Applicability of a health literacy test from the U.S. in a South African population
- Lecoko, Motlalepule Lebogang Elizabeth
- Authors: Lecoko, Motlalepule Lebogang Elizabeth
- Date: 2001 , 2013-04-29
- Subjects: Literacy , Literacy -- South Africa , Literacy -- Ability testing , Reading -- Ability testing
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:3824 , http://hdl.handle.net/10962/d1005931 , Literacy , Literacy -- South Africa , Literacy -- Ability testing , Reading -- Ability testing
- Description: This thesis investigates the suitability and applicability of a health literacy test from the U.S. in a black, Xhosa-speaking, South African population. The concept of literacy is a controversial one which has been much debated, as it is not easy to classifY people as simply either literate or illiterate. As a result there are a number of definitions of literacy that vary with purpose and culture, but the most common one is that a person is literate if he/she can read and write. Estimating literacy from years of schooling is an inexpensive method but is also unreliable, since people generally read 3 to 5 grades below their stated educational level. This method affords little insight into the ability of patients to adequately function in a health care enviromnent, an ability which is referred to as functional health literacy. A number of health literacy tests such as the REALM (Rapid Estimate of Adult Literacy in Medicine) test have been developed to assess this skill. The REALM test is a word recognition test which places people into a relevant grade range estimate according to the number of words pronounced correctly. It appears to assume understanding of the word if the person is able to read that word correctly. In this project 125 black Xhosa-speaking respondents of varying educational levels who were literate in English were interviewed with the aid of an interpreter. Comprehensive demographic data were collected. Respondents were first asked to read all 66 words aloud during which time pronunciation was checked, and thereafter they were asked to explain each word. It was found that the ability to automatically decode and read the words did not necessarily guarantee comprehension of these words. Many of the words proved to be unfamiliar to the majority of the Xhosa respondents who were able to pronounce them correctly, but could not explain them. These tended to be phonetically transparent words which were therefore more accessible to the unfamiliar reader. This research has proven to be of great value in helping identify such words which should be substituted with simpler words for use in health information materials. A number of words could neither be pronounced nor understood by the population majority and, interestingly, a small group of words could not be pronounced but were satisfactorily explained by some respondents. The results showed an extremely poor correlation between the stated educational level and the REALM grade range estimate. This emphasizes the inappropriateness of years of formal schooling as an indicator of functional health literacy. The criteria were established for deciding cases in which the REALM test could be applied (or succeeds) and when it is inapplicable (or fails). It was found to be inapplicable in 41% of cases which clearly indicates that, in its current form, it is not a valid, reliable test to use in determining health literacy in this English second language population. It can, however, be used as a basis fur the development of a more appropriate test. Recommendations for future research direction are presented and an alternative structure for a health literacy test is suggested. , KMBT_363 , Adobe Acrobat 9.53 Paper Capture Plug-in
- Full Text:
- Authors: Lecoko, Motlalepule Lebogang Elizabeth
- Date: 2001 , 2013-04-29
- Subjects: Literacy , Literacy -- South Africa , Literacy -- Ability testing , Reading -- Ability testing
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:3824 , http://hdl.handle.net/10962/d1005931 , Literacy , Literacy -- South Africa , Literacy -- Ability testing , Reading -- Ability testing
- Description: This thesis investigates the suitability and applicability of a health literacy test from the U.S. in a black, Xhosa-speaking, South African population. The concept of literacy is a controversial one which has been much debated, as it is not easy to classifY people as simply either literate or illiterate. As a result there are a number of definitions of literacy that vary with purpose and culture, but the most common one is that a person is literate if he/she can read and write. Estimating literacy from years of schooling is an inexpensive method but is also unreliable, since people generally read 3 to 5 grades below their stated educational level. This method affords little insight into the ability of patients to adequately function in a health care enviromnent, an ability which is referred to as functional health literacy. A number of health literacy tests such as the REALM (Rapid Estimate of Adult Literacy in Medicine) test have been developed to assess this skill. The REALM test is a word recognition test which places people into a relevant grade range estimate according to the number of words pronounced correctly. It appears to assume understanding of the word if the person is able to read that word correctly. In this project 125 black Xhosa-speaking respondents of varying educational levels who were literate in English were interviewed with the aid of an interpreter. Comprehensive demographic data were collected. Respondents were first asked to read all 66 words aloud during which time pronunciation was checked, and thereafter they were asked to explain each word. It was found that the ability to automatically decode and read the words did not necessarily guarantee comprehension of these words. Many of the words proved to be unfamiliar to the majority of the Xhosa respondents who were able to pronounce them correctly, but could not explain them. These tended to be phonetically transparent words which were therefore more accessible to the unfamiliar reader. This research has proven to be of great value in helping identify such words which should be substituted with simpler words for use in health information materials. A number of words could neither be pronounced nor understood by the population majority and, interestingly, a small group of words could not be pronounced but were satisfactorily explained by some respondents. The results showed an extremely poor correlation between the stated educational level and the REALM grade range estimate. This emphasizes the inappropriateness of years of formal schooling as an indicator of functional health literacy. The criteria were established for deciding cases in which the REALM test could be applied (or succeeds) and when it is inapplicable (or fails). It was found to be inapplicable in 41% of cases which clearly indicates that, in its current form, it is not a valid, reliable test to use in determining health literacy in this English second language population. It can, however, be used as a basis fur the development of a more appropriate test. Recommendations for future research direction are presented and an alternative structure for a health literacy test is suggested. , KMBT_363 , Adobe Acrobat 9.53 Paper Capture Plug-in
