From A to Z: Weekly Treasures

From the Oak Cliff Advocate, a story about a literacy tutor helping to make a difference in Texas. I LOVE stories like these!!

The Open Doors program in Winnipeg Canada is helping to change the learning experience for adults who can not read. Here is the whole story from The Times website.

Ok, this is so cool. I found out about this on the BBC website. Well known personalities in South Wales were approached to write short novels that are aimed at new adult readers. What I want to know is when are we going to do this in the US?

Quick reads boost adult learners

Health literacy is a two-way street. Agreed Agreed! Check out this blog post from the timesunion.com. It is written by a doctor who seems to understand that improving health literacy comes from both sides. I really enjoyed the "Mom's RX" list at the bottom, especially the advice: "Talk to your doctor when you are fully dressed, not while sitting in a hospital gown."

Take this test which is an excerpt from he Newest Vital Sign written by Dr. Barry Weiss. This blog post written by Joe Rojas-Burke challenges: "Are you health literate?"

This video of an adult literacy student named Edward is so awesome! Brings a tear to my eye!

Literacy is NOT Defined as Reading

A common misconception among most people is that just because you can read you are literate. Not true. What if you don't understand what you are reading?






What do you think when you read the word "Hypertension"? Of course if you are a doctor or nurse, or actually suffer from this and have learned what it is you would know. But what if you have never heard this term before, you go to your doctor, and they say, "well you are suffering from hypertension so I want you to take this prescription and come back in a month." If you don't specifically ask what it means what would you think? I am too tense maybe?


A study done by the CDC (Centers for Disease Control) back in 1996 showed that patients with low literacy thought the term "high tension" (what they used to call hypertension) meant "a disease of the nerves caused by stress, worry, or an anxious personality." The book Explaining Illness: research, theory, and strategies, written by Bryan B. Whaley, says that these patients "believed the way to treat "high pretension" was to rest and relax-to take it easy."


I looked up the word and it means, High Blood Pressure. I don't even know what that means. The medical websites say it is high tension in the arteries. Well what does that even mean? There are a lot of words that I did not understand when I tried to look it up. Systolic, Diastolic, oh and then there was pre-hypertension.


Basically after wading through all those terms I got to the heart of the matter, and basically if you have a "High Blood Pressure" (what is high anyway), you could die from it.


So if an adult, with only a 3rd or 4th grade reading level, or an immigrant who does not understand the language very well and is maybe somewhat intimidated by the whole health care system was told they have "hypertension" with no other explanation; would they know what it meant? Would they know where to go to find out? What is the likelihood that they will do what is required to take care of it?


Here is another example. You walk into a doctor's office and the receptionist hands you the "Privacy Statement" that you are required to sign. If you are like me you just sign it without really thinking about it, because let's face it I am there to see the doctor and whatever I need to do to get into that room faster and get out and on with my life I am going to do.


But I challenge you to actually read it the next time, and tell me honestly if you recognize all of the words and acronyms that are used throughout. Here is an excerpt taken from a local doctor's privacy statement:





Okay, because I am pretty well read and went to college and was forced at college to learn most of the words in this paragraph, I think I can easily figure out the gist of it. But what about an adult that only reads at a 3rd grade level. Do you think they would understand this paragraph? The word "Pursuant" for example. Or "Provision" or "Disclosure".


These privacy statements aren't life threatening, and they aren't meant to hurt us as patients, but they are confusing and somewhat intimidating in nature. Isn't that how most forms are at the doctor's office, or hospital, or clinic?


I went to an in-service on Tuesday at the Plainfield Public Library. It was titled: "What Adult Literacy Tutors can do to Increase Health Literacy." This workshop was taught by a well known expert in the field of Health Literacy. She is one of the founders of the Health Coalition of NJ and has given many workshops to tutors, students, and even health care professionals.

First question: What is Health Literacy? Well Health Literacy is defined many different ways actually, and has changed throughout the years. One definition put forth by The Centre for Literacy of Quebec states:

• Health literacy allows the public and personnel working in all health-related contexts to find, understand, evaluate, communicate and use information.
• Health literacy is the use of a wide range of skills that improve the ability of people to act on information in order to live healthier lives.
• These skills include reading, writing, listening, speaking, numeracy, and critical analysis, as well as communication and interaction skills.

All these skills are required to be able to understand health and wellness: Reading, Writing, Speaking, Numeracy, and Critical Analysis.

