Assessment of Adult Literacy
Assessment of Adult Literacy
Patient–physician communication Drug labeling medical instructions and medical compliance Health information publications and other resources Informed consent Responding to medical and insurance forms Giving patient history Public health training Assessments for allied professional programs, such as social work and speech-language pathology
It is alarming that these skills and strategies are absent in more than half of the U.S. population. This fact is more disturbing when one considers that these are the very skills and strategies that often lead to longer life, improved quality of life, reduction of both chronic disease and health disparities, and cost savings. Health literacy is estimated to cost $106 billion to $238 billion annually (National Network of Libraries of Medicine, 2014).
According to the Agency for Healthcare Research and Quality (AHRQ), low health literacy is linked to higher risk of death and more emergency room visits and hospitalizations. Health literacy may not be related to years of education or general reading ability. A person who functions adequately at home or work may have marginal or inadequate literacy in a health care environment (National Network of Libraries of Medicine, 2014).
The National Assessment of Adult Literacy (NAAL) measures the health literacy of adults living in the United States. Health literacy was reported using four performance levels: Below Basic, Basic, Intermediate, and Proficient. According to the NAAL, approximately 36% of adults in the United States have limited health literacy: 22% have Basic and 14% have Below Basic health literacy. An
additional 5% of the population is not literate in English. Only 12% of the population has a proficient health literacy level (National Network of Libraries of Medicine, 2014).
Here are some tips for working with people with low literacy:
Speak Slowly and Clearly: Not Loudly.
Repeat if Necessary: Make it clear at the outset that you are happy to repeat anything you say in conversation.
Avoid Acronyms, Idioms, and Abbreviations: The medical culture has a language of its own that includes many acronyms such as ED, HMO, and NPO. Take the time to say words the long way and avoid terms that will create confusion for non-native speakers. It is best when setting appointments to say “ eight o’clock in the morning” instead of “ 8 a.m.” Common expressions and idioms also can block communication. If you say “ I’ll run that past the doctor,” a patient with limited English proficiency may literally picture you running to the doctor, which sounds urgent when you intended a casual tone.
You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.