Understanding and Assessing Literacy

Michelle M. Cueto, PTRP, MASEd

Literacy
The ability to read and speak US Department of Education defined as the ability to use printed and written information to function in society, to achieve ones goal and to develop ones knowledge and potential.

Category of literacy into 3 general kinds of task

1. Prose task

Which measure reading comprehension and the ability to extract themes from newspaper, magazines, poems and books
2. Document task

Which assess the ability of readers to interpret documents such as insurance reports, consent forms and transportation schedules
3. Quantitative task

Which assess the ability to work with numerical information embedded in written materials such as computing restaurant menu bills, figuring out taxes, interpreting paychecks stubs, or calculating calories on a nutrition checklist.

4 classification levels of NALS Literacy test

Level I. BELOW BASIC Ranges from non literate English to the ability to find simple information in the prose text. Can perform simple math such as addition Level 2 BASIC Understand information in short prose text with everyday language. Can use numbers to solve simple one-step arithmetic problem such as comparing 2 prices Level 3 INTERMEDIATE Understand and can locate information in fairlt dense prose and documents and can make simple inferences from them. Can solve quantitative problems even when the necessary steps are not previous Level 4 PROFICIENT Understand complex prose and analyze complex documents. Can solve multistep arithmetic problems

Assessing Literacy
People with low literacy give us clues that can lead us to a realization that they may have a reading or comprehension problem:
1. Not even attempting to read printed materials

2. Asking to take PEMS home to discuss with SO

3. Claiming that eyeglasses were left at home 4. Stating that they cannot read something because they are too tired or they do not feel well.

5. Avoiding discussion of written material or not asking questions about it

6. Mouthing words as they try to read

2 test used to measure patient literacy

REALM rapid estimate of adult literacy in medicine
It measures ability to read medical and health related vocabulary, it takes less time to administer, the scoring is simpler and is well recieved by most clients

WRAT

Wide Range Achievement Test

It is a word recognition screening test. It is used to asses a learners ability to recognize and pronounce a list of words out of context as a criterion for measuring reading skills.

Teaching people with low literacy

Assessing reading ability is only the first step in the process of health education for people with low literacy skills The second step is planning an approach to teaching that will best meet the needs of individuals in this group.

Steps in teaching people with low literacy

Set objectives that are realistic for person level of understanding. Choose information that will meet the objectives and pare it down to the minimum amount that is necessary. Keep instruction simple by breaking them down into smaller units. For example:when teaching about taking digoxin, first teach a liitle about the action of the drug, then how to take the pulse rate and the need for follow up visit If possible, use more then one teaching method to reinforce the learning.computer or videotape In the process of teaching, use examples and analogies with which the person can relate. Use familiar illustrations and pictures that are culturally relevant Be creative in evaluating them , ask them to repeat what you have said in their own words.

Developing Printed Educational Materials

Consider the following:

Organizational Factors 1. Include a short but descriptive title 2. Use brief heading and subheadings 3. Incorporate only one idea per paragraph, and be sure the first semester is the topic sentence 4. Divide complex instruction into small steps 5. Consider using a question-answer format 6. Address no more than three or four main points 7. Reinforce main points with a summary at the end

Linguistic Factors
Keep the reading level at grade 5 and 6 to make the material understdable to most low literate persons Use mostly one or two syllable words and short sentences

Use a personal and conversational style.

For example: you should weigh yourself everyday is preferable. Define technical terms if they must be used. Use words consistently throughout the text

Example: stay with pill rather than medicine

Avoid the use of idioms that mean different thing to other people. The term junk food may mean different to other people Use graphics and language that are culturally and age relevant for the intended audience Use active rather than passive voice Example: take one pill every morning rather than A pill should be taken every morning Incorporate examples and simple analogies to illustrate concepts

 Avoid a cluttered appearance by including enough white space Include simple diagrams that are well labeled Use upper and lower case letter. All capitals are difficult to evryone to read 12 to 14 serif is preferred Placed emphasized word on bold do not use capital Use list when appropriate Try to limit limit line length of no more than 50 or 60 characters

Appearance factors

Information literacy
Information literacy is the ability to identify the need for information; to collect, evaluate, and interpret ; and it use appropriately. Computer literacy is a basis for information literacy, because the nurse must be able to use the computer in order to access information.