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Journal of Community Health

, Volume 40, Issue 3, pp 431–438 | Cite as

A Multisite Community-Based Health Literacy Intervention for Spanish Speakers

  • F. Soto MasEmail author
  • C. Cordova
  • A. Murrietta
  • H. E. Jacobson
  • F. Ronquillo
  • D. Helitzer
Original Paper

Abstract

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.

Keywords

Hispanics English language ESL Collaborative 

Notes

Acknowledgments

This project was supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences of the National Institutes of Health through Grant Number 8UL1TR000041. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The authors thank the University of New Mexico Office of Community Health for its contribution to the project. Many thanks to Mr. Frank Martinez and the Citizens Information Committee of Martineztown. We also thank the Martineztown House of Neighborly Service and Santa Barbara/Martineztown Neighborhood Association.

References

  1. 1.
    Ratzan, S. C., & Parker, R. M. (2000). Introduction. In C. R. Selden, M. Zorn, S. C. Ratzan, & R. M. Parker (Eds.), National library of medicine current bibliographies in medicine: Health literacy. Vol. NLM Pub. No. CBM 2000-1. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services.Google Scholar
  2. 2.
    Baker, D. W., Wolf, M. S., Feinglass, J., & Thompson, J. A. (2008). Health literacy, cognitive abilities, and mortality among elderly persons. Journal of General Internal Medicine, 23(6), 723–726.CrossRefPubMedCentralPubMedGoogle Scholar
  3. 3.
    Berkman, N. D., DeWalt, D. A., Pignone, M. P., et al. (2004). Literacy and health outcomes (AHRQ Publication No. 04-E007-2). Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
  4. 4.
    Nielsen-Bohlman, L., Panzer, A. M., & Kindig, D. A. (Eds.). (2004). Health literacy: A prescription to end confusion. Washington, DC: National Academies Press.Google Scholar
  5. 5.
    Cheng, T. L., Dreyer, B. P., & Jenkins, R. R. (2009). Introduction: Child health disparities and health literacy. Pediatrics, 124(Suppl 3), S161–S162.CrossRefPubMedGoogle Scholar
  6. 6.
    Hasnain-Wynia, R., & Wolf, M. S. (2010). Promoting health care equity: Is health literacy a missing link? Health Services Research, 45(4), 897–903.CrossRefPubMedCentralPubMedGoogle Scholar
  7. 7.
    Kelly, P. A., & Haidet, P. (2007). Physician overestimation of patient literacy: A potential source of health care disparities. Patient Education and Counseling, 66(1), 119–122.CrossRefPubMedGoogle Scholar
  8. 8.
    Horowitz, A. M., & Kleinman, D. V. (2012). Oral health literacy: A pathway to reducing oral health disparities in Maryland. Journal of Public Health Dentistry, 72(Suppl 1), S26–S30.CrossRefPubMedGoogle Scholar
  9. 9.
    Paasche-Orlow, M. K., & Wolf, M. S. (2010). Promoting health literacy research to reduce health disparities. Journal of Health Communication, 15(Suppl 2), S34–S41.CrossRefGoogle Scholar
  10. 10.
    Sentell, T. L., & Halpin, H. A. (2006). Importance of adult literacy in understanding health disparities. Journal of General Internal Medicine, 21(8), 862–866.CrossRefPubMedCentralPubMedGoogle Scholar
  11. 11.
    U.S. Department of Education. (2006). National assessment of adult literacy (NAAL): A first look at the literacy of America’s adults in the 21st century (NCES Publication No. 2006-470). Washington, DC: Institute of Education Sciences.Google Scholar
  12. 12.
    Kutner, M., Greenberg, E., Jin, Y., & Paulsen, C. (2006). The health literacy of America’s adults: Results from the 2003 National Assessment of Adult Literacy (NCES 2006–483). U.S. Department of Education. Washington, DC: National Center for Education Statistics.Google Scholar
