None listed
Conditions
Brief summary
ABSTRACT Background: People with low literacy and low health literacy have poorer health outcomes. Literacy and health literacy are distinct but overlapping constructs that impact wellbeing. Interventions that target both could improve health outcomes. Methods & Design This is a cluster randomised controlled trial with a qualitative component. Participants are 300 adults enrolled in basic language, literacy and numeracy programs at adult education centres across New South Wales, Australia. Each adult education institute (regional administrative centre) contributes (at least) two classes matched for student demographics, which may be at the same or different campuses. Classes (clusters) are randomly allocated to receive either the health literacy intervention (an 18-week program with health knowledge and skills embedded in language, literacy, and numeracy training (LLN)), or the standard Language Literacy and Numeracy (LLN) program (usual LLN classes, specifically excluding health content). The primary outcome is functional health literacy skills – knowing how to use a thermometer, and read and interpret food and medicine labels. The secondary outcomes are self-reported confidence, health literacy; shared decision making skills, patient activation, health knowledge and self-reported health behaviour. Data is collected at baseline, and immediately and 6 months post intervention. A sample of participating teachers, students, and community health workers will be interviewed in-depth about their experiences with the program. Ethics and dissemination The study has ethical approval from the University of Sydney and 10 NSW Institutes of TAFE. Results will be published in peer reviewed journals, and reported to partner organisations.
Interventions
An 18-week (semester-long) health literacy program embedded in an exisiting adult language, literacy, and numeracy (LLN) program at TAFE NSW. Core topics cover reading medicine and food labels, communicating with health professionals and shared decision making, and understanding serve size. Non-core topics cover immunisation and screening, understanding prescriptions and talking to the pharmacist, completing medical forms, being active, understanding diet and nutritional information. Teachers
An 18-week (semester-long) health literacy program embedded in an exisiting adult language, literacy, and numeracy (LLN) program at TAFE NSW. Core topics cover reading medicine and food labels, communicating with health professionals and shared decision making, and understanding serve size. Non-core topics cover immunisation and screening, understanding prescriptions and talking to the pharmacist, completing medical forms, being active, understanding diet and nutritional information. Teachers can select non-core topics based on learner needs and interests. The program has been planned on the basis of 2x3 hour lessons per week, for 18 weeks; however, not all TAFE colleges will fit that model. A suggested lesson plan is included in the “Study Manual”, given to all participating teachers. It includes an overview of the trial and suggested time to cover each core topic. Students (even within the same class) will vary in their language, literacy, numeracy, and communication skills – and teachers are responsible for tailoring their teaching to suit their students’ needs. For this reason the intervention program was designed to be flexible, with a relatively small number of “core” units. Every effort will be made to match class size and student characteristics; however, class composition is determined by student enrolments and consent. Class sizes are expected to range from 5 to 20 students. Intervention teachers were instructed to cover 10 ”core” topics, and to use their discretion when selecting other topics. The 2 course manuals ("Being Healthy" and "Staying Healthy") invite teachers to rate each activity as they teach it, and return the completed ratings sheet to the study centre. This enables us to monitor which activities and topics are taught. Qualitative interviews with students and teachers also assess course content and topics covered.
Sponsors
Sydney School of Public Health, University of Sydney
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Subject, Investigator)
Eligibility
Sex/Gender
All
Age
16 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Participants will be recruited following standard TAFE processes for enrolling students. Participating TAFE teachers will invite 300 adults assessed at ACSF level 2, seeking basic education at TAFE in NSW to join the study. As part of standard procedures, students literacy and numeracy levels are assessed by TAFE teachers on enrolment day. We will recruit classes from TAFE Institutes in metropolitan and regional centres across NSW, Australia, including multiple Sydney districts, and Illawarra, Hunter, New England, and Southern NSW. Eligible classes will be learning basic language, literacy and numeracy at Australian Core Skills Framework level 2 (in one of 4 eligible course codes). Intervention and standard LLN classes will be matched on typical demographic characteristics including age, sex, English proficiency, literacy skills, course code, and region.
Exclusion criteria
Refusal to provide informed, written consent (or failure to provide consent from a parent or guardian for students under 16 years). It is a requirement of the ethics committees of TAFE and the University of Sydney that additional consent be obtained for students under 18 years.
Outcome results
None listed