How do the particular characteristics of less-educated employees with disabilities impact survey implementation?

BACKGROUND: Employees with disabilities make up a significant share of the working population. The group of employees covered by this study is hard to include in research and yet must be researched due to the vulnerable position it holds in the labour market. The topic is quite complex. OBJECTIVE: The article's main goal is to demonstrate how to implement a survey and adapt a questionnaire for assessing competencies and motivation for training and career changes among older and less-educated employees who have disabilities. METHODS: In the paper, we discuss the approach to adapting a questionnaire and a survey by undertaking an extensive process of different testing and adaptation stages that is presented in the article. RESULTS: We highlight some obstacles that employees with disabilities face when participating in surveys due to their low literacy skills, as well as low self-esteem, accessibility issues and other general methodological issues in the context of our population. Potential solutions gathered from all phases of the adaptation process are discussed. CONCLUSIONS: Proper survey implementation and questionnaire modification must be ensured if researchers aim to increase the willingness of individuals with disabilities to participate in the survey and to gather quality results.

Translation, Cross-cultural Adaptation, and Psychometric Properties of the Hausa Versions of the Numerical Pain Rating Scale and Global Rating of Change Scale in a Low-literate Population With Chronic Low Back Pain.

STUDY DESIGN: Translation, cross-cultural adaptation, and psychometric testing. OBJECTIVE: To translate, cross-culturally adapt, and validate the Numerical Pain Rating Scale (NPRS) and the Global Rating of Change Scale (GRCS) into Hausa language. SUMMARY OF BACKGROUND DATA: The NPRS and GRCS are commonly used patient-reported outcome measures in a variety of pain-related conditions including low back pain. To date, neither the NPRS nor GROC are available in Hausa language. METHODS: The Hausa versions of the NPRS (NPRS-H) and GRCS (GRCS-H) were developed using recommended guidelines. The final versions were then administered to 120 patients with chronic low back pain to access their psychometric properties. Reliability assessment included calculations of intraclass correlation coefficient (ICC) and minimal detectable change among the stable group. Construct validity and concurrent validity were assessed using the Spearman rank correlation coefficient. Internal responsiveness was assessed using mean change scores, standardized effect size, and standard response mean. Receiver operating characteristic curves were plotted to determine the external responsiveness of the NPRS-H using the area under the curve, and minimal important change for small, medium, and large improvements. Outcome measures consisted of the Visual Analogue Scale for pain and Oswestry Disability Index. RESULTS: The NPRS-H and GRCS-H were successfully developed. High test-retest reliability was demonstrated for both the NPRS-H (ICC = 0.95) and GRCS-H (ICC = 0.94) with minimal detectable change points of 1.0 and 1.2 respectively. The scales showed moderate to strong correlation with the Visual Analogue Scale for pain and Oswestry Disability Index. The mean change of the NPRS-H scores correlated moderately with the GRCS-H. Both scales demonstrated good internal responsiveness. External responsiveness of the NPRS-H was demonstrated at three levels with area under the curve  = 0.875 to 0.972, and minimal important change  = 2.5 to 3.5. CONCLUSIONS: The NPRS and GRCS were successfully adapted into Hausa language with acceptable reliability, validity, and responsiveness. These measures are appropriate for clinical and research use among Hausa-speaking patients. LEVEL OF EVIDENCE: 2.

Spelling performance on the web and in the lab.

Several dictionary websites are available on the web to access semantic, synonymous, or spelling information about a given word. During nine years, we systematically recorded all the entered letter sequences from a French web dictionary. A total of 200 million orthographic forms were obtained allowing us to create a large-scale database of spelling errors that could inform psychological theories about spelling processes. To check the reliability of this big data methodology, we selected from this database a sample of 100 frequently misspelled words. A group of 100 French university students had to perform a spelling-to-dictation test on this list of words. The results showed a strong correlation between the two data sets on the frequencies of produced spellings (r = 0.82). Although the distributions of spelling errors were relatively consistent across the two databases, the proportion of correct responses revealed significant differences. Regression analyses allowed us to generate possible explanations for these differences in terms of task-dependent factors. We argue that comparing the results of these large-scale databases with those of standard and controlled experimental paradigms is certainly a good way to determine the conditions under which this big data methodology can be adequately used for informing psychological theories.

Patient-Centered Measure Development and Spanish Validation Exemplar.

Traumatic brain injury (TBI) often results in cognitive impairments that require investigators to consider language accessibility of survey instruments, clinical evaluations, and other research tools. We describe an iterative language validation process for the Behavioral Assessment Screening Tool (BAST) and BAST Spanish version (BAST-ESP), consisting of two phases: (1) achieving an accessible literacy level for English-speaking people with TBI and (2) translating, validating, and cognitively testing the BAST-ESP for Spanish-speaking people with TBI. Investigators recruited scientific experts and members of the target populations to adapt and test the surveys. Modifications to original survey instruments included simplified semantic structures, enhanced conceptual clarity, rephrased idiomatic expressions, and rewording to bridge cultural differences in linguistic connotation. Findings from participants in focus groups and cognitive interviews confirmed accuracy and ease of comprehension and informed further adjustments and content relevant to the specific target populations. We demonstrate the importance of a systematic adaptation and validation process to develop a lower-literacy instrument appropriate for people with cognitive deficits and to enhance the BAST-ESP beyond translation alone. This article, along with a previously published article about BAST content validity process, provides a road map for other investigators to conduct systematic adaptation of scientific instruments for low-literacy and non-English-speaking populations. [HLRP: Health Literacy Research and Practice. 2019;3(4):e243-e249.].

Pilot Implementation of a Low-Literacy Zone Tool for Heart Failure Self-management.

Heart failure affects 6.5 million Americans, with 1 million hospitalizations annually, a 22% readmission rate, and $31 billion in health care costs. Palliative care decreases symptom burden, readmissions, and costs. Many elderly patients have difficulty recognizing and reporting heart failure symptoms to their providers in a timely manner. Self-management tools with color-coded zones (green = "all clear," yellow = "caution," red = "take action") help patients recognize and respond to heart failure symptoms and reduce readmissions. The purpose of this quality improvement project was to develop, implement, and evaluate a low-literacy zone tool for heart failure self-management with home-based palliative care patients. An interdisciplinary palliative care team developed this zone tool. Health literacy was prescreened with the Newest Vital Sign instrument. Nurses provided the zone tool to patients and caregivers and instructed them in use of this tool for daily self-monitoring. In postimplementation surveys, participants rated the zone tool as easy to understand and helpful in recognizing and reporting symptoms. This project demonstrated feasibility of a new zone tool for heart failure self-management, resulting in a practice change for this home-based palliative care program. The interdisciplinary team eventually developed similar zone tools for cancer, cirrhosis, chronic obstructive pulmonary disease, dementia, and frailty self-management.

Impact of social media use on reading levels in third-year student pharmacists.

INTRODUCTION: The majority of Americans report using social media, but there is limited research describing impact of social media on academic performance and reading. Our objectives were to describe the association between social media use and reading levels of third-year student pharmacists (P3), describe the association between reading level and pharmacy school admissions data, and assess texts used in the curriculum for readability. METHODS: This was a prospective, cohort study. Reading level was determined by a standardized test. Social media data were collected via questionnaire. Admissions data were obtained from the admissions office. Readability of texts was assessed using readability software. RESULTS: Eighty-nine student pharmacists completed the study. The average reading level was 16.4. Students reported using social media for an average of 126 min daily. Students reported using an average of four social media sites and spending 88 min weekly on extracurricular reading. Negligible linear correlations were found between reading level and time spent on social media (ρ = 0.063), number of sites used (ρ =0.062), and time spent on extracurricular reading (ρ= 0.130). A moderate correlation (ρ = 0.524) was found between reading level and Pharmacy College Admission Test (PCAT) score. The average readability of guidelines and textbook chapters were 18.1 ±â€¯1.0 and 20.4 ±â€¯0.3, respectively. CONCLUSIONS: In P3 students, reading level was not associated with social media use. However, PCAT scores were positively associated with reading level. Furthermore, the readability of assigned texts exceeded the average reading level of the students.

Great Expectations and e-mental health: The role of literacy in mediating access to mental healthcare.

