Evaluating Comfort in Accessing Healthcare Among Adult Learners in GED and English Language Programs

Abstract

Problem Statement: This research examines health anxiety and comfort with healthcare providers among adults seeking a high school equivalency degree and those learning English as a second language. 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 that provides individuals with limited education or low English proficiency an opportunity to obtain a high school diploma, skill certificates, and/or positions in the workforce. Through survey administration, this project aimed to determine if there was a connection between a student’s education level and their comfort with navigating the healthcare system. The results of the survey created changes to the Literacy Alliance’s programs and helped put their students in contact with resources to improve their health literacy. Additionally, the data collected during this project was used in a grant proposal for LA, which could further help fund its program and mission. 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 General Education Development (GED) and those who are learning English as a second language. The population sample was recruited through LA, a local non-profit organization focused on providing literacy education in the Fort Wayne community. Any student obtaining their GED or taking English classes with LA was 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 were completed once, prior to the start of class, and were administered by us, the research team. They were collected from 2/26/24 until 4/29/24. Responses to the surveys were analyzed using a one-tailed t-test to examine the presence of a difference in the level of comfort in navigating the medical system between native and non-native English speakers. The overall comfort level of adult learners as well as specific reasons for discomfort were also assessed. The data was presented to LA in addition to a pamphlet covering general health information which was distributed to students at LA. Results: Overall comfort engaging with the healthcare system was graded on a 1-5 scale based on responses to survey questions ranging from Strongly Disagree to Strongly Agree. The average score for all students was 3.6, which corresponds to a neutral to slight comfortability in interacting with the healthcare system. Non-native English speakers had an average score of 3.61 (n=77, SD=0.70). Native English speakers had an average score of 3.57 (n=21, SD=0.57). No statistically significant difference was found between the comfort levels of native English vs non-native English speakers (p=0.39). Question 7 assessed specific reasons that students would feel uncomfortable when attempting to access medical care. Forty-five percent of non-native English speakers reported that low English proficiency was a primary reason for being uncomfortable interacting with the healthcare system. Thirty-seven percent also reported cost of healthcare as a barrier to comfortably accessing medical care. For native English speakers, cost of healthcare was the most common reason provided for discomfort interacting with the medical system, with 27% of respondents choosing this answer. Past negative experiences with the healthcare system were reported by 18% of native English speakers and 9% of non-native speakers. Potential Impact or Lessons Learned: There was no significant difference in comfort levels between adult learners in GED and English Language programs. However, with non-native English speakers reporting low proficiency as a reason for being uncomfortable, more efforts are needed to advertise the translation services at healthcare facilities to non-native English speaking communities. References:

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