Investigating Health Literacy Levels of Individuals Enrolled in GED and English Learning Programs

Abstract

Idea: A survey administered to adults enrolled in GED and English learning classes to assess their health literacy. Need/Rationale: Health literacy is defined as the ability for someone to obtain and understand health information to make informed decisions about their healthcare. Numerous studies have shown that low health literacy leads to poor health outcomes, making health literacy a significant social determinant of health (1). Low health literacy has been linked to populations such as minorities, persons with limited educational background and English proficiency skills, as well as those of low socioeconomic status (2). The Literacy Alliance (LA) is an organization in Fort Wayne, Indiana, that provides individuals with a limited educational background or low English proficiency an opportunity to obtain a high school diploma, skill certificates, and positions in the workforce. LA wants to understand if their program has an impact on improving students' health literacy. Through survey administration, this project aims to determine if there are connections between a student’s education level and their comfort with navigating the healthcare system. The results of the survey will allow changes to the Literacy Alliance’s programs and put their students in contact with resources to improve their health literacy. Methods: The goal of the project is to examine the current states of comfort with navigating the healthcare system in adults who are seeking a GED and those who are learning English as a second language. The population sample is recruited through LA, a local non-profit organization focused on providing literacy education in the Fort Wayne community. Any student who is getting their GED or taking English classes with LA are eligible to complete an anonymous survey that assesses their current level of comfort with visiting a doctor, expressing their medical concerns, and advocating for their medical care. The surveys are completed once, prior to the start of class. Responses to the surveys are analyzed to examine the state of comfort in navigating the medical system between native vs non-native English speakers and between levels of English proficiency. The overall comfort levels in adult learners will also be assessed. If the majority of students are reporting low levels of comfort and inability to express medical concerns, community/classroom resources will be created in order to address these issues. The results will then be presented to LA in order to provide them with more evidentiary support for their mission of increasing literacy and improving health outcomes in Fort Wayne. The project is estimated to take place from September 2023 through February 2024, pending approval from Indiana University School of Medicine Institutional Review Board. Evaluation Plan: A student interest and skill set survey will be given prior to the start of the research to help select students best fit for the project. Throughout the project, periodic email check-ins will be sent to our community partner, Literary Alliance, and GroupMe messages will be sent to the participating medical students to assess project satisfaction and also project progress. At the end of the project, satisfaction surveys will be administered to our community partner, and all the medical students involved to further assess the strengths and weaknesses of our research project. To measure self-improvement in project planning, data collection, data entry and analysis, and presentation skills, pre and post-surveys will be given to the medical students. Furthermore, pre and post-surveys will be administered to assess medical students’ satisfaction on engaging in a community-based research project, learning how to administer and analyze survey data, understanding social determinants of health, and addressing real-world health-related community issues. Potential Impact: Assessing comfort levels during healthcare visits highlights areas of anxiety that non-native English speakers and low educational background individuals face when navigating the healthcare system. This project can provide interventions that LA can implement to combat issues these individuals face to increase health literacy and health outcomes. References:

Nutbeam D, Lloyd JE. Understanding and Responding to Health Literacy as a Social Determinant of Health. Annu Rev Public Health. 2021;42:159-173. doi:10.1146/annurev-publhealth-090419-102529 Schillinger D. The Intersections Between Social Determinants of Health, Health Literacy, and Health Disparities. Stud Health Technol Inform. 2020;269:22-41. doi:10.3233/SHTI200020