BACKGROUND AND OBJECTIVES: e-Mental health (eMH) resources are design---ed to provide early intervention and treatment to patients with common mental disorders. They have been proclaimed as a key strategy to address the treatment gap for disadvantaged patients who have difficulty accessing face-to-face services. The evidence for the efficacy of eMH is good, but clinical trials often fail to report the key demographic characteristics of participants, including literacy levels and socioeconomic disadvantage. Risk factors for poor literacy include low socioeconomic status, cultural and linguistic diversity, rurality and Aboriginal or Torres Strait Islander background. These are also the patients most in need of services. METHOD: We assessed the readability of evidence-based eMH programs in Australia using two measures of reading age. RESULTS: The literacy required for eMH engagement is beyond the reach of most Australians. DISCUSSION: Text-based eMH programs may exacerbate the treatment gap rather than relieve it.

Analysis of written resources for parents of children discharged from a paediatric emergency department.

The aim of this study was to profile the information and readability of parent-focused resources to support care at home following a child's discharge from a paediatric emergency department (ED). Analysis included recording the scope, source, readability scores and benchmarking the contents against previous recommendations for discharge information. Information from 46 resources (on 41 conditions) from three separate sources was analysed. Overall, a wide range of resources was available. Inconsistency was evident in the framework and design of resources available. Approximately two-thirds of resources provided information about referral to community resources, and most had links to community health providers. Assessment of readability levels showed a predominant pitch towards a relatively high level of schooling. Existing written resources available for parents to use in caring for their child following discharge from an ED could improve with more streamlined designs as well as consistent references to community resources and additional health providers. Parents with low reading capacity may not be able to make the most of existing resources to care for their child at home following ED discharge. This framework was developed for reviewing the resources that could be useful for quality assessment of other parent-focused discharge information.

Academic Vocabulary Knowledge and Reading Comprehension Skills Among Seventh-Graders in Arabic as L1.

The current study attempted to investigate the contribution of an intervention program to fostering Arabic academic vocabulary knowledge and reading comprehension skills among seventh grade Arabic native speaking pupils. For this purpose, 247 pupils from four schools in northern Israel have participated in the study. Arabic literacy units that targeted academic vocabulary and reading comprehension skills were administrated for a period of 5 months. To assess the efficacy of the intervention program, academic vocabulary tests (receptive and productive) as well as reading comprehension test were administrated. As indicated by the results, the interventional group showed significantly higher performance in reading comprehension and productive academic vocabulary when compared to the control group. In contrast, no significant improvement was noted in receptive academic vocabulary knowledge. Taken together, the study results point to the contribution of comprehensive and direct academic vocabulary instructional approaches to promoting academic vocabulary knowledge and reading comprehension of academic texts. Moreover, it stresses the need for policy change and curricular adjustments in Arabic language instruction, acknowledging the importance of fostering academic language skills in the road to academic success.

Etiology of teacher knowledge and instructional skills for literacy at the upper elementary grades.

The purpose of this research was to study the etiology of teacher knowledge about and factors that influence implementation of evidence-based reading and writing interventions at the upper elementary grade levels. Five data sources are used in this study: first, we used teacher surveys about their pre-service preparation on reading comprehension and literacy practices gathered during a recent cluster randomized control trial on a reading comprehension intervention conducted with 280 fourth and fifth-grade teachers and their classroom students. We also conducted focus group interviews with 43% of the teachers and observed 90% of the teachers once during the implementation years. For writing, we used data collected from 32 teachers during a 3-year design project for a teacher-led computer-supported writing intervention. We also collected data from groups of school administrators using structured interviews during both studies. Finally, we conducted an artifact review of school curricula and posted professional development (PD) plans. Our results show that in both reading comprehension and writing, all teachers reported not receiving sound evidence-based pre-service preparation and they were not currently employing any evidence-based approaches. Most teachers reported using the basal reading series with very little variation from the lesson scope and sequence. Teachers and administrators frequently reported that skills were being taught in isolation (e.g., skill of the week is summarizing) and that writing was neglected. The interviews showed very interesting patterns of curricula decision-making by school administrators and these findings were further confirmed through the artifact reviews. Based on these results, we recommend that any review of teacher practices focus also on administrator decision-making and school level factors that are driving what happens in the classrooms. The review showed that the teachers themselves do not feel empowered to learn and deliver evidence-based literacy practices and feel constrained by the system.

