Evaluation of an Australian Health Literacy Program Delivered in Adult Education Settings

Kirsten McCaffery, Suzanne Morony, Danielle M Muscat, Andrew Hayen, Sian K Smith, Heather Shepherd, Haryana Dhillon, Erin Cvejic, Wedyan Wedyan Meshreky, Karen Luxford, Don Nutbeam

Research output: Contribution to journalArticle

Abstract

Background: Adult education targeting health literacy (HL) may bring added value in the form of improved health.

Objective: This study evaluated the effects of a HL program as part of an adult education curriculum for adults with low literacy and numeracy.

Methods: This was a partial-cluster randomized controlled trial among 308 adults enrolled in basic education programs in Australia. Of the 308 participants, 141 (46%) were randomized to either the standard program (language, literacy, and numeracy [LLN]), or the HL intervention (LLN with embedded health content); the remainder ( n = 167) were allocated to standard intervention programs by the education provider at the class level. The main outcomes were functional HL, self-reported confidence, patient activation, generic HL (ie, HLQ, health knowledge, and self-reported health behavior). Data were collected at baseline, immediately after, and at 6 months post-intervention.

Key Results: Of the 308 participants, 71% had limited literacy and 60% spoke a language other than English at home. Both interventions benefited participants, with improvements from baseline to immediate follow up on individual-level functional HL (e.g., reading a thermometer; HL group 18.4% vs. standard group 7.2%; p = .001), confidence (HL group 0.34 vs. standard group 0.06; p = .014) and health literacy questionnaire (HLQ) subscales. At 6 months, improvements in confidence ( p < .001) and some HLQ measures were retained. A consistent pattern of increased improvement in the HL program was observed compared to the standard program, although only some measures reached statistical significance: reading a food label (HL group 6.03/10 correct vs. standard group 5.49/10 correct; p = .022); confidence ( p = .008); ability to actively manage health (HLQ) ( p = .017), and health knowledge at 6 months (HL group 68% vs. standard group 60% correct, p = .052). HL participants reported being more likely to share course information and rated the program more useful to understand their health.

Conclusions: Improving language, literacy, and numeracy generally has potential public health benefits that are retained at 6 months. Integrating health content adds further value to adult basic learning, is feasible, and potentially scalable. [ HLRP: Health Literacy Research and Practice. 2019;3(Suppl.):S42-S57.] .

Plain Language Summary: We compared the effect of an adult education-based health literacy (HL) program versus a standard language, literacy, and numeracy program on students' HL skills and psychosocial outcomes. Although students in both trial arms improved their skills, students in the HL program had better outcomes with higher HL, greater confidence, and higher health knowledge scores at 6 months.

Original languageEnglish
Pages (from-to)S42-S57
Number of pages16
JournalHLRP: Health Literacy Research and Practice
Volume3
Issue number3
DOIs
Publication statusPublished - 4 Oct 2019

Cite this

Evaluation of an Australian Health Literacy Program Delivered in Adult Education Settings. / McCaffery, Kirsten; Morony, Suzanne; Muscat, Danielle M; Hayen, Andrew; Smith, Sian K ; Shepherd, Heather; Dhillon, Haryana; Cvejic, Erin ; Wedyan Meshreky, Wedyan ; Luxford, Karen; Nutbeam, Don.

In: HLRP: Health Literacy Research and Practice, Vol. 3, No. 3, 04.10.2019, p. S42-S57.

