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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
3219.0: Monday, December 12, 2005 - 12:30 PM

Abstract #111333

Expecting the Best: Formative evaluation of a health education and English instruction program for adult English language learners

Sandra J. Diehl, MPH, Coastal Area Health Education Center, PO Box 9025, Wilmington, NC 28402-9025, 910-343-0161, sandy.diehl@coastalahec.org, Merry-K. Moos, RN, FNP, MPH, Dept. of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, University of North Carolina at Chapel Hill, CB # 7570, 213 MacNider Hall, Chapel Hill, NC 27599, Carrie Fesperman, BID, Health Behavior and Health Education, The University of North Carolina at Chapel Hill, Rosenau Hall, Chapel Hill, NC 27514, and Katie J. Waters, The North Carolina Community College System, 200 W. Jones Street, Caswell Building, Raleigh, NC 27603.

Background: Low health literacy is a serious problem that is linked to poor health status and outcomes. Adults with limited English proficiency are a growing multicultural population who are disproportionately affected by low health literacy. We created: (1) a curriculum that provides health care, nutrition, and fitness information through English as a Second Language (ESL) classes; and (2) a model state-level partnership between literacy and health organizations to facilitate program development, implementation, and evaluation.

Methods: A formative evaluation guided the development of our program; one piece addressed satisfaction with the curriculum; another addressed program implementation. Student and instructor surveys administered anonymously at each class site after each lesson provided satisfaction data. Statewide meetings with ESL administrators, instructors, and health care professionals and meetings with an interdisciplinary state-level advisory board informed program implementation.

Results: Nineteen lessons were piloted in 17 community college and community-based ESL class sites in 9 counties. Seventy-one percent of participants had less than 12 years of education. Students returned 348 evaluations and instructors returned 72 evaluations. Data informed the program by confirming that students ‘liked' the lessons (92% of item response). Instructors said lessons were ‘easy to teach,' the health content was ‘just right,' and the English level was ‘just right' (94%, 91% and 83% of item responses). Additional qualitative comments informed lesson revisions. Focused discussions among the advisory board and at state meetings guided implementation.

Conclusion: Innovative programs to improve health literacy skills are needed. Program strengths include long-term sustainability due to partnerships and national relevance.

Learning Objectives:

Keywords: Health Literacy, Health Disparities

Related Web page: www.expectingthebest.org

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Exploring Health Disparities

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA