Simplified COVID-19 guidance for adults with intellectual and developmental disabilities.

BACKGROUND: During the COVID-19 pandemic, the United States' Centers for Disease Control and Prevention (CDC) created guidance documents that were too complex to be read and understood by the majority of adults with intellectual and developmental disabilities who often read at or below a third-grade reading level. This study explored the extent to which these adults could read and understand CDC documents simplified using Minimised Text Complexity Guidelines. METHOD: This study involved 20 participants, 18-48 years of age. Participants read texts and responded to multiple-choice items and open-ended questions to gather information about how they interacted with and understood the texts. RESULTS: The results provide initial evidence that the Minimised Text Complexity Guidelines resulted in texts that participants could read and understand. CONCLUSION: Implications for increasing the accessibility of public health information so that it can be read and understood by adults with extremely low literacy skills are discussed.

Literacy: A lever for citizenship?

Within citizenship education, literacy is often promoted in a narrow functional sense of skills for civic engagement or is used synonymously with "knowledge" to refer to an awareness-raising process around rights. Through an analysis of evolving models of citizenship, this article moves beyond literacy for citizenship to consider the ways in which literacy learning can emerge through active citizenship. Drawing on published ethnographic studies of literacy in everyday life to analyse both the symbolic and instrumental meanings of literacy in specific contexts, the author introduces a social practice lens on literacy and citizenship. She explores the pedagogical implications for literacy within citizenship education, particularly in relation to informal learning of "real literacies", critical digital literacy to distinguish "fake news" and literature as a way of entering someone else's experiences. UNESCO's current vision for global citizenship education as nurturing empathy and understanding between peoples implies that literacy providers need to recognise participants as not only consumers, but as co-constructors of texts.

L'alphabétisation, un levier de la citoyenneté ? ­ Dans le domaine de l'éducation à la citoyenneté, soit l'alphabétisation fait souvent l'objet d'une promotion dans le sens fonctionnel étroit de l'acquisition de compétences favorisant l'engagement civique, soit elle est employée comme synonyme de « savoir ¼ renvoyant à un processus de sensibilisation lié aux droits. En analysant les modèles de citoyenneté qui évoluent, cet article va au-delà de l'alphabétisation pour la citoyenneté et examine les façons dont l'alphabétisation peut apparaître par le biais de la citoyenneté active. L'autrice s'appuie sur des études ethnographiques sur l'alphabétisation dans la vie quotidienne pour analyser les significations symboliques et instrumentales de l'alphabétisation dans des contextes spécifiques et éclaire l'alphabétisation et la citoyenneté du point de vue des pratiques sociales. Elle examine les implications pédagogiques pour l'alphabétisation dans le cadre de l'éducation à la citoyenneté, notamment en ce qui concerne l'apprentissage informel d'« alphabétisations réelles ¼, l'alphabétisation numérique critique pour distinguer les « infox ¼ et la littérature comme moyen de pénétrer dans l'expérience d'un autre. La vision actuelle de l'UNESCO selon laquelle l'éducation à la citoyenneté mondiale nourrit l'empathie et favorise la compréhension entre les peuples implique que les prestataires d'alphabétisation ne considèrent pas les participants uniquement comme des consommateurs, mais qu'ils voient en eux des co-constructeurs de textes.

Empirical validation of the OCRAT framework. A holistic and systematic guideline for audio-only instructional design.

This work empirically validates 23 audio-only instructional guidelines regrouped under the Organisation Content Retention Auditory and Technology (OCRAT) framework. A total of 10 audio courses consisting of 40 audio lessons/chapters equivalent to around 3 h on various topics in agriculture and fisheries were devised based on the OCRAT guidelines. A group of 225 and 180 literate and semi-literate populations both in Mauritius and India were identified. Through a range of ten (10) courses regrouping the respective audio lessons, the framework was tested over an ACALEs platform. A survey was conducted on learners who participated and completed the course. From the collected data, empirical testing using inferences on population proportions based on the binomial distribution was conducted to validate the proposed set of guidelines. The results proved to be very conclusive. Moreover, this work elaborates even further on the validated guidelines and substantiates them with additional literature. Henceforth, it can confidently be used by instructional designers for the development of interactive audio-only courses not only on ACALEs platforms but even with conventional audio-based learning like radio programs.

Overcoming the hurdles: Understanding motivation and supporting adult learners with poor literacy and dyslexia in the homelessness sector.

Literacy difficulties are often reported by adults with experience of homelessness. Yet, research on their learning experiences and clarity on how best to support this group is lacking. The present study explored the experience of homeless literacy learners (HLLs) and asked what motivated them to engage with literacy support and the teaching-related factors perceived to be most effective. Semi-structured interviews were conducted with 10 HLLs (aged 31-68) engaged in literacy provision at a homelessness charity in the United Kingdom. Thematic analysis of the data revealed five key themes: challenging early experiences; barriers to improving literacy; the perceived impact of poor literacy; current motivation to improve literacy; and approaches that support literacy in adulthood. A significant majority of HLLs reported early traumatic learning experiences and 7 out of 10 (70%) disclosed a diagnosis of dyslexia. Specialist dyslexia support was reported to help HLLs feel understood and positive relationships with teachers helped self-esteem and self-efficacy related to their literacy learning. Recommendations are made for specialist teachers to be made more readily available to support HLLs, as well as to advise service providers and professionals engaging with adult learners with experience of homelessness across the sector.

The reliability and validity of the Romanian rapid estimate of adult literacy in dentistry (RREALD-30).

OBJECTIVES: This study aimed to translate and adapt the Rapid Estimate of Adult Literacy in Dentistry (RREALD-30) instrument for Romanian urban adults and to test its reliability and validity for oral health literacy studies. MATERIAL AND METHODS: The study examined urban adult patients (n = 224) who attended the dental school clinic at the Faculty of Dental Medicine, Bucharest. We collected data through face-to-face interviews utilising the REALD-30 instrument. The interviews enquired about the Oral Health Impact Profile (OHIP-14), background characteristics, oral health-related knowledge, visits to dentists and self-rated oral health status. We applied principal component analysis for factor structure and Item Response Theory models to discriminate ability. A structural equation model (SEM) evaluated whether knowledge, perceived oral health, and visits to the dentist mediate the effect of RREALD on OHIP-14. RESULTS: Of the 224 participants, 113 (50.4%) were males. The internal consistency of the RREALD-30 measured by Cronbach's alpha was 0.88. The test-retest reliability was excellent (Spearman's correlation coefficient 0.98, ICC 0.90). RREALD-30 exhibited good concurrent and predictive validity. SEM demonstrated that RREALD mediated the effect of visits to dentist on OHIP-14. CONCLUSION: The RREALD-30 proved satisfactory psychometric properties and may serve to evaluate dental health literacy among Romanian adults.

The Factor Structure of Vocabulary: An Investigation of Breadth and Depth of Adults with Low Literacy Skills.

The purpose of this study was to examine the factor structure of vocabulary. We believe that not only is vocabulary multidimensional, but depth of vocabulary knowledge should also be assessed with multiple measures since it too, is composed of multiple aspects. Furthermore, to explore the predictive validity of the different aspects of vocabulary knowledge, we assessed the relationship between vocabulary breadth, vocabulary depth, and reading comprehension in adults with low literacy skills. The participants were 103 adults. They completed 12 tasks that have been used in past studies to measure vocabulary breadth, depth, and reading comprehension. We had several important findings. First, we confirmed that all of the assessments were highly reliable for adults with low literacy skills. Second, the results of the factor analysis indicated two distinct vocabulary factors. Finally, both breadth and depth contribute independently to explaining variance in reading comprehension. Implications for vocabulary measurement are suggested.

Scholarly culture: How books in adolescence enhance adult literacy, numeracy and technology skills in 31 societies.

A growing body of evidence supports the contention of scholarly culture theory that immersing children in book-oriented environments benefits their later educational achievement, attainment and occupational standing. These findings have been interpreted as suggesting that book-oriented socialization, indicated by home library size, equips youth with life-long tastes, skills and knowledge. However, to date, this has not been directly assessed. Here, we document advantageous effects of scholarly culture for adult literacy, adult numeracy, and adult technological problem solving. Growing up with home libraries boosts adult skills in these areas beyond the benefits accrued from parental education or own educational or occupational attainment. The effects are loglinear, with greatest returns to the growth in smaller libraries. Our evidence comes from regressions with balanced repeated replicate weights estimated on data from 31 societies which participated in the Programme for the International Assessment of Adult Competencies (PIAAC) between 2011 and 2015.

Health Literacy Among People with Serious Mental Illness.

People diagnosed with a mental illness are at higher risk of developing preventable chronic diseases; thus, health literacy improvements may have great potential to impact health outcomes for this typically underserved population. However, there is a dearth of research on health literacy of persons with severe mental illness. The purpose of this research was to investigate aspects of health literacy and identify factors associated with low literacy among adults with severe mental illness using three literacy assessment tools. Seventy-one adults with serious mental illness were assessed and a high proportion had limited literacy levels: 42% with the Single Item Literacy Screener, 50% with the Rapid Estimate of Adult Literacy in Medicine-Short Form, and 67% with the Newest Vital Sign. Findings suggest that individuals with certain mental illnesses and lower functioning may have more difficulty understanding health information and have limited numerical literacy.

Low Literacy Levels Among U.S. Adults and Difficult Ballot Propositions.

High-level literacy skills are required for full participation in the democratic process through voting. Consequently, adults with low-level literacy skills are at a disadvantage. This work investigated the disparity between the readability of U.S. ballot propositions for year 2022 state elections and grade level reading estimates (≤eighth grade) for adults. Educational attainment was also examined. Propositions (n = 140) from 38 states were included. Mean readability was 18 (range 7.0-64.0). Only four measures (3%) fell within range of national estimates for adult reading ability. Thirty-nine percent of adults completed high school or less, yet 74% of ballots were written well above a high school reading level. There is a discrepancy between the literacy skills of the average voter and the readability of most propositions. The findings of this study have important implications for individuals with learning disabilities. Policy changes and educational support efforts should be initiated.

It's about time! Exploring time allocation patterns of adults with lower literacy skills on a digital assessment.

Introduction: Despite the necessity for adults with lower literacy skills to undergo and succeed in high-stakes computer-administered assessments (e.g., GED, HiSET), there remains a gap in understanding their engagement with digital literacy assessments. Methods: This study analyzed process data, specifically time allocation data, from the Program for the International Assessment of Adult Competencies (PIAAC), to investigate adult respondents' patterns of engagement across all proficiency levels on nine digital literacy items. We used cluster analysis to identify distinct groups with similar time allocation patterns among adults scoring lower on the digital literacy assessment. Finally, we employed logistic regression to examine whether the groups varied by demographic factors, in particular individual (e.g., race/ethnicity, age) and contextual factors (e.g., skills-use at home). Results: Adults with lower literacy skills spent significantly less time on many of the items than adults with higher literacy skills. Among adults with lower literacy skills, two groups of time allocation patterns emerged: one group (Cluster 1) exhibited significantly longer engagement times, whereas the other group (Cluster 2) demonstrated comparatively shorter durations. Finally, we found that adults who had a higher probability of Cluster 1 membership (spending more time) exhibited relatively higher literacy scores, higher self-reported engagement in writing skills at home, were older, unemployed, and self-identified as Black. Discussion: These findings emphasize differences in digital literacy engagement among adults with varying proficiency levels. Additionally, this study provides insights for the development of targeted interventions aimed at improving digital literacy assessment outcomes for adults with lower literacy skills.