Theory and reported practice in EFL literacy instruction: EFL teachers' perceptions about classroom practices.

Acquiring literacy in English as a foreign language (EFL) is important for language development. However, many students enter middle school without adequate EFL literacy skills. This may indicate a gap between EFL literacy instruction theory and the classroom practice that is occurring in elementary school classrooms. The aim of this study was to explore the components of EFL literacy instruction as perceived by teachers. The study investigated whether perceptions of classroom practices are theoretically based, thus shedding light on the gap between EFL literacy theory and practice. The participants were 167 EFL elementary school teachers, who submitted anonymous online questionnaires regarding their reported EFL teaching in year one, two, three, four, and five of elementary school. The research was based on the five pillars of literacy instruction for English as a first language (National Reading Panel, 2000) and additional EFL components (August & Shanahan, 2006). Results of this study showed that EFL teachers expressed views that may indicate a gap between teachers' practices and most cutting-edge research. The study concluded that providing EFL elementary school teachers with theoretical knowledge may lead to more productive literacy programs and may improve classroom practices.

Expert reading coaching via technology: Investigating the reading, writing, and spelling outcomes of students in grades K-8 experiencing significant reading learning disabilities.

While qualitative research has shown great benefits for teachers who receive coaching, there is a paucity of experimental research examining students' academic outcomes after their teachers received ongoing support from a knowledgeable and experienced coach. Thus, a quasi-experimental design investigated the literacy outcomes of 452 students experiencing reading learning disabilities in grades K-8th whose special education and/or resource room teachers (n = 44) received student data-focused coaching support through on-site coaching, on-demand coaching (teachers could request support if needed), or through technology-based coaching. Specifically, researchers wanted to investigate if technology-based coaching was as effective as in-classroom support for increasing teachers' knowledge and implementation of research-based reading instructional routines and ultimately, improving the reading, writing, and spelling outcomes of students with reading learning disabilities. Results yielded positive student academic growth for all three methods of coaching; however, coaching via technology, a more efficient, less time-consuming method of giving teachers ongoing professional development, produced larger statistically significant Cohen's d effect sizes than the other two forms of coaching ranging from 0.22 to 1.01 in areas of phonemic awareness, decoding, comprehension, fluency, writing, and spelling. Other findings as well as the educational implications of implementing coaching via technology are also included.

Explicit linguistic knowledge is necessary, but not sufficient, for the provision of explicit early literacy instruction.

Teacher's knowledge can influence the act of teaching and affect children's learning outcomes. Linguistic and language knowledge of teachers plays an important role in supporting learners at the beginning to read stage. This study examines the language and linguistic knowledge of teachers of beginning readers in New Zealand, how these teachers perceive their own practices in teaching reading, and the relationship with the nature of observed instructional practices. The teachers in the study used predominantly implicit approaches to early reading instruction, with word-level instruction and prompting used only after context, even when teachers with high linguistic knowledge used implicit approaches, suggesting that teacher's knowledge is not sufficient, on its own, to ensure effective, explicit, word-level instruction to beginning readers.

Characterizing the knowledge of educators receiving training in systematic literacy instruction.

Addressing the needs of students with dyslexia requires an in-depth knowledge of various components of a multi-dimensional approach to reading intervention, which is supported by an understanding of the structure of the language being taught. The current study explored the association between teacher knowledge of the English language and different stages of training provided through 2-year courses that meet the objectives of the International Dyslexia Association (IDA) standards of teacher knowledge and practice. It included 347 K-12 licensed teachers who were at various stages of training when they completed a test of knowledge in the areas of Phonological Sensitivity, Phonemic Awareness, Decoding, Spelling, and Morphology. The level of terminal degree (i.e., BA or MA) held by participating teachers and their amount of teaching experience did not predict performance on the test. In contrast, participating teachers differed in their level of knowledge as a function of how much training they had received as part of a 2-year course. Increased training was associated with elevated levels of knowledge. Moreover, teachers who completed the 2-year training program and went on to obtain certification through a national certifying organization had reliably greater knowledge than those who had not. Additionally, the weakest domains of knowledge across all teachers were in spelling and morphology, suggesting a need for improved training in these domains, given that they are identified deficiencies for persistently poor responders to reading intervention and in children presenting with late emerging forms of reading disability.

