Evaluation of an Australian health literacy training program for socially disadvantaged adults attending basic education classes: study protocol for a cluster randomised controlled trial

Abstract

BackgroundPeople with low literacy and low health literacy have poorer health outcomes. Literacy and health literacy are distinct but overlapping constructs that impact wellbeing. Interventions that target both could improve health outcomes.Methods/designThis is a cluster randomised controlled trial with a qualitative component. Participants are 300 adults enrolled in basic language, literacy and numeracy programs at adult education colleges across New South Wales, Australia. Each adult education institute (regional administrative centre) contributes (at least) two classes matched for student demographics, which may be at the same or different campuses. Classes (clusters) are randomly allocated to receive either the health literacy intervention (an 18-week program with health knowledge and skills embedded in language, literacy, and numeracy training (LLN)), or the standard Language Literacy and Numeracy (LLN) program (usual LLN classes, specifically excluding health content).The primary outcome is functional health literacy skills – knowing how to use a thermometer, and read and interpret food and medicine labels. The secondary outcomes are self-reported confidence, more advanced health literacy skills; shared decision making skills, patient activation, health knowledge and self-reported health behaviour. Data is collected at baseline, and immediately and 6 months post intervention. A sample of participating teachers, students, and community health workers will be interviewed in-depth about their experiences with the program to better understand implementation issues and to strengthen the potential for scaling up the program.DiscussionOutcomes will provide evidence regarding real-world implementation of a health literacy training program with health worker involvement in an Australian adult education setting. The evaluation trial will provide insight into translating and scaling up health literacy education for vulnerable populations with low literacy.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12616000213448.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3034-9) contains supplementary material, which is available to authorized users.

Learners’ experience and perceived impact of a health literacy program in adult basic education: a qualitative study

“…This study forms part of a larger program of work evaluating the impact of our adult education health literacy training program. 12,13,[15][16][17][18] Combined, our results add to the growing evidence that adult basic education institutions have potential to develop transferable health literacy skills among socially disadvantaged groups. These qualitative findings further support theories of adult learning, which posit that adult learners are motivated to learn when they understand the relevance of the content to their daily lives.…”

“…Learners completed approximately 18 weeks of language, literacy and numeracy (LLN) classes as part of an existing adult basic education program, covering either health or nonhealth (standard LLN) content. See McCaffery et al 12 for full details of the program. The health literacy program had 31 topics (Table 1).…”

“…11 Here we report the findings of a qualitative interview study carried out as part of a clusterrandomised controlled trial of a health literacy program delivered in adult education settings in New South Wales (NSW) Australia. 12 Qualitative methodologies were employed to gain a broader understanding of program impacts from the perspective of participants, with specific aims to examine: 1) learners' experience of the course; and 2) its impact on their lives, and health-related understanding and confidence.…”

Qualitative insights into the experience of teaching shared decision making within adult education health literacy programmes for lower‐literacy learners

“…We developed a novel SDM training programme for adults with lower literacy to develop communicative and critical health literacy skills . The programme was delivered in Australian adult basic education settings in 2014 by trained adult educators as a core component of a broader health literacy programme and was evaluated as a cluster‐randomized controlled trial . An exploratory qualitative substudy was conducted with adult educators who participated in the trial to explore views and experiences of teaching health literacy skills (including SDM) and determine whether the programme is contextually appropriate and sufficiently tailored to learner needs, and teaching and institutional objectives.…”

Embedding a Health Literacy Intervention Within Established Parenting Groups: An Australian Feasibility Study

“…We developed a health literacy program for new parents based on our previous work (McCaffery et al, 2016;Muscat et al, 2016). The program was initially developed for, and piloted in, antenatal settings in New South Wales (NSW), Australia.…”