BACKGROUND:Health literacy (HL) is an important public health issue. Current measures have drawbacks in length and/or acceptability. The US-developed Newest Vital Sign (NVS) health literacy instrument measures both reading comprehension and numeracy skills using a nutrition label, takes 3 minutes to administer, and has proven to be acceptable to research subjects. This study aimed to amend and validate it for the UK population.METHODS:We used a three-stage process / (1) a Delphi study with academic and clinical experts to amend the NVS label to reflect UK nutrition labeling (2) community-based cognitive testing to assess and improve ease of understanding and acceptability of the test (3) validation of the NVS-UK against an accepted standard test of health literacy, the Test of Functional Health Literacy in Adults (TOFHLA) (Pearson's r and the area under the Receiver Operating Characteristic (ROC) curve) and participant educational level. A sample size calculation indicated that 250 participants would be required. Inclusion criteria were age 18-75 years and ability to converse in English. We excluded people working in the health field and those with impaired vision or inability to undertake the interview due to cognitive impairment or inability to converse in English.RESULTS:In the Delphi study, 28 experts reached consensus (3 cycles). Cognitive testing (80 participants) yielded an instrument that needed no further refinement. Validation testing (337 participants) showed high internal consistency (Cronbach's Alpha = 0.74). Validation against the TOFHLA demonstrated a Pearson's r of 0.49 and an area under the ROC curve of 0.81.CONCLUSIONS:The NVS-UK is a valid measure of HL. Its acceptability and ease of application makes it an ideal tool for use in the UK. It has potential uses in public health research including epidemiological surveys and randomized controlled trials, and in enabling practitioners to tailor care to patient need.

The research is clear; given the opportunity to do so, children begin transacting with print at very young ages (Ferreiro & Teberosky, 1982). Deaf children with full access to language from birth frequently experience higher success rates in literacy acquisition (Kuntze, 1998). However, there remains a paucity of studies on how young Deaf children whose success with literacy development can be reasonably predicted, begin their journeys toward literacy. With the understanding that early literacy experiences significantly impact all children's literacy development (Bus, Van Ijzendoorn, & Pelligrini, 1995), it is important to have a clearer understanding of how Deaf children develop emergent literacy skills.This dissertation presents a year-long case study on four young Deaf children from native-ASL families who were immersed in literacy-rich environments and how they developed literacy skills in school and at home. In order to provide the fullest possible picture, parents, teachers and children were interviewed and observed. As literacy development does not happen in isolation; this dissertation provides information about the children's sociocultural context that included the literacy experiences and beliefs of the adult participants and the children's own experiences at home and in school. Artifacts including writing samples and data from an early literacy checklist were also collected to provide information about each child's individual written language development.The data were organized and analyzed based on salient themes and framed by socio-psycholinguistic studies on hearing children by researchers such as Dyson (1993), Ferreiro & Teberosky (1982), and Goodman (1996). Results show that with full access to language and opportunities to develop reading and writing abilities, Deaf children's emergent literacy development is highly similar to that of monolingual and bilingual hearing children with some characteristics unique to Deaf ASL-English bilinguals. The results of this dissertation study adds to the general body of knowledge of how children develop literacy abilities even when they do not have face-to-face communication in their literate language. The results also inform current practices in Deaf education and provide researchers, educators, and parents with a framework for understanding the critical role that language and communication play on Deaf children's literacy development.

No description available.

Health literacy is demonstrated when individuals can obtain, process, and understand basic health information and services needed to make appropriate health decisions. Veteran health literacy is believed to be lower than the general population due to the aging and culturally diverse population. Veterans require adequate health literacy to manage their diverse high acuity physical injuries, psychological conditions, and chronic diseases. Clear communication between the clinician and veteran patient is essential to provide high quality health services. The objective of this quality-improvement project was to evaluate the ability of nurses in the ambulatory environment to identify low health literacy patients and to deliver an educational intervention focused on health literacy awareness and communication strategies. A pre-intervention Clear Communications Questionnaire (CCQ), a validated instrument, was delivered to 299 ambulatory nurses with a 20% response rate. The results from this questionnaire informed the development of a 40-minute educational program, multimedia and discussion format, provided to 200 nurses. Following the education program, the post-intervention CCQ was sent to the nurses, with a 30% response rate. Survey Monkey was utilized to collect the CCQ data and Minitab for the statistical analysis, including a pre- and post-intervention data analysis with a t test. While this project was unable to show a significant difference between the pre- and post-intervention CCQ, the individual survey items indicated increased awareness about the importance of health literacy and the ability to locate patient health literacy level in the medical record. Further work needs to be undertaken to assure veteran patients can actively engage in clear communication with clinicians, discern between treatment options, adhere to treatment recommendations, and develop health-seeking behaviors across their lifespans.

This thesis takes the position that once schools and school systems adopt reform programs,the values and meanings inherent in those programs create and perpetuate powerful forms of discourse that characterize the projects themselves, evoke loyalty and commitment and may ultimately serve to stifle other voices. The thesis examines several primary schools involved with the Children’s Literacy Success Strategy (CLaSS) in the Victorian Catholic Education system. It is an analysis of the dominant discourse created and perpetuated by the CLaSS documentation, education officers, principals, and classroom teachers. The study characterizes the nature of that discourse and explores its effects on the work of teachers, principals, and on school improvement. The analysis proposed in no way disparages CLaSS itself, nor does it seek to judge its objectives, or offer a critique of the specific methods used to improve literacy. Rather, it advocates that genuine school improvement requires one to step outside the circle of discourse engendered by reform programs such as CLaSS which promote a ‘single minded’ discourse about themselves and that which the school is attempting. When programs such as CLaSS are introduced into schools as part of a sector wide reform agenda they are expected to provide proof of improved results in order to justify the financial investment associated with the initiative. The values and beliefs of the reform initiative are expected to be accepted by school systems usually without question (Apple, 2000). The effects of such unquestioned acceptance of particular values are examined in the current study. As schools are expected to accept programs like CLaSS in their entirety, it is not possible within the rhetoric of CLaSS to select what elements of the program to adopt. This appears to lead to the creation and perpetuation of an ‘officially’ sanctioned way of thinking about school reform and teaching. Proponents of reform programs may argue that such sanctions are a necessary feature of whole school reform programs and provide a focus for energy and activism, for winning people’s support, and for conveying to parents and the wider school community a sense of purposeful action and rational planning. However, these dominant discourses seem to obscure other perspectives, disallowing critique and preventing reflective discourse and analysis. Indeed, this study holds that genuine school reform requires schools to break out of the imprisonment of dominant discourses and remain open to critical reflection

Thesis (M.Ed.)--Memorial University of Newfoundland, 2005. / Includes bibliographical references.

Thesis (doctoral)--University of Bath, 2001. / BLDSC reference no.: DX217256.

Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 183-201).

Thesis (Ph. D.)--Florida State University, 2003. / Advisor: Dr. Jane B. Robbins, Florida State University, School of Information Studies. Title and description from dissertation home page (viewed Oct. 6, 2003). Includes bibliographical references.

Thesis (D. Min.)--Gordon-Conwell Theological Seminary, Boston, MA, 2001. / Abstract and vita. Includes bibliographical references (leaves 136-138).