- Full Text:
An investigation into the visual literacy skills of Black primary-school children from an informal settlement in Cape Town, with particular reference to visual imagery in educational textbooks
- Authors: Griffiths, Corona Gracelyn
- Date: 1997
- Subjects: Textbooks Illustrations , Visual literacy , Literacy -- South Africa , Visual literacy -- South Africa , Visual communication , Black people -- Education (Primary) -- South Africa , School children -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2403 , http://hdl.handle.net/10962/d1002199 , Textbooks Illustrations , Visual literacy , Literacy -- South Africa , Visual literacy -- South Africa , Visual communication , Black people -- Education (Primary) -- South Africa , School children -- South Africa
- Description: This thesis provides evidence that learning difficulties some. black primary-schoolchildren may experience with certain textbooks, can be attributed, in part, to the visual text (imagery). These difficulties were established by eliciting responses from educationally dlscfdvantaged urban black primary learners to selected examples of visual texts using the Research Interview method. To further establish if these difficulties were attributable either to poorly executed/unrecognizable visual text, or to low levels of learned educational visual literacy skills - white primary-school children were also interviewed - as it was anticipated that they would be familiar with Western pictorial material due to their consistent exposure to books from an early age. The difficulties experienced by the black interviewees were attributed mainly to their level of learned pictorial perceptual skills and to a lesser extent to poorly/inadequately illustrated visual texts. It was found from interviews with the developers of visual texts - publishing personnel and illustrators - that the former were not entirely certain e.xactly which aspects of visual text were difficult for black primary learners to comprehend, while the latter were generaUy very uncertain. The procedure for visual text development by the developers (including textbook authors), was found to be problematic due to the lack of synthesis and consultative decision making in the process- between these persons. The limited time allocated to illustrators for producing visual text, as well as their professional isolation, were found to be factors which can give rise to ineffective and inadequate visual texts. Most publishers and authors, if they trial (field-test) materials, generally do not trial the visual text. The visual text is usually decided upon ultimately by the poblishers and produced after trialling and/or consultants have examined the written text. Consequently incongruent meanings and inconsistencies can result between written and visual text, which can affect the learning effectiveness of the composite text. Trialling (field-testing) of visual and written text together, was recommended to identify and address any difficulties experienced by learners prior to final publication of the textbook. Recommendations were provided for textbook selection committees, authors, teachers, publishers and illustrators.
- Full Text:
- Authors: Griffiths, Corona Gracelyn
- Date: 1997
- Subjects: Textbooks Illustrations , Visual literacy , Literacy -- South Africa , Visual literacy -- South Africa , Visual communication , Black people -- Education (Primary) -- South Africa , School children -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2403 , http://hdl.handle.net/10962/d1002199 , Textbooks Illustrations , Visual literacy , Literacy -- South Africa , Visual literacy -- South Africa , Visual communication , Black people -- Education (Primary) -- South Africa , School children -- South Africa
- Description: This thesis provides evidence that learning difficulties some. black primary-schoolchildren may experience with certain textbooks, can be attributed, in part, to the visual text (imagery). These difficulties were established by eliciting responses from educationally dlscfdvantaged urban black primary learners to selected examples of visual texts using the Research Interview method. To further establish if these difficulties were attributable either to poorly executed/unrecognizable visual text, or to low levels of learned educational visual literacy skills - white primary-school children were also interviewed - as it was anticipated that they would be familiar with Western pictorial material due to their consistent exposure to books from an early age. The difficulties experienced by the black interviewees were attributed mainly to their level of learned pictorial perceptual skills and to a lesser extent to poorly/inadequately illustrated visual texts. It was found from interviews with the developers of visual texts - publishing personnel and illustrators - that the former were not entirely certain e.xactly which aspects of visual text were difficult for black primary learners to comprehend, while the latter were generaUy very uncertain. The procedure for visual text development by the developers (including textbook authors), was found to be problematic due to the lack of synthesis and consultative decision making in the process- between these persons. The limited time allocated to illustrators for producing visual text, as well as their professional isolation, were found to be factors which can give rise to ineffective and inadequate visual texts. Most publishers and authors, if they trial (field-test) materials, generally do not trial the visual text. The visual text is usually decided upon ultimately by the poblishers and produced after trialling and/or consultants have examined the written text. Consequently incongruent meanings and inconsistencies can result between written and visual text, which can affect the learning effectiveness of the composite text. Trialling (field-testing) of visual and written text together, was recommended to identify and address any difficulties experienced by learners prior to final publication of the textbook. Recommendations were provided for textbook selection committees, authors, teachers, publishers and illustrators.
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