  13. 13.
    Berkman, N. D., DeWalt, D. A., Pignone, M. P., et al. (2004). Literacy and health outcomes (AHRQ Publication No. 04-E007-2). Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
  14. 14.
    U.S. Department of Health and Human Services. (2010). National Action Plan to Improve Health Literacy. DHHS, Office of Disease Prevention and Health Promotion. Washington, DC: Author.Google Scholar
  15. 15.
    Ryan, C. (2013). Language use in the United States: 2011. American Community Survey Reports. U.S. Department of Commerce, Economics and Statistics Administration, U.S. CENSUS BUREAU, August.Google Scholar
  16. 16.
    Creighton, S., & Hudson, L. (2002). Participation trends and patterns in adult education: 1991 to 1999 (NCES Technical Report No. 2002-119). Washington DC: U.S. Department of Education, Office of Educational Research and Improvement.Google Scholar
  17. 17.
    Singleton, K. (2002). Health literacy and adult English language learner. Washington, DC: National Center for ESL Literacy Education, Center for Applied Linguistics.Google Scholar
  18. 18.
    Rudd, R. E., Zahner, L., & Banh, M. (1999). Findings from a national survey of state directors of adult education. Harvard School of Public Health, The National Center for the Study of Adult Learning and Literacy (NCSALL) Reports #9, Cambridge, MA, January.Google Scholar
  19. 19.
    Povenmire, A. V., & Hohn M. (2001). Why teach health. Field Notes 10(4), Spring.Google Scholar
  20. 20.
    LaMachia, J., & Morris, E. (2001). Teachers’ concerns about incorporating health into adult education. Field Notes, 10(4), Spring.Google Scholar
  21. 21.
    Rudd, R. E., Zacharai, C., & Daube, K. (1998). Integrating health and literacy: Adult educators’ experiences. National Center for the Study of Adult Learning and Literacy. NCSALL Reports #5. Cambridge, MA, August.Google Scholar
  22. 22.
    Rudd, R. E., Moeykens, B. A., & Colton, T. C. (1999). Health and literacy: A review of medical and public health literature. In J. Comins, B. Garners, & C. Smith (Eds.), Annual review of adult learning and literacy. New York: Jossey-Bass.Google Scholar
  23. 23.
    Brice, J. H., Travers, D., Cowden, C. S., Young, M. D., Sanhueza, A., & Dunston, Y. (2008). Health literacy among Spanish-speaking patients in the emergency department. Journal of the National Medical Association, 100(11), 1326–1332.PubMedGoogle Scholar
  24. 24.
    Garbers, S., Schmitt, K., Rappa, A. M., & Chiasson, M. A. (2010). Functional health literacy in Spanish-speaking Latinas seeking breast cancer screening through the National Breast and Cervical Cancer Screening Program. International Journal of Women’s Health, 9(1), 21–29.Google Scholar
  25. 25.
    Koskan, A., Friedman, D. B., & Messias, D. K. H. (2010). Health literacy among Hispanics: A systematic research review (1992–2008). Hispanic Health Care International, 8(2), 65–76.CrossRefGoogle Scholar
  26. 26.
    Penaranda, E., Diaz, M., Noriega, O., & Shokar, N. (2012). Evaluation of health literacy among Spanish-speaking primary care patients along the US–Mexico border. Southern Medical Journal, 105(7), 334–338.CrossRefPubMedGoogle Scholar
  27. 27.
    Sudore, R. L., Landefeld, C. S., Pérez-Stable, E. J., Bibbins-Domingo, K., Williams, B. A., & Schillinger, D. (2009). Unraveling the relationship between literacy, language proficiency, and patient-physician communication. Patient Education and Counseling, 75(3), 398–402.CrossRefPubMedCentralPubMedGoogle Scholar
  28. 28.
