Improving health literacy through adult basic education in Australia

Abstract

Adults with low literacy are less empowered to take care of their health, have poorer health outcomes and higher healthcare costs. We facilitated partnerships between adult literacy teachers and community health providers to deliver a health literacy training program in adult basic education classrooms. Following course completion we interviewed 19 adult education teachers (15 delivering the health literacy program; 4 delivering standard literacy classes) and four community health providers (CHPs) about their experiences, and analysed transcripts using Framework analysis. Written feedback from eight teachers on specific course content was added to the Framework. Health literacy teachers reported a noticeable improvement in their student's health behaviours, confidence, vocabulary to communicate about health, understanding of the health system and language, literacy and numeracy skills. CHP participation was perceived by teachers and CHPs as very successful, with teachers and CHPs reporting they complemented each other's skills. The logistics of coordinating CHPs within the constraints of the adult education setting was a significant obstacle to CHP participation. This study adds to existing evidence that health is an engaging topic for adult learners, and health literacy can be successfully implemented in an adult basic learning curriculum to empower learners to better manage their health. Health workers can deliver targeted health messages in this environment, and introduce local health services. Investment in adult literacy programs teaching health content has potential both to meet the goals of adult language and literacy programs and deliver health benefit in vulnerable populations.

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.…”

“…The social support derived from the course was frequently commented on as a positive outcome of participation, and this observation was also made by teachers of the program (reported elsewhere). 13 Importantly, learners reported that they had become more confident in areas that extended beyond performing the targeted health behaviours, such as engaging in LLN activities in class, and interacting with people in their community. Sharing new knowledge with others in their communities was frequently reported; however, language differences remained an important barrier to engaging with the health system (e.g.…”

“…Some health literacy classes (n = 4) were visited by local community health providers, although logistical issues made this the exception. 13…”

“…[22][23][24] A small number of community health providers who visited health literacy classrooms within our study similarly noted that learner questions often related to family and friends. 13 In this way, health literacy can be seen as 'distributed' through family and social networks as learners pass on their health literacy skills 25 , extending the impact of programs beyond the classroom. For people with lower health literacy, who are more likely to rely on personal experience and information obtained through lay networks 26 , creating an environment to build those networks has potential to disseminate accurate health information directly to these hard-to-reach groups.…”

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

“…This analysis focuses on teachers’ reflections on SDM programme components. Data relating to the other components of the health literacy programme are reported elsewhere . While the focus of this article is on teachers’ experience of delivering SDM content within a health literacy programme, quotes from adult learners are incorporated throughout to support teachers’ reflections on subjective learner experiences.…”