Health literacy and ophthalmology: A scoping review.

As of 2020, it is estimated that 43.3 million people are blind, and an additional 553 million have mild to severe vision impairment.50 At least 1 billion worldwide have a vision impairment that could have been prevented or has yet to be addressed.54 Poor health literacy may be a significant contributor to the prevalence of eye disease. With implications on disease burden, progression, and health outcomes, a greater understanding of the role health literacy plays in ophthalmology is needed. This is the first scoping review to assess the impact of health literacy on eye health outcomes and blindness, including ocular screening rates and/or follow-up rates, treatment adherence, and self-care practices. PubMed, Embase, and CINAHL databases were searched systematically through November 12, 2021, and we evaluated the association between health literacy and ophthalmic outcomes in 4 domains: clinical outcomes, treatment adherence rates, screening and/or follow-up rates, and self-care practices. There is evidence to suggest that health literacy is associated with ophthalmic outcomes in all these domains. To better understand how health literacy impacts eye health, further longitudinal studies examining the effect of health literacy (using standardized health literacy measures) on ophthalmic outcomes are needed. We believe a specific ophthalmic health literacy survey could help achieve this goal and help target interventions to ultimately improve outcomes among ophthalmology patients.

Phonological and orthographic processing in basic literacy adults and dyslexic children.

The aim of the present study was to examine the hypothesis that, compared to typically reading children matched on regular word reading, adults with basic literacy (either adult literacy students or adult basic education students) struggle on phonologically demanding tasks but are relatively performant on orthographic demanding tasks, and hence present a performance pattern similar to that of dyslexic children. Using various reading and phoneme awareness tests, we therefore compared the adults to both typically reading children from Grades 3 and 4 and dyslexic children, these two groups being matched to the adults on regular word reading. The dyslexic children were also compared to either chronological age- or reading level-matched children. The hypothesis was only partly supported by the data, as results depended on the subgroup of adults considered. While the literacy students presented poorer phoneme awareness and a somewhat stronger length effect in reading than the dyslexic children, the basic education students outperformed the latter on irregular word reading. The adults, and in particular the literacy students, also relied frequently on orthography in a complex phoneme awareness task. Taken together, these results suggest that adults with basic literacy rely more on visual memory than both dyslexic and typically reading children. This opens the question of whether the peculiar profile of these adults is intrinsic to adult literacy acquisition or is related to the way they are taught and trained to read and write. The results also highlight the need for better characterization of subgroups of adults with basic literacy.

The READ-IT study protocol for a feasibility randomised controlled trial of using a support worker/family carer mediated online reading programme to teach early reading skills to adults with intellectual disabilities.

BACKGROUND: Many individuals with intellectual disability (ID) have not learnt basic reading skills by the time that they reach adulthood, potentially limiting their access to critical information. READ-IT is an online reading programme developed from the Headsprout® Early Reading (HER®) intervention and supplemented by support strategies tailored for adults with ID. HER® has been successfully used to teach adults with ID to read in a forensic setting by trained staff. The aim of this study is to assess the feasibility of delivering READ-IT to adults with ID by family carers/support workers and will assess whether it would be feasible to conduct a later definitive randomised controlled trial (RCT) of the effectiveness of the programme. The study will aim to contribute to the evidence base on improving outcomes for adults with ID and their caregivers. METHODS: This study is a feasibility RCT, with embedded process evaluation. Forty-eight adults with ID will be recruited and allocated to intervention: control on a 1:1 basis. Intervention families will be offered the READ-IT programme immediately, continuing to receive usual practice and control participants will be offered the opportunity to receive READ-IT at the end of the trial follow-up period and will continue to receive usual practice. Data will be collected at baseline and 6 months post-randomisation. DISCUSSION: The results of this study will inform a potential future definitive trial, to evaluate the effectiveness of READ-IT to improve reading skills. Such a trial would have significant scientific impact internationally in the intellectual disability field. TRIAL REGISTRATION: ISRCTN11409097.

