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This paper discusses the implications of health literacy during the COVID-19 pandemic for adults with lower literacy skills. It highlights the challenges faced by individuals in understanding complex health information and emphasizes the role of adult educators in providing trustworthy and comprehensible health information. Incorporating health literacy into adult education programs has shown positive impacts on students' self-efficacy and health knowledge. Overall, improving health literacy in the ABE classroom can empower individuals to make informed health decisions.

In the United States, worker health care is funded through health insurance plans paid for by employers. Insurance plans are written in complicated language that low wage earners (LWE), who have lower levels of education, may find difficult to understand. We examined the relationship between health insurance literacy (HIL), education, and literacy skills for 75 LWE. Results indicated low to moderate associations between literacies (reading, numeracy, digital), educational attainment and HIL; in a multiple regression analysis, only reading was uniquely significant. LWE with low educational attainment and poor reading skills may need additional support to understand and use their health insurance.

Young children from parents with low income and low-literacy skills are often late in being diagnosed with developmental disabilities. To try to understand this phenomenon, we conducted six focus groups with 17 parents of low income with low-literacy skills living in an urban area who had children between 6 months and 4 years of age. Parents were asked how they access general information about child development and parenting resources. They were also probed about their experiences learning about their specific children's development. Their feedback was also sought on the Centers for Disease Control and Prevention's Learn the Signs Act Early materials. Results highlighted the resourcefulness of the parents to find information and the difficulties they had with printed information. Their focus group responses indicate the need for agencies to think more broadly about where to provide information for parents and the need to utilize easy-to-read printed materials.

The purpose of this research was to analyze oral communication patterns between patients with varying degrees of individual health literacy (how patients access, understand, and use health information) and their health providers. We analyzed a secondary data set of 68 patient--nurse provider audiotaped clinic encounters using REALM (Rapid Estimate of Adult Literacy in Medicine, a health literacy measure), correlations, and quantile regression to look at the use of provider dialogue components: closed-ended questions, open-ended questions, data gathering--biomedical, education/counseling--biomedical, data gathering--lifestyle/psychosocial, education and counseling--lifestyle/psychosocial, and checking for understanding. Patients with lower health literacy levels were asked more closed-ended biomedical and lifestyle/psychosocial questions than those with higher literacy levels. Providers did not check for understanding with patients at any health literacy level. Implications for health literacy and adult education in the medical setting, adult classroom, and community organizations are described.

Background: Research suggests that younger adult African American people (age 18–35 years) have more than double the risk of having a stroke than White people. Stroke risk education is lacking for this cohort; there is a dearth of materials that are targeted and focused for young adult African Americans. There is also little research on developing and testing age and culturally appropriate health literate materials that may help this population better understand personal risk factors for stroke. Objective: The aim of this study was to understand factors to guide creating and disseminating plain language health messages about stroke risk awareness among young adult African Americans. Methods: African American participants age 18 years and older completed an online survey (N = 413). Descriptive statistics, one-way analysis of variance, and two-step cluster analyses were used to evaluate stroke risk awareness, perceived risk of stroke, message creation factors, and online health information seeking behavior. Open-ended survey items described modifiable and non-modifiable reasons for perceived risk of stroke. Key Results: Participants reported differences on overall stroke risk factor awareness by perceived risk of stroke was significant (F[2, 409] = 4.91, p =.008) with the very low/low group (M = 1.66, p <.01), showing significantly lower overall stroke risk factor awareness compared to the moderate and high/very high groups. Both respondents who thought their stroke risk was very low/low and moderate/high/very high commented about family history (54.1% and 45.9%, respectively) as the reason and 88.2% of very low/low commented that they did not have risk factors for stroke because they were young. Cluster analysis indicated the Mostly Clear Preferences cluster was more likely to select mostly/very on positive, informational, and long-term messages and medical authority sources. The largest of three clusters reported medical sources as the highest rated source for both finding and trusting health information (47.2%, n = 195). Conclusion: Young adult African Americans have a scarce understanding of modifiable stroke risk factors; health education materials should focus on positive information messaging that shows a long-term result and is presented by a medical authority. We did not observe any age or sex differences among the data, which suggests different message modalities may not be needed. [HLRP: Health Literacy Research and Practice. 2024;8(1):e38–e46.] Plain Language Summary: In this study, we collected data to create a targeted stroke risk awareness health education video for young African American adults (age 18 years and older). The video was based on analysis of data from 413 participants focusing on perception of stroke risk, stroke risk knowledge, as well as preference for message type, source credibility, and modality. [ABSTRACT FROM AUTHOR]

Background: Multimedia videos are important tools to inform uptake of the COVID-19 vaccine. Video design using health literacy guidelines may help optimize video usefulness. Many health organizations (HO) (provides information) and health care (HCO) (provides direct health care) organizations have used YouTube to deliver videos about COVID-19 vaccines. Objective: We examined HO and HCO COVID-19 vaccine videos shown on YouTube for health literacy guidelines (quality, understandability and actionability). Methods: The top 30 most viewed COVID-19 vaccine videos posted by HO and HCO were analyzed using the Global Quality Score (GQS) and the Patient Education Assessment Tool for evaluating audiovisual formats (PEMAT-AV). Key Results: GQS scores averaged 3.12 (standard deviation [SD].789), which is equivalent to 80%. Using PEMATAV, there was a relationship between actionability and quality (r(28) =.453, p <.05) for HO; for HCO, there was a relationship between usability and quality (r(28) =.455, p <.05). Odds ratio analysis showed quality in HO leading to higher odds of actionability (3.573, 95% confidence interval [CI] [1.480–14.569]) and quality in HCO videos leading to higher understandability (4.093, CI [1.203–17.865]). Conclusion: Few organizations applied all health literacy principles to video design. Video creation for mass media health campaigns by HO and HCO should include consideration of evidence-based health literacy measures (quality, understandability, actionability) to ensure intended results across viewers with different health literacy levels including communities who have been disproportionately affected by COVID-19. [HLRP: Health Literacy Research and Practice. 2023;7(2):e111–e118.] [ABSTRACT FROM AUTHOR]

