The National Action Plan to Improve Health Literacy emphasizes the importance of community-based opportunities for education, such as English as a second language (ESL) programs. It recommends collaborations among the adult literacy and ESL communities. However, limited attention has been given to researching the effectiveness of community-based interventions that combine ESL and health literacy. The purpose of this study was to explore the feasibility of using different community settings for improving health literacy among adult Spanish speakers through an English language program. The study used a pre-experimental, single arm pretest-posttest design, and implemented the Health Literacy and ESL Curriculum. A collaborative was established between the community and university researchers. Participants were recruited at three distinctive sites. Health literacy was assessed using the Spanish version of the Test of Functional Health Literacy in Adults (TOFHLA). Analysis included descriptive and paired-group t test. Forty-nine participants completed the intervention and post-tests (92% retention rate). Overall--all sites--posttest scores significantly improved for total TOFHLA, raw numeracy, and reading comprehension (p < 0.0001). Similarly, all three sites yielded significantly better mean differences for the total TOFHLA score while numeracy and reading comprehension significantly improved in some sites. Results suggest that community sites are viable venues for delivering health literacy/language instruction to Spanish speaking adults. The study also points to community engagement and ESL programs as two essential components of effective health literacy interventions among Spanish speakers.

The HRPO is the Institutional Review Board (IRB) ethics committee for research with human subjects at UNM. All participants provided signed informed consent. Declaration of Conflicting Interests We wish to draw the attention of the Editor to the following fact that may be considered as a potential conflict of interest regarding this manuscript. We note that Jackie Perez works for the Hopkins Center, and previously worked for the Center under its previous name, St. Joseph Center for Children and Families. Tamara Thiedeman previously worked for the St. Joseph Center for Children and Families. Perez is currently the Director of the Center and Thiedeman was it's previous Director. Both are licensed mental health professionals and they provide/provided services to clients, including some of the women who participated in this study. Both were involved in establishing the Women's Social Isolation Support Group discussed here and both participated in the research. However, we believe that this relationship did not interfere with their ability to carry out the research, as they were interested in an objective analysis of the dynamics of the group process as part of an assessment of the services they provide.