Research output: Contribution to journalArticle

McCaffery, K, Morony, S, Muscat, DM, Hayen, A, Smith, SK, Shepherd, H, Dhillon, H, Cvejic, E, Wedyan Meshreky, W, Luxford, K & Nutbeam, D 2019, 'Evaluation of an Australian Health Literacy Program Delivered in Adult Education Settings', HLRP: Health Literacy Research and Practice, vol. 3, no. 3, pp. S42-S57. https://doi.org/10.3928/24748307-20190402-01
McCaffery, Kirsten ; Morony, Suzanne ; Muscat, Danielle M ; Hayen, Andrew ; Smith, Sian K ; Shepherd, Heather ; Dhillon, Haryana ; Cvejic, Erin ; Wedyan Meshreky, Wedyan ; Luxford, Karen ; Nutbeam, Don. / Evaluation of an Australian Health Literacy Program Delivered in Adult Education Settings. In: HLRP: Health Literacy Research and Practice. 2019 ; Vol. 3, No. 3. pp. S42-S57.
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title = "Evaluation of an Australian Health Literacy Program Delivered in Adult Education Settings",
abstract = "Background: Adult education targeting health literacy (HL) may bring added value in the form of improved health.Objective: This study evaluated the effects of a HL program as part of an adult education curriculum for adults with low literacy and numeracy.Methods: This was a partial-cluster randomized controlled trial among 308 adults enrolled in basic education programs in Australia. Of the 308 participants, 141 (46{\%}) were randomized to either the standard program (language, literacy, and numeracy [LLN]), or the HL intervention (LLN with embedded health content); the remainder ( n = 167) were allocated to standard intervention programs by the education provider at the class level. The main outcomes were functional HL, self-reported confidence, patient activation, generic HL (ie, HLQ, health knowledge, and self-reported health behavior). Data were collected at baseline, immediately after, and at 6 months post-intervention. Key Results: Of the 308 participants, 71{\%} had limited literacy and 60{\%} spoke a language other than English at home. Both interventions benefited participants, with improvements from baseline to immediate follow up on individual-level functional HL (e.g., reading a thermometer; HL group 18.4{\%} vs. standard group 7.2{\%}; p = .001), confidence (HL group 0.34 vs. standard group 0.06; p = .014) and health literacy questionnaire (HLQ) subscales. At 6 months, improvements in confidence ( p < .001) and some HLQ measures were retained. A consistent pattern of increased improvement in the HL program was observed compared to the standard program, although only some measures reached statistical significance: reading a food label (HL group 6.03/10 correct vs. standard group 5.49/10 correct; p = .022); confidence ( p = .008); ability to actively manage health (HLQ) ( p = .017), and health knowledge at 6 months (HL group 68{\%} vs. standard group 60{\%} correct, p = .052). HL participants reported being more likely to share course information and rated the program more useful to understand their health. Conclusions: Improving language, literacy, and numeracy generally has potential public health benefits that are retained at 6 months. Integrating health content adds further value to adult basic learning, is feasible, and potentially scalable. [ HLRP: Health Literacy Research and Practice. 2019;3(Suppl.):S42-S57.] . Plain Language Summary: We compared the effect of an adult education-based health literacy (HL) program versus a standard language, literacy, and numeracy program on students' HL skills and psychosocial outcomes. Although students in both trial arms improved their skills, students in the HL program had better outcomes with higher HL, greater confidence, and higher health knowledge scores at 6 months.",
author = "Kirsten McCaffery and Suzanne Morony and Muscat, {Danielle M} and Andrew Hayen and Smith, {Sian K} and Heather Shepherd and Haryana Dhillon and Erin Cvejic and {Wedyan Meshreky}, Wedyan and Karen Luxford and Don Nutbeam",
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T1 - Evaluation of an Australian Health Literacy Program Delivered in Adult Education Settings

AU - McCaffery, Kirsten

AU - Morony, Suzanne

AU - Muscat, Danielle M

AU - Hayen, Andrew

AU - Smith, Sian K

AU - Shepherd, Heather

AU - Dhillon, Haryana

AU - Cvejic, Erin

AU - Wedyan Meshreky, Wedyan

AU - Luxford, Karen

AU - Nutbeam, Don

N1 - © 2019 McCaffery, Morony, Muscat, et al.