Background: The importance of engaging patients in their cancer care cannot be ignored. Health literacy communication skills like Teach-Back may help improve patient engagement by providing patients with accessible, understandable, and usable information and then confirming that patients understand what they are being told, thereby improving patient self-efficacy. Teach-Back is a method in which patients confirm their understanding by responding to questions that are framed by the navigator saying, "I gave you a lot of information, and I want to make sure I was clear." Objective: To evaluate implementation of the Teach-Back method and to measure patient understanding of information and engagement. Methods: We collected data on the number of patient questions using a standard navigator script (N = 65). Navigators were trained on use of Teach-Back, and the navigator script was modified to include Teach- Back language. Patients (n = 55) called in to the navigator center to talk with a navigator who used the modified navigator script. Navigators collected data on each call, identifying which Teach-Back question they used, correctness of patient responses, and types of information Teach-Back by patients. Results: By adding Teach-Back language to standardized navigator scripts, navigators found patients more conversational and more focused in their questions. Conclusions: Teach-Back is an effective method of reinforcing or confirming patient education and will be implemented and measured by the Cancer Center in all standard navigator scripts. [ABSTRACT FROM AUTHOR]

BACKGROUND: Respiratory therapists (RTs) should communicate with patients in a way that leads to patients understanding their discharge plans and medical device instructions. The teach-back method is a patient-centered, health-literate technique that allows health care professionals to confirm patient understanding. The purpose of this mixed-methods pilot study was to measure the use of teach-back by first-year undergraduate RT students in a simulation-center experience after a 1-h teach-back skills training. METHODS: First-year RT students' health literacy knowledge and belief in communication skills were measured using a pre- and post- survey about their knowledge and beliefs. A 1-h health literacy and teach-back skills training lecture (ie, intervention) was delivered after the pre-testing. RT students were then assessed for teach-back use during a regularly scheduled simulation center experience. Their experiences were recorded in a semistructured interview immediately after the simulation-center experience. RESULTS: 14 of 20 RT students used teach-back in the simulation center. Knowledge scores increased from 8.278 to 8.944 postintervention, and the median scores for belief increased from 111 to 117 postintervention. There was a statistically significant postintervention increase in knowledge scores (P < .001) and in communication belief scores (P = .038). Thematic content analysis revealed 2 primary themes for teach-back use: to confirm patient understanding and to confirm proper use of medical devices. Teach-back was not used due to the discharge scenario used in the simulation center, due to the student forgetting and/or being nervous, due to how engaged the patient was, or due to individual communication style. CONCLUSIONS: Results from our pilot study indicate that RT students may benefit from a 1-h health literacy and teach-back skills training. Furthermore, we identified reasons why the teach-back method was not used and determined what communication training students perceived would be helpful. Our findings can be used to help improve and implement communication skills training in the RT curriculum. [ABSTRACT FROM AUTHOR]

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Background: How individuals perceive their health literacy may differ based on demographic and individual characteristics., Objective: The purpose of this study was to understand the dispersion of health literacy across demographics in the state of Georgia in 2021 and to determine which factors influence health literacy., Methods: Study participants were age 18 years and older and completed an on-line Health Literacy Questionnaire ( N = 520). The participant pool was stratified to mirror state-wide demographics of geography and race. Results were further collapsed into composite scales reflecting basic, communicative, and critical health literacy. Descriptive statistics, bivariate Pearson's correlations, and multiple regression analyses were used. A two-step cluster analysis was performed with the nine health literacy scales., Key Results: Rural county and no health insurance were negatively related to all three composite scales ( rs = .093-.254, ps < .05). Demographic predictors accounted for 6.7% of the variance in basic (F[6, 439] = 5.287, p < .001), 10% in communicative (F[6, 438] = 8.154, p < .001), and 6% for critical (F[6, 439] = 4.675, p < .0010. In all scales, health insurance status was the strongest primary unique predictor ( βs = .236, .295, .181, ps <.05, respectively). In a two-step cluster analysis only health insurance status differentiated the health literacy level clusters ( X 2 (3) = 9.43, 34.51, ps = 024, <.001 respectively)., Conclusion: Lacking health insurance is the most consistent and largest contributor to low health literacy across the state of Georgia; population demographics are not. Health literacy policies and practices should be developed for universal application and not focus on specific populations. [ HLRP: Health Literacy Research and Practice . 2022;6(3):e182-e190. ] Plain Language Summary: In this study, demographics that are usually associated with low health literacy like age, sex, race, educational attainment, and type of county (rural or urban) were not associated with; the only significant factor was lack of health insurance. This relationship strengthens the case for universal health literacy precautions that go beyond population demographics.