A Preliminary Study of Health Literacy in an Ethnically Diverse University Sample.

There is a considerable body of research on health literacy in adult healthcare settings, mostly among at-risk clinical populations. However, much less is known about health literacy among youth transitioning to adulthood, including college students. Despite the protective effects of higher levels of education, some college students might have other risk factors for low health literacy (i.e., minority status). Hence, the purpose of the present study was to explore health literacy in an ethnically diverse public urban university. Although a majority of the students performed within the adequate range, we observed a subset of Hispanic and foreign students with lower health literacy, particularly in the domain of numeracy. Our preliminary results suggest that, contrary to common belief, there exists a vulnerable subpopulation of college students that have difficulty understanding and using health-related information. Health professionals should be alert to possible low health literacy among college students that may interfere with communication of vital health-related information and decision-making.

Environmental Lead Exposure and Adult Literacy in Myanmar: An Exploratory Study of Potential Associations at the Township Level.

Environmental lead exposure is a population health concern in many low- and middle-income countries. Lead is found throughout Myanmar and prior to the 1940s the country was the largest producer of lead worldwide. The aim of this study was to examine any potential association between lead mining and adult literacy rates at the level of 330 townships in Myanmar. Townships were identified as lead or non-lead mining areas and 2015 census data were examined with association being identified using descriptive, analytical and spatial statistical methods. Overall, there does appear to be a significant relationship between lead mining activity and adult literacy levels among townships with both low access (p = 0.05; OR = 2.701 (1.136⁻6.421)) as well with high access to safe sanitation (p = 0.01; OR = 18.40 (1.794⁻188.745)). Local Indicators of Spatial Association (LISA) cluster maps confirm these findings. This exploratory analysis is a first step in the examination of potential environmental lead exposure and its implications in Myanmar.

Morpho-phonemic analysis boosts word reading for adult struggling readers.

A randomized control trial compared the effects of two kinds of vocabulary instruction on component reading skills of adult struggling readers. Participants seeking alternative high school diplomas received 8 h of scripted tutoring to learn forty academic vocabulary words embedded within a civics curriculum. They were matched for language background and reading levels, then randomly assigned to either morpho-phonemic analysis teaching word origins, morpheme and syllable structures, or traditional whole word study teaching multiple sentence contexts, meaningful connections, and spellings. Both groups made comparable gains in learning the target words, but the morpho-phonemic group showed greater gains in reading unfamiliar words on standardized tests of word reading, including word attack and word recognition. Findings support theories of word learning and literacy that promote explicit instruction in word analysis to increase poor readers' linguistic awareness by revealing connections between morphological, phonological, and orthographic structures within words.

How struggling adult readers use contextual information when comprehending speech: Evidence from event-related potentials.

We investigated how struggling adult readers make use of sentence context to facilitate word processing when comprehending spoken language, conditions under which print decoding is not a barrier to comprehension. Stimuli were strongly and weakly constraining sentences (as measured by cloze probability), which ended with the most expected word based on those constraints or an unexpected but plausible word. Community-dwelling adults with varying literacy skills listened to continuous speech while their EEG was recorded. Participants, regardless of literacy level, showed N400 effects yoked to the cloze probability of the targets, with larger N400 amplitudes for less expected than more expected words. However, literacy-related differences emerged in an earlier time window of 170-300 ms: higher literacy adults produced a reduced negativity for strongly predictable targets over anterior channels, similar to previously reported effects on the Phonological Mapping Negativity (PMN), whereas low-literacy adults did not. Collectively, these findings suggest that in auditory sentence processing literacy may not notably affect the incremental activation of semantic features, but that comprehenders with underdeveloped literacy skills may be less likely to engage predictive processing. Thus, basic mechanisms