Honestly it never occurred to me how really cut off low literate people are from really understanding health care. I am thankful for this workshop, for opening my eyes to the facts.

I learned that according to the 2003 National Assessment of Adult Literacy that 88% of the country is below the proficient level in health literacy. To me that is way too high and it is so obvious that there is a clear disconnect between how the information is being given to us and how it is received.

So what can be done? The workshop presenter gave us tutors, tips and ideas, and resources to use to help introduce the topic into our tutoring. But she also mentioned that it is a two way street. She feels, and I agree, that the health care providers need to learn to make it simple. That doesn't mean dumb it down, it means make it easier for everyone to understand the important information that we as patients need to know. And maybe doctor's and even nurses could take a little extra time to make sure their patients really understand and not just assume that they do.

My mother is a nurse and I have an aunt who is a doctor, and I have many friends who are in medical professions. I love these people and have learned many important things from them, and because of them I do not feel intimidated to ask questions. But I know many people still are, and I challenge those who work in this profession to learn to look out for these patients. In the mean time I will do my best to help my student with whatever health literacy needs she has or wants.

If you would like more information about Health Literacy in NJ, please click here:

"Going slow does not prevent arriving." ~Nigerian Proverb

Life is overwhelming in general for me as it is for most people. I am a mother and wife and I work part time and help out at my daughters' school all the time. I feel like every day I am going 60 miles an hour and sometimes I forget to slow down and enjoy something that I am doing. When I am tutoring D, I am forced to slow down and revel in the process of learning and teaching. I leave our sessions actually breathing slower and feeling more calm. We read a story together and talk about it and I help her learn new words and understand them and while we only get through one story in an hour, it feels like longer because we take our time. While I know I am helping to teach her something new each week, she is inadvertently teaching me about patience.

D never comes to class prepared. I have been asking her to buy a cheap spiral bound notebook and maybe a little journal and some pencils since the first week we started. She has never brought them. I never say anything negative about it, I just keep reminding her to bring them. She also does not do homework most days, but I still try and give her at least one small assignment to do each week.

D is still a child in many ways, she lives at home still, relies on her family for most things like transportation and she actually whines sometimes to me about how hard the reading and writing is for her. I finally brought her a small examination booklet to use as a journal, just to get her writing. I asked her what she might be interested in writing about, she shrugged her shoulders. I asked her what her favorite t.v. shows were. She started naming some shows that my 10 year old daughter watches. She said "I am still a big kid." I smiled and said, we all have a kid in us.

I tell her all the time, "you CAN read, and you are very capable of learning to read more, you just need to practice, and they only way to practice reading, is to READ." She usually looks at me and smiles and says, "yeah I know."

So how do you motivate a student who has never been motivated to learn to read or write fluently. They teach us all about goal setting in tutor training, using the SMART goal system. But she has only one goal in mind, to pass her online masseuse course and get a job. It is not going to happen that way. The goals need to be broken down into smaller pieces. This is something I am determined to work on with her next week. Otherwise she will never be motivated to do the work in between now and her ultimate goal.

Some new things I have learned: 1. She really enjoys reading magazines. We tried with some People magazines for a couple of weeks, because she told me she is really into gossip and entertainment news. But she stumbled over so many of the words that I knew it was too advanced. So I thought about some kids magazines. I pulled a National Geographic for kids and a Girl's Life magazine out and let her choose. She picked the Girl's Life magazine and did much better with the reading. She really enjoys reading human interest stories and I noticed that once she got into the story she was reading much more fluently, and sounding out words without me having to remind her. She would stop after each paragraph and ask me questions about the story and I would smile and say, "let's keep reading and find out."

2. Also as you can see in the picture above I have her use a pencil point to keep track of the words while she is reading, and it has helped so much with helping her keep track of where she is and to focus on really reading each word. When she gets to a word that she doesn't immediately recognize she often tries to guess at it, but I make her sound it out. I use my thumb and finger to cover parts of the word to help her break it down.

I will continue to push her, though I have learned it can not be too much. I will continue to push myself and keep learning new things and new ways to help her learn. Next week we will be working on some short term goals, and I am going to try reading a play with her, I think the back and forth of the dialogue will be an interesting change.

The business of tutoring continues everywhere, everyday, and I am really enjoying being a part of the process. I am reminded each week that patience and caring can go so far. Until next week...