Hudson Valley region of New York State.
I was trained at the LAC by my health literacy mentor and friend, Dr. Winston Lawrence. After learning the model and putting it into practice, I then took Dr. Rima Rudd and Lisa Soricone's suggestions to heart....I used the materials and ran! Our study circles included health professionals, i.e., pharmacists, registered nurses, LPN's, technicians, etc, many of whom were retired. Adding their expertise to that of adult education teachers created many Ah Ha moments. Powerful? Yes, indeed. The discussion took off in many different directions but always reverted to how can we help low functioning adults navigate the health care system, manage chronic diseases, and become better able to advocate for themselves.
We adapted the lesson plans provided by NCSALL to meet the needs of the diverse population served in the Hudson Valley. The expertise of the adult educators was invaluable. The convening of three study circles gave teachers the opportunity to not only adapt their lesson plans, but to put them into practice and report back to their colleagues. The lessons became even more relevant with the inclusion of the expertise of the health care professionals as they worked side by side with the adult ed teachers to create lesson plans that were accurate and challenging.
I'm looking forward to following the discussion.
Sincerely,
June White
Director of Adult and Continuing Education
Afton Central School
29 Academy St.
Afton, NY 13730
From: julie_mcKinney@worlded.org
To: healthliteracy@nifl.gov
Date: Tuesday - June 20, 2006 12:50 PM
Subject: [HealthLiteracy 222] Re: Welcome to the discussion: Using theHealthLite...
Hi Everyone,
It is so nice to hear about the interesting things you are all doing in
this field! I would like to think about the study circles themselves and
how they could be used in the different venues that you all represent.
I would like to know if you David, Karyn, Bill and others can see using
the study circles in your organizations. What do you think of the study
circle approach to professional development of health educators or
health care providers? Would this work within the culture of your
organization?
How would it work for any of you to do a study circle wth a mixed group
of health and literacy professionals the way June did? (How exciting--I
love the idea of health educators, pharmacists, and adult educators
working together to create lessons!)
Does anyone have any thoughts on this?
Perhaps we can get a better sense of the experience using the study
circles in order to explore this question. If you have questions for
Winston and Lisa and June to help think about it, please ask!
All the best,
Julie
Julie McKinney
Discussion List Moderator
World Education/NCSALL
jmckinney@worlded.org
From: sabrina_kurtz-rossi@worlded.org
To: healthliteracy@nifl.gov
Date: Tuesday - June 20, 2006 2:54 PM
Subject: [HealthLiteracy 223] Re: Welcome to thediscussion: Using theHealthLite...
Dear All,
I've used the study circle approach in my teaching, training, and professional development work and have found it to be very useful. Most recently, I had a group of health communication graduate students explore select health literacy topics using a study circle format. Students developed guides on a variety of health literacy topics, including international health literacy, measuring health literacy, materials development and assessment, etc. In brief, they explored issues related to these topics by reading select research article, and then developing and facilitating a study circle discussion.
In terms of the Health Literacy Study Circle Plus, I was wondering how the topic of searched for and using health information on the Internet is covered? Thanks so much for this informative topic and discussion.
- Sabrina
Sabrina Kurtz-Rossi
World Education
44 Farnsworth Street
Boston, MA 02210
617-482-9485
skurtz@worlded.org
From: WinstonL@lacnyc.org
To: healthliteracy@nifl.gov
Date: Tuesday - June 20, 2006 4:06 PM
Subject: [HealthLiteracy 224] Re: Welcome to the discussion: UsingtheHealth Literacy Study Circles+
Hi all: In response to Karyn query about advocacy, in the first study
circle that I conducted in New York city, all of the teachers felt that
advocacy was a major element in the definition of health literacy. It
was incredible to see how teachers were concerned about the need for
adult literacy students to be able to be advocates for themselves and
their families. They saw advocacy as important especially in the area
of accessing the health care system, to be able to express their needs
and desires for services. They pointed out that frequently adult
literacy students feel as though they are not entitled to services
because they are poor or do not speak English well. Teachers left the
study circle determined to provide health literacy information to
students so they feel capable of raising their voices when encountering
the health care bureaucracy. The focus was not on HIV but in any health
context. The study circle format really allowed teachers to talk about
issues, share common concerns and emerge with common understandings.
Winston
Winston Lawrence Ed. D
Senior Professional Deveopment Associate,
Literacy Assistance Center
32 broadway, 10th Floor
New York, NY 10004
Tel: 212-803-3326
Fax: 212-785-3685
Email: winstonl@lacnyc.org
From: WinstonL@lacnyc.org
To: healthliteracy@nifl.gov
Date: Tuesday - June 20, 2006 4:31 PM
Subject: [HealthLiteracy 225] Re: Welcome tothediscussion: Using theHealthLite...
Hi Sabrina and others; As I have worked with the study circles, researching and using health information on the internet was done in two ways. Firstly, internet sites were disseminated to teachers as part of a list of health resources. Participants then went online and included the ideas from the sites in their lessons or provided print outs as class reading materials..