Improving Research Literacy in Diverse Minority Populations with a Novel Communication Tool.

Racial/ethnic minorities are underrepresented in clinical research in the USA for multifarious reasons, including barriers to effective communication between researchers and potential research participants. To address the communication barriers between researchers and potential participants, we developed a Research Literacy Support (RLS) tool. The focus of this report is to present findings from the second and third phases of development that refined and assessed usability of the RLS tool. We utilized a mixed-methods approach that entailed iterative cognitive testing with participants (N = 52) from diverse racial/ethnic backgrounds and interviews with clinical research recruiters (N = 20) to modify and refine the design and content of the RLS tool (phase 2). This was followed by assessment of the usability of the RLS tool by 100 participants (phase 3). During phase 2, participants provided feedback about layout, word choice, and comprehension of the tool. In phase 3, participants recognized that they had gained knowledge about clinical research from the RLS tool, although they still had a substantial learning gap after using the tool, indicating an opportunity for further refinement. The RLS tool may help advance health equity by addressing communication barriers that may impede minority participation in clinical research.

Can a reset of digital literacy standards improve nursing practice?

Duncan Hamilton, final year adult nursing student at the University of Surrey, reflects on the questions around technology proficiency for future nurses.

A standardized logarithm of the minimum angle of resolution visual acuity chart in Hindi.

Purpose: The purpose of this study to develop and calibrate a new Hindi logarithm of the minimum angle of resolution (logMAR) visual acuity chart. Methods: A new Hindi visual acuity chart was designed to logMAR specifications using Hindi optotypes experimentally selected to have similar relative legibility under equivalent spherical and cylindrical defocus. The chart calibration study was carried out in a large clinical setup in India. Participants who were literate in English and Hindi participated in the study. Visual acuity was measured with the new Hindi logMAR chart and a modified ETDRS (m-ETDRS) logMAR chart. The method of presentation was randomized between the charts. Repeat visual acuity was measured on a subsequent day with a second version of the Hindi logMAR chart. Results: The Hindi logMAR chart correlated highly with the m-ETDRS logMAR chart (r2 = 0.92); however, the mean visual acuity difference (Hindi logMAR-m-ETDRS logMAR) was nearly one and half lines (0.13 logMAR, 95% confidence interval [CI] = ±0.15 logMAR). The Hindi logMAR chart also proved to be highly repeatable (r2 = 0.99; mean difference 0.005, 95% CI = ±0.04 logMAR). Conclusion: This study reports the first standardized visual acuity chart developed in Hindi incorporating equal letter legibility and logMAR chart design features. The Hindi logMAR visual acuity chart provides a valid and repeatable tool for the measurement of visual acuity in native Hindi language speakers. Future use of the new Hindi chart should incorporate an increase in optotype size of 0.13 logMAR.

A human right to literacy education: Implications for serving Syrian refugee children.

Forty percent of Syrian refugees are younger than 12, and many have not attended school for up to five years, disadvantaging them academically, emotionally, and psychosocially. Article 19 of the Universal Declaration of Human Rights dictates "the right to freedom of opinion and expression…and to seek, receive and impart information and ideas…)". Resettled refugee children face the challenge of integration into majority-English school systems with limited ability to express themselves or linguistic means to access education. However, Syrian adults possess high rates of literacy and funds of knowledge that can promote an environment of learning in the home language. With incomplete language and literacy skills in their native Arabic, learning English for academics proves challenging. Without language and literacy instruction, refugee children experience a lower likelihood of class participation and a greater likelihood of social isolation or drop out. To inform speech-language pathologists and other educators, this literature review aims: (1) to apply second language learning concepts relevant to refugees, (2) to inform pedagogy specific to reading by highlighting cross-linguistic differences between Arabic and English, and (3) to illuminate strategies that families and educators of Arabic-speaking refugee students may employ to resume and promote language and literacy development.