PY - 2019/10/4

Y1 - 2019/10/4

N2 - Background: Adult education targeting health literacy (HL) may bring added value in the form of improved health.Objective: This study evaluated the effects of a HL program as part of an adult education curriculum for adults with low literacy and numeracy.Methods: This was a partial-cluster randomized controlled trial among 308 adults enrolled in basic education programs in Australia. Of the 308 participants, 141 (46%) were randomized to either the standard program (language, literacy, and numeracy [LLN]), or the HL intervention (LLN with embedded health content); the remainder ( n = 167) were allocated to standard intervention programs by the education provider at the class level. The main outcomes were functional HL, self-reported confidence, patient activation, generic HL (ie, HLQ, health knowledge, and self-reported health behavior). Data were collected at baseline, immediately after, and at 6 months post-intervention. Key Results: Of the 308 participants, 71% had limited literacy and 60% spoke a language other than English at home. Both interventions benefited participants, with improvements from baseline to immediate follow up on individual-level functional HL (e.g., reading a thermometer; HL group 18.4% vs. standard group 7.2%; p = .001), confidence (HL group 0.34 vs. standard group 0.06; p = .014) and health literacy questionnaire (HLQ) subscales. At 6 months, improvements in confidence ( p < .001) and some HLQ measures were retained. A consistent pattern of increased improvement in the HL program was observed compared to the standard program, although only some measures reached statistical significance: reading a food label (HL group 6.03/10 correct vs. standard group 5.49/10 correct; p = .022); confidence ( p = .008); ability to actively manage health (HLQ) ( p = .017), and health knowledge at 6 months (HL group 68% vs. standard group 60% correct, p = .052). HL participants reported being more likely to share course information and rated the program more useful to understand their health. Conclusions: Improving language, literacy, and numeracy generally has potential public health benefits that are retained at 6 months. Integrating health content adds further value to adult basic learning, is feasible, and potentially scalable. [ HLRP: Health Literacy Research and Practice. 2019;3(Suppl.):S42-S57.] . Plain Language Summary: We compared the effect of an adult education-based health literacy (HL) program versus a standard language, literacy, and numeracy program on students' HL skills and psychosocial outcomes. Although students in both trial arms improved their skills, students in the HL program had better outcomes with higher HL, greater confidence, and higher health knowledge scores at 6 months.

AB - Background: Adult education targeting health literacy (HL) may bring added value in the form of improved health.Objective: This study evaluated the effects of a HL program as part of an adult education curriculum for adults with low literacy and numeracy.Methods: This was a partial-cluster randomized controlled trial among 308 adults enrolled in basic education programs in Australia. Of the 308 participants, 141 (46%) were randomized to either the standard program (language, literacy, and numeracy [LLN]), or the HL intervention (LLN with embedded health content); the remainder ( n = 167) were allocated to standard intervention programs by the education provider at the class level. The main outcomes were functional HL, self-reported confidence, patient activation, generic HL (ie, HLQ, health knowledge, and self-reported health behavior). Data were collected at baseline, immediately after, and at 6 months post-intervention. Key Results: Of the 308 participants, 71% had limited literacy and 60% spoke a language other than English at home. Both interventions benefited participants, with improvements from baseline to immediate follow up on individual-level functional HL (e.g., reading a thermometer; HL group 18.4% vs. standard group 7.2%; p = .001), confidence (HL group 0.34 vs. standard group 0.06; p = .014) and health literacy questionnaire (HLQ) subscales. At 6 months, improvements in confidence ( p < .001) and some HLQ measures were retained. A consistent pattern of increased improvement in the HL program was observed compared to the standard program, although only some measures reached statistical significance: reading a food label (HL group 6.03/10 correct vs. standard group 5.49/10 correct; p = .022); confidence ( p = .008); ability to actively manage health (HLQ) ( p = .017), and health knowledge at 6 months (HL group 68% vs. standard group 60% correct, p = .052). HL participants reported being more likely to share course information and rated the program more useful to understand their health. Conclusions: Improving language, literacy, and numeracy generally has potential public health benefits that are retained at 6 months. Integrating health content adds further value to adult basic learning, is feasible, and potentially scalable. [ HLRP: Health Literacy Research and Practice. 2019;3(Suppl.):S42-S57.] . Plain Language Summary: We compared the effect of an adult education-based health literacy (HL) program versus a standard language, literacy, and numeracy program on students' HL skills and psychosocial outcomes. Although students in both trial arms improved their skills, students in the HL program had better outcomes with higher HL, greater confidence, and higher health knowledge scores at 6 months.

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DO - 10.3928/24748307-20190402-01

M3 - Article

C2 - 31687657

VL - 3

SP - S42-S57

JO - HLRP: Health Literacy Research and Practice

JF - HLRP: Health Literacy Research and Practice

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ER -