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Health Literacy Resources & Programs for Adult ESL

Compiled by Kate Singleton and Lynda Terrill
June 2003

Learning the language and cultural rules necessary for accessing healthcare has been a staple of adult ESL programs for the last 25 years. In the 1990s, education and healthcare professionals started working together to better understand the needs of and provide more effective support for adult basic education (ABE) students and adult English language learners who are dealing with the increasingly complex American healthcare system. Many of the resources in this bibliography have been extracted from curricula developed with English Literacy/Civics funding available to states from the U.S. Department of Education's Office of Vocational and Adult Education. All materials need to be adapted to fit the specific needs of the learners in each program. The following is a selection of documents from the ERIC database and other print and Web resources arranged alphabetically by author.

Adkins, M. A., Birman, D., Sample, B., Brod, S., & Silver, M. (1998). Cultural Adjustment and Mental Health: The Role of the ESL Teacher. Wheat Ridge, CO: Spring Institute for International Studies. 48 pages. (ERIC ED427550)
This booklet is designed to provide ESL practitioners with practical information to help them assist refugees in coping with a new cultural environment and promoting mental health. Parts 1-3 provide background information and a framework that are helpful for understanding the normal process of cultural adjustment for refugees. Some historical information on refugee migration to the United States is provided, and there are sections on acculturation, stress and mental illness, and what the ESL teacher's role is in helping refugees with mental health. Part 4 addresses ways in which the connection between ESL and mental health can be made in the classroom. Part 5 sets up categories of activities to use with students such as dialogue journals, Total Physical Response (TPR), skits, and role-plays. Also included is an article illustrating how cultural perspectives manifest themselves in the classroom.

Arlington Education and Employment Program (REEP). (2003). REEP ESL Curriculum for Adults: Health Lesson Plans. Arlington, VA: Author.
The newest revision of the REEP curriculum is available free online to practitioners and programs. The curriculum includes specific health lessons on essential topics such as making emergency phone calls and filling out medical forms. It also includes Web Quests (for example, one deals with alternative medicine); learner-centered activities; related links; and ideas for needs assessment and performance-based assessment.

Isserlis, J. (2000). Trauma and the Adult English Language Learner. Washington, DC: National Center for ESL Literacy Education. 4 pages. (ERIC ED444397)
This digest describes trauma and abuse in immigrant communities (concerning mainly women and children), discusses the effects of trauma on learning, and suggests ways in which practitioners can modify their practice to facilitate learning among victims of trauma and violence. The author also reminds the reader that despite the fact that there is much more awareness of the prevalence of violence due to trauma, there is still much work to be done.

Longo, P. J., & Donahue, V. (1997). Amplifying the Health Literacy of Migrant Farm Workers. Dayton, VA: Virginia Adult Educators Research Network. 29 pages. (ERIC ED419429)
Approximately 100 seasonal and migrant farm workers and their family members were interviewed in an attempt to explore their health culture. The focus of the study was to investigate individuals' decisions, when ill, not to go to a doctor or to delay going to a doctor. The survey also investigated whether English language learners would judge certain situations in a medical encounter as more difficult to negotiate verbally than others (e.g., making appointments by telephone, making appointments in person, registering and giving personal and insurance information, talking with doctors, etc.). The authors propose the following for all who provide services to similar populations: do baseline assessments of individuals' health literacy levels; analyze the socio-linguistic forms and communicative competencies needed in medical contexts; and provide a list of symptoms and related medical terms to which immigrants can respond when they are unable to communicate their medical needs. The survey forms are in English and Spanish, and tabulated results are appended.

Massachusetts Department of Education Adult and Community Learning Services. (2001, October). Massachusetts Adult Basic Education Curriculum Framework for Health. Malden, MA: Author.
This framework document integrates the needs of ABE learners and adult English language learners and offers a rationale for integrating health literacy into adult education programs. The reasons include "poor health interferes with the success of adult learners" (p. 9); "health information and practical skills can be applied directly to adults' lives and incorporated into daily decision-making" (p.10); and "literacy and health goals have a better chance for success when pursued together" (p. 12). The framework stresses participatory, problem-solving learning. For example, five over-arching concepts are identified for use in a variety of levels and types of programs to suit the needs of the learners: (1) perception and attitude; (2) behavior and change; (3) prevention, early detection, and maintenance; (4) promotion and advocacy; and (5) systems and interdependence.

McKinney, J., & Kurtz-Rossi, S. (2000). Culture, Health, and Literacy: A Guide to Health Education Materials for Adults With Limited English Literacy Skills. Boston: World Education. (ERIC ED465311)
This guide identifies and annotates a variety of resources that teachers and programs can use to assist adult English language learners access health information and appropriate healthcare. The guide discusses seven kinds of resources: (1) background information that informs education and healthcare workers about the culture complexities of immigrants; (2) fact books, readers, and stories; (3) bibliographies and resource guides; (4) curricula and workbooks; (5) videos and audiocassettes; (6) Web sites; and (7) pertinent organizations and agencies.

Virginia Adult Learning Resource Center (compiled by Singleton, K.). (2003). Virginia Adult Education Health Literacy Toolkit.
Although developed for teachers and programs in Virginia, this online resource guide is useful to programs across the country that serve immigrants. It defines the term health literacy, identifies resources, and provides guidance on appropriate and effective instructional approaches for teaching health topics. This toolkit notes that "health has been touched upon in adult literacy programs for many years, but materials and approaches have not kept up with learner needs in the ever changing healthcare system" (p. iv). The resources and advice available in this Web document help close the gap between immigrants' needs and program responses.

This bibliography was prepared with funding from the U.S. Department of Education (ED), Office of Vocational and Adult Education (OVAE), under Contract No. ED-99-CO-0008. The opinions expressed in this paper do not necessarily reflect the positions or policies of OVAE or ED. This document is in the public domain and may be reproduced without permission.