The Health Literacy and ESL Study: A Community-Based Intervention for Spanish-Speaking Adults

Abstract

Although Hispanics have a documented high risk of limited health literacy, there is a scarcity of research with this population group, and particularly with Hispanic immigrants who generally confront language barriers that have been related to low health literacy. The National Action Plan to Improve Health Literacy identified community-based English-language instruction as a strategy that can facilitate a health literate society. However, the literature lacks discussion on this type of intervention. This randomized control trial aimed to test the feasibility of using conventional English-as-a-second-language (ESL) instruction for improving health literacy among Spanish-speaking adults. Objectives included the development, implementation, and evaluation of a health literacy/ESL curriculum. The Test of Functional Health Literacy in Adults (TOFHLA) in English was used to assess health literacy levels. Analyses included independent sample t test, chi-square, and multiple linear regression. A total of 155 people participated. Results showed a significantly higher increase in the TOFHLA posttest score in the intervention group (p = .01), and noticeable differences in health literacy levels between groups. Results indicate that ESL constitutes a promising venue for improving health literacy among Spanish-speaking adults. Incorporating health literacy-related content may provide additional benefits.

Health literacy interventions for immigrant populations: a systematic review

“…Similarly, numerical skills were taken into account only in the studies by Soto‐Mas et al. (,b), and their omission may be deemed a limitation of the other studies reviewed. This same problem was highlighted by the US Agency for Healthcare Research and Quality, which found that the strength of evidence for the relationship between numeracy and health outcomes was insufficient or low, given the small number of studies (Berkman et al.…”

Blending Health Literacy With an English as a Second Language Curriculum: A Systematic Literature Review

“…Four curricula reported results from evaluations designed to assess their effectiveness in improving students' health literacy Elder et al, 1998Elder et al, , 2000Soto Mas et al, 2014;Soto Mas, Ji, Fuentes, & Tinajero, 2015;Taylor et al, 2009Taylor et al, , 2011. All reported evaluations were conducted by the curriculum developers=personnel.…”

“…The first one (Soto Mas et al, 2014) consisted of a pretest-posttest design assessing students' health literacy with the Spanish version of the Test of Functional Health Literacy in Adults (Parker, Baker, Williams, & Nurss, 1995). The second one (Soto Mas et al, 2015) comprised a randomized control trial, and the results showed a significantly higher increase in scores on the Test of Functional Health Literacy in Adults for the intervention group compared to the control group. This latest curriculum was evaluated using a health literacy measurement tool, whereas other curricula measured a specific dimension of health literacy, such as knowledge and communication skills.…”

Health Literacy Among Migrants in the EU: A Collection of Best Available Interventions and Indirect Measures

“…Moreover, all used an experimental study design. The study participants were recruited from the following settings: community partnerships [10], through local radio and television stations [9], community nurse [7], via English-asa-second-language classrooms [8], and social and welfare clubs [11]. All but two studies [8,9], which both added health information to language courses, used different types of interventions such as: 1) workshops wherein health information was presented to the participants, with the use of activities such as lectures, role-play exercises, demonstrations, drama, group presentations and group discussions [10], 2) a community conference wherein awareness was raised, mainly among the local health care providers, about the Somali Bantu refugees' presence in the American community, their culture and their information needs, with additional education for Somali Bantu refugee mothers about necessary health information through welcome packages [7], and 3) an online depression information intervention, consisting of multilingual information about depression [11].…”

“…Only one study [9] specifically conducted measurements to gain outcomes about health literacy, and used the Test of Functional Health Literacy in Adults (TOFHLA) for this. Another study [11] aimed to measure depression literacy directly, which is a specific type of (mental) health literacy, through the Analyses of Variances (ANOVA).…”