Secondly, some teachers built into their lessons student internet search for health related materials in order to fulfill class requirements. Students actually did internet searches in many classes. There is so much health information on the internet. Of course there are issues about literacy levels of some internet sites as well as accuracy of the information. But it is really beneficial for teachers to engage students in online activities so that they build both their internet and computer skills as well as acquire useful health information.
Winston.
From: Nancy Hansen <sfallsliteracy@yahoo.com>
To: healthliteracy@nifl.gov
Date: Tuesday - June 20, 2006 4:58 PM
Subject: [HealthLiteracy 226] Re: Welcome to the discussion: Using theHealthLiteracy Study Circles+
Hi Bill ... et all lurkers:
I'm Nancy Hansen, Bill. I am an adminstrator/practictioner for a midwestern community-based organization, which serves only adults with limited literacy skills.
For 2-3 years now we have been pushing, dragging, cajoling our learners to "get concerned" .. to be the spokespersons who address the social issue called "their right to good healthcare". Basically ... it's been unsuccessful ... except for one fine gentleman from Iowa named Archie.
How did you get an even younger group than this to do the following?
You wrote:
<< Having youth present the problem to local hospital staff and community
leaders was a real eye opener and may be helpful as many of you look
for ways to make health literacy more real to decision-makers in your
community. >>
Indeed. I agree that the patient (or prospective patient) make the best 'storytellers', if you will, and do get the undivided attention of the healthcare provider. It's a tough project to initiate, however.
I'd be interesting in hearing from any of the other lurkers about how they managed to jump the barriers of confidentiality and lack of self-confidence of adults served so that the learners can participate alongside the hospital personnel in making changes? And how are the learners being involved? Are study circles the only way? Or are there others?
One of our hospital systems has applied for funding to carry out an initative that will begin the process of raising the public and healthcare providers' awareness about this being a real problem - "real" as in non-fiction ... not imagined, but real. Anyone using the AMA Health Literacy training materials and the "Ask Me 3" program?
If funded, our agency will be asked to provide either our volunteers or our adult learners to sit on a panel to present/lead discussion for 5 healthcare facilities in our community-at-large about the health literacy topic.
I'm having some misgivings because in initial discussion with the grantwriter, I got the sense that there are nay-sayers out there - that there isn't a need, so say the authorities - the doctors - the healthcare provider. ("They may have a problem somewhere else, but WE surely do NOT," has been heard said.) How would others suggest addressing that issue, although as yet the comment has not been made directly to me who could tell them differently?
I am enjoying this discussion thread. Thanks for the comments.
Nancy Hansen, Ex. Director
Sioux Falls Area Literacy Council
Sioux Falls, SD
From: esltilla@gmail.com
To: healthliteracy@nifl.gov
Date: Tuesday - June 20, 2006 5:37 PM
Subject: [HealthLiteracy 228] Re: Welcome to the discussion: Using theHealthLiteracy Study Circles+
Hi. In response to Nancy's question as to how to get our students concerned and assertive in their own health care and Winston's statement about the study circle group in New York City, I have found that when we presented the issue of patient rights and responsibilities. as well as problems the students have encountered in health settings, they were very forthcoming with ideas and suggestions. We created several lessons around these areas of advocacy and actually got them thinking about ways of changing their behavior with health professionals. They were not shy at all to express their feelings. Our school, the Mid-Manhattan Adult Learning Center, formed a partnership with Harlem Hospital. Our students visited the hospital to take part in an assembly presented by the heads of various departments who spoke in plain language to our students. A few days later, several groups of students visited specific departments. This had a tremendous positive impact on our students.
Tilla Alexander
esltilla@gmail.com
From: esltilla@gmail.com
To: healthliteracy@nifl.gov
Date: Tuesday - June 20, 2006 5:28 PM
Subject: [HealthLiteracy 227] Re: Welcome to thediscussion: UsingtheHealthLite...
Hi June, Winston, Sabrina and others,
I have been involved in the study circle + training for the past three years with Dr. Winston Lawrence at the LAC. As an ESL Clerical Pre-Voc teacher I have frequently used the Internet to acquaint my students with health sites and information, current newspaper articles on timely issues, finding lesson plans and activities for my students, and have my students search the Internet on various health subjects. I, myself, am constantly searching for valuable material to use with my students. The New York Times has a wonderful section on personal health (Jane Brody). When they had the series on Diabetes, I had the students read an article, ask questions, answer reading comprehension questions, and express their opinions through discussion and writing. When we explored OTC medications, I used Susan Gaer's drugstore lesson--which worked extraordinarily well. Last year, during the chronic disease phase, I had the students research and report on the body systems. I taught them how to search for photos and diagrams to add to their reports. As Winston said, there is an enormous amount of good health literacy material on the Internet. I look forward to continue following the discussion.
Tilla Alexander
esltilla@gmail.com
This is great information
Thanks,
David L. Mount, Psy.D., M.A.
