目前日期文章:201506 (4)

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Although writing and reading seems to be the “traditional” elements of literacy in the modern fields such as health and media, undeniably, they are still one of the most important things in health literacy (HL), as well the complicated things.

In these four chapters the author talks mainly about the writing materials of HL. First, unlike the literature or journal paper, these “practical” writing requires different skills, ideas and perspectives. Usually, printed and Web materials not only need to be written clearly and simply, they also should be designed in ways that readers find inviting and appealing. This kind of “information design” refers to the art of doing, for example, combining words and images to encourage readers to start, and keep, reading.

This is exactly what a blog, or all other modern digital writing should pursue, because nowadays we are all, when writing online and seeking potential readers, “authors”. Therefore I think not only the health materials such as a Website or a pamphlet, but also a blog, an email and even a literature, when people look at a text that is confusing, they don't feel respect because they feel as though they are not “being talked to”, just “being talked at”. Writers should remember that reading isn’t just an intellectual cognitive activity, but also an emotional one, sometimes even toward the efferent texts. In this point of view, the writing of “information design” is more like an art, not a science, with lots of room for subjective judgement from both writers and readers.

However, this is not an easy task for writers. Health materials, whether it’s medical instructions or informed consent forms, always content difficult concepts. How to make it simple without omitting too many information, how to use easy words to explain hard terms, and how to present statistic numbers are all challenges. A good way to identify project goals is by asking yourself what readers should know, do, and feel after reading this document.

But not only documents that has writing. In clinical settings, there are signs everywhere. Even before you walk into a hospital you need to find the right “entrance”.
stock-photo-hospital-entrance-sign-56668519 
Patients and families today speak a wide variety of languages, come from many different countries, and vary widely in their learning abilities. To help people more easily find their way, using symbols such as pictograms or images is a good idea.
160_F_34367578_IlXqlUJw1TxKImWXooUkqs97bVdy1ZD9 veterinary-cardiology

Readers sometimes struggle, too. Today, health care is filled with forms and other “reading-to-do” documents, which the author refers to “written materials that require readers to perform word-based tasks such as filling in numbers, rating satisfaction, checking off instructions, and signing consent”. According to studies, about 1/3 adults has insufficient literacy level to do these. Even our general literacy is ok, when it comes to professional terms we still suffer sometime. Therefore providers should not only try to use plain language, but also provide an environment where people could feel comfortable to read, think and write, and could easily access assistance when needed.

Questions for thinking:
1. Do we need to teach students different kinds of writing, such as the digital writing, in classroom? If so, how?

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These four chapters of Health Literacy (HL) are mainly about communicating.

First, the author talks about “emotion”, which is a very important element when discussing your own (or your loved family’s) disease. As I mentioned in my last article, even your know very well how to read and write and also talk and listen, when, for example, the doctor tells you that you have cancer. Suddenly the world just falls apart and you lose all your communicating function. Therefore the author suggest some strategies for both providers and patients to better communicate in clinical settings when scared, sick, and overwhelmed. One of them that catches my eyes is that to use writing as a tool. Whether to provide easy-to-read materials for supplement, or to write down the questions you want to ask your doctor before meeting them, or to track your condition by writing them down, it seems that writing and reading what you’ve wrote is a good way to overcome the overwhelming emotion that taking control of your mind. This reminds me of what Emig states in her article that writing involves both left and right hemispheres of the brain, not just the emotion part.

Second, the author discusses about the importance of getting feedback throughout creating writing health materials for people. Not only because that these materials are so related to people’s health (sometime even their lives), but also because writers, not just in the field of health, but all other professional topics such as science, are usually so familiar with the content that they cannot objectively judge whether words and concepts make sense to others. The author suggests that writers should first know the intended audiences, even meet with several potential readers and ask what types of information they require. Then throughout the writing process seek feedbacks from individual interviews, focus groups or usability testing. This reminds me of Rosenblatt’s transactional theory, maybe for practical materials such as health information, the reader’s response is, and should be the most important issue.

Third, teach-back technique is a good strategy in clinical settings to make sure that patients do understand what professional staffs say. Don’t ask questions like “do you understand” because most of the time patients will just nod and smile (maybe students too). Rather, asking things by adding the attitude like “I just want to make sure I explained things well” will encourage them to speak out. I remember when I was young, in my class my teacher would assign the best student to teach the worst student during the recess time. Sometimes the “teacher” was me. Before doing that I thought it’s a waste of my time, but when I taught my classmates I found I need to think A LOT, like to summarize what I have known in mind before talking about it. This teaching experience really strengths my learning and enforces my memory of the knowledge more than ever. This teach-back technique somehow make me think of the Flipped Classroom.

Questions for thinking:

1. Is it possible that we use interviews, focus groups or testing to get feedback in classroom of writing?
2. Is it possible that we use teach-back technique in classroom to improve writing and reading?

