Deborah L. Begoray

Developing and evaluating a relevant and feasible instrument for measuring health literacy of Canadian high school students

Health literacy has come to play a critical role in health education and promotion, yet it is poorly understood in adolescents and few measurement tools exist. Standardized instruments to measure health literacy in adults assume it to be a derivative of general literacy. This paper reports on the development and the early-stage validation of a health literacy tool for high school students that measured skills to understand and evaluate health information. A systematic process was used to develop, score and validate items. Questionnaire data were collected from 275, primarily 10th grade students in three secondary schools in Vancouver, Canada that reflected variation in demographic profile. Forty-eight percent were male, and 69.1% spoke a language other than English. Bivariate correlations between background variables and the domain and overall health literacy scores were calculated. A regression model was developed using 15 explanatory variables. The R(2) value was 0.567. Key findings were that lower scores were achieved by males, students speaking a second language other than English, those who immigrated to Canada at a later age and those who skipped school more often. Unlike in general literacy where the family factors of mothers education and family affluence both played significant roles, these two factors failed to predict the health literacy of our school-aged sample. The most significant contributions of this work include the creation of an instrument for measuring adolescent health literacy and further emphasizing the distinction between health literacy and general literacy.

A Social Ecological Conceptual Framework for Understanding Adolescent Health Literacy in the Health Education Classroom

With the rising concern over chronic health conditions and their prevention and management, health literacy is emerging as an important public health issue. As with the development of other forms of literacy, the ability for students to be able to access, understand, evaluate and communicate health information is a skill best developed during their years of public schooling. Health education curricula offer one approach to develop health literacy, yet little is known about its influence on neither students nor their experiences within an educational context. In this article, we describe our experience applying a social ecological model to investigating the implementation of a health education curriculum in four high schools in British Columbia, Canada. We used the model to guide a conceptual understanding of health literacy, develop research questions, select data collection strategies, and interpret the findings. Reflections and recommendations for using the model are offered.

High school health curriculum and health literacy: Canadian student voices

This study explores the relevance of health literacy, and its development through a health curriculum, as a necessary but insufficient component to facilitate healthy living among adolescents through comprehensive school health models. This paper presents qualitative findings from focus groups with students (N = 33) in four schools toward the end of their experience in a health class that focused on topics related to healthy living, healthy relationships, health information and decision-making. Students reported mostly negative experiences citing repetitive course content, routinely delivered by teachers and passively received by students. As well, students described their experiences of using health information sources beyond the classroom, such as the media. The findings suggest that the curriculum, and particularly its implementation, have had limited effect on health literacy: students’ abilities to access, understand, communicate and evaluate health information. The paper concludes with recommendations for improving health education. (Global Health Promotion, 2009; 16(4): pp. 35-42)

BEYOND TALKING GROUPS: STRATEGIES FOR IMPROVING ADOLESCENT HEALTH EDUCATION

In a study that focused on adolescent girls’ health issues within their dating relationships, we found that nonstructured focus group conversation can be augmented with structured strategies to generate a nonthreatening environment in which participants are enabled to co-create an understanding of their experiences. The use of free writing, role playing, and body tracing helped raise participants’ awareness and understanding of some of their health behaviors. We suggest that these strategies can be used in health care and educational contexts to promote the health of adolescents. By sharing strategies between education and health care professionals, both professions will benefit.

Learning about Aboriginal contexts: the reading circle approach.

As more opportunities arise for nursing students to obtain experience in community sites, they will be called on to practice in culturally appropriate ways more often. Although nurses remain challenged by the range of populations needing differentiated approaches, Aboriginal cultural contexts deserve special attention. Nurse educators must help students increase their understanding of Aboriginal life and ways of knowing. One way to facilitate this understanding is through a learning approach called reading circles. Reading circles offer a structure in the classroom for students to interact about ideas or readings. The reading circle process is congruent with Aboriginal ways of learning, which emphasize working in circle, with each member having a role and an equal chance to be heard. Aboriginal students in the class may be particularly comfortable with this learning method. This article describes specific steps for incorporating the reading circle approach into the nurse education classroom.

Using Curriculum Design Principles to Improve Health Education for Adolescent Girls

Learning and teaching are main concepts within health contexts, but curriculum theory is generally overlooked in the design of health education. In this paper, we describe the curriculum development component of a health research study designed to develop and present educational interventions for adolescent girls. Through the use of these interventions, we encouraged the girls to recognize and address potential health compromises in their dating relationships. By blending our disciplinary approaches of nursing and education to address the challenges of this research, we developed a curriculum that would effectively meet the needs of the participants. To do this, we assessed humanistic, social reconstructionist, technological, and academic curriculum approaches to determine that our approach is one of social reconstruction. We then considered teacher-centered, learner-centered, and problem-centered curriculum designs, choosing both learner and problem centered, and analyzed six dimensions of these designs. We describe these approaches, designs, and dimensions of curriculum considering pedagogical issues, criteria for evaluation, and appropriateness to educational health intervention programs.

Online, Tuned In, Turned On: Multimedia Approaches to Fostering Critical Media Health Literacy for Adolescents.

The commercial media is an influential sociocultural force and transmitter of health information especially for adolescents. Instruction in critical media health literacy, a combination of concepts from critical health literacy and critical media literacy, is a potentially effective means of raising adolescents’ awareness about commercial media and its influence on their health. We first provide background on critical media health literacy for adolescents. We then discuss the potential for involving adolescents in creating multimedia to demonstrate basic principles of critical media health literacy skills. Using excerpts from two of our research projects to illustrate our ideas, we draw conclusions and suggest future research in critical media health literacy for adolescents.

Authoring the Textual Classroom in Digital Times

This article explores language and literacy teachers’ classroom experiences in a digital age. Drawing on multi‐literacies and new literacy studies frameworks, we use metaphors of classroom as text and teacher as author to build an understanding of the challenges and changes examined in the findings of two separate studies. The teachers were challenged to reconsider conceptions of individual ‘knowers’ and textual authority/authorship in their classrooms and how they engage students critically in an exploration of the word and the world beyond the edges of the page and the walls of the English language arts classroom.

Responding to Adolescent Women's Reproductive Health Concerns: Empowering Clients Through Health Literacy

Adolescents have particular needs in health care that are often not met. Health care providers can help overcome barriers that hinder adolescents’ effective use of health services by incorporating health literacy strategies that are developmentally and contextually appropriate, and that actively involve adolescents in their own learning. Based on extensive practice and research experience in Canada with rural and urban high school adolescent women, we offer suggestions for how health care providers can respond to adolescent womens reproductive health concerns by teaching these young women how to increase their skills in functional, communicative/interactive, and critical health literacy.