    Fuentes, B., Soto Mas, F., Mein, E., & Jacobson, H. (2011). Un currículo interdisciplinario de base teórica para enseñar inglés como segunda lengua (An interdisciplinary theory-based ESL curriculum). Colombian Journal of Applied Linguistics, 13(2), 60–73.Google Scholar
  29. 29.
    Soto Mas, F., Ji, M., Fuentes, B., & Tinajero, J. (2014). The health literacy & ESL study: A community-based intervention for Spanish speaking adults. Journal of Health Communication. doi: 10.1080/10810730.2014.965368.
  30. 30.
    Soto Mas, F., Mein, E., Fuentes, B., Thatcher, B., & Balcázar, H. (2013). Integrating health literacy and ESL: An interdisciplinary curriculum for Hispanic immigrants. Health Promotion Practice, 14(2), 263–273.CrossRefPubMedGoogle Scholar
  31. 31.
    U.S. Census Bureau, (n.d.). Community Facts. 2008–2012 American Community Survey 5-Year Estimates. Retrieved September 15, 2014, from http://factfinder2.census.gov/faces/nav/jsf/pages/community_facts.xhtml.
  32. 32.
    Khanlian, S., & Scharmen, T. (2005). Albuquerque and Bernalillo County zip code maps. Health and social indicators. New Mexico Department of Health, Public Health Division, District 1. Office of Community Assessment, Planning and Evaluation.Google Scholar
  33. 33.
    Soto Mas, F., Fuentes, B. O., Arnal, P., Mein, E., & Tinajero, J. (2013). Health literacy & ESL curriculum. MedEdPORTAL. Retrieved September 15, 2014, from https://www.mededportal.org/publication/9420.
  34. 34.
    Parker, R. M., Baker, D. W., Williams, M. V., & Nurss, J. R. (1995). The test of functional health literacy in adults: A new instrument for measuring patients’ literacy skills. Journal of General Internal Medicine, 10(10), 537–541.CrossRefPubMedGoogle Scholar
  35. 35.
    Kirsch, I., Jungeblut, A., Jenkins, L., & Kolstad, A. (Eds.). (1993). Adult literacy in America: A first look at the National Adult Literacy Survey (NALS). Washington, DC: U.S. Department of Education.Google Scholar
  36. 36.
    Pippins, J. R., Alegría, M., & Haas, J. S. (2007). Association between language proficiency and the quality of primary care among a national sample of insured Latinos. Medical Care, 45(11), 1020–1025.CrossRefPubMedCentralPubMedGoogle Scholar
  37. 37.
    Boyas, J. F. (2013). Correlates of health literacy among Latinos in Arkansas. Social Work in Public Health, 28(1), 32–43.CrossRefPubMedGoogle Scholar
  38. 38.
    Sentell, T., & Braun, K. L. (2012). Low health literacy, limited English proficiency, and health status in Asians, Latinos, and other racial/ethnic groups in California. Journal of Health Communication, 17(Suppl 3), S82–S99.CrossRefGoogle Scholar
  39. 39.
    Mas, F. S., Jacobson, H. E., & Dong, Y. (2014). Health literacy level of Hispanic college students. Southern Medical Journal, 107(2), 61–65. doi: 10.1097/SMJ.0000000000000050.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • F. Soto Mas
    • 1
    Email author
  • C. Cordova
    • 2
  • A. Murrietta
    • 2
  • H. E. Jacobson
    • 3
  • F. Ronquillo
    • 4
  • D. Helitzer
    • 5
  1. 1.Public Health Program, Department of Family and Community Medicine, MSC09 50601 University of New MexicoAlbuquerqueUSA
  2. 2.Clinical and Translational Science CenterUniversity of New MexicoAlbuquerqueUSA
  3. 3.Department of Linguistics, MSC 03 21301 University of New MexicoAlbuquerqueUSA
  4. 4.Office of Community HealthUniversity of New Mexico Health Sciences CenterAlbuquerqueUSA
  5. 5.Department of Family and Community Medicine, School of Medicine, MSC09 50401 University of New MexicoAlbuquerqueUSA

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