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My subject is a little different than the traditional literacy. The book I chose is “Health Literacy From A To Z: Practical Ways to Communicate Your Health Message” by Helen Osborne, who is a Occupational Therapist with Master degree in education, and also the president of Health Literacy Consulting.

During past decades there are more and more studies of “literacy in a specific field”, such as digital literacy or media literacy. And “health” is one of the subject. Although the early focus was traditionally on the “read and write abilities of patients in clinical settings”, recently the study extends it’s meaning to the definition that is not just reading and writing, and not just within the hospital.

However, HL still contains a lot about reading and writing in a specific discipline (health). I think it might be an interesting idea to bring something different, broader the discussion about literacy but also connect all the things we learn from this course. This book has 42 chapters so I will read about 4 chapters a day and write a summary/review about it.

In general, health literacy (HL) refers to “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions”. I think this definition presents different levels/steps of being “literate”:

1. able to read/write or communicate
2. able to access any kinds of health service/information
3. able to analyze or judge those information
4. able to make a proper decision
5. able, or have enough motivation to DO it and gain a better health status

In addition, just like any other fields of literacy, HL is all about the “provider”, the “receiver”, and the “message”. Whether they are doctor-patient, teacher-student or policymaker-community member, the goal is to promote health understanding hence the health condition through communication.

There are many researches show that HL is getting more important nowadays. First, the face-to-face time between information receiver and professional provider is less and shorter, while chances to access messages from ads or online forums are more. Second, lower HL results poorer health outcome, such as longer hospitalization. Third, lower HL results higher financial cost, both from institutions and individuals.

But overall, I think the most important reason the makes HL so important is that, because health is an issue of all human beings. You could choose not to be “digital”, or even have no contact with any “media”, but everyone must face his/her own health issue sooner or later.

Back to the clinical settings, there are debates about whether to test patients’ literacy level to offer needed help, or not to do it to avoid making people have lower HL feel anxious or ashamed. But if anyone wants to do the test, many assessment tools have already been proofed useful, such as REALM or TOFHLA. However, it’s not just about people who can’t read well. Age, disability, language, culture, SES, an even emotion affect our HL (imaging maintain “literate” when you hear you have cancer!)

It’s not just the message receivers that matter. Writing easy-to-read materials or offer enough resources from the providers is also important.

And a lot more from the book (and myself) to be continued!

Questions for thinking:

1. Are you for or against testing patients’ literacy level in clinical settings? Why?
2. Have you had any healthy experiences that made you feel helpless, bewildered and “illiterate”?

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I love reading blogs. When I have time I can read many articles about many topics in many blogs as a leisure activity. Makeup tutorial, movie review, travel planning…any information I want to know I can find lots of amateurs or even professionals discussing about them in a comprehensive yet fun way for free for us to read and learn.

For example, I am going to have a event that I need to do makeup by myself. Realizing that I don’t have either tools nor skills make me anxious. I started searching for some basic knowledge online. In my opinion, makeup is a field that is very easy to go out of fashion in a short period therefore we tend not to learn it from books. After watch some Youtubers’ videos, I surprisingly found that many times an article works better than a video, or an article with photos plus a video could make a perfect teaching material.

Makeup blogs are just one kind of blog, but I think the criteria that make a quality blog is all the same for me: well organized (efferent) and sincere (aesthetic). When writing an article publicly, whether a long one or a short “Twitter” one, you must have a clear topic and purpose in mind throughout the writing process, then it’s possible that you organize it and make it readable. In addition, the content must be true and honest. As the Wikipedia pointed out, consumer-generated advertising and sponsored posts are now everywhere. For me you definitely can get pay on what you write, but only if you don’t pretend that you doesn’t.

Back to my makeup example, there is a famous Taiwanese blogger called Gisele (Sorry it’s in Chinese), I think she is one of the best makeup blog I found so far. First the structure of her blog is very good that you could always find topics you need by following the index. Second the balance of words, photos and videos is good, she makes the advantages of all three forms work well. Third the tone she chooses is friendly yet professional. It doesn’t have to be serious and distant even you want to teach some difficult ideas in your articles such as the ingredients of a foundation. However I also don’t like bloggers who “act (write) like your best friend” since them just aren’t.

After reading some professional articles about reading and writing, I think running a blog might be a good way of teaching them. Find a theme that you interest in, list out some topics of it, combine your background knowledge and information you found online (remember to site them), write them down and prepare them to be read the way you like reading other blogs, and finally interact with your reader, get feedbacks and write more!

I already have had a blog since long time ago but before I just use the albums in it until last year I decided to write down my memory of my wedding then I post my first article. I decide to use this one in this course too to “keep my stuff together”. Some of the layout might be in Chinese, I hope it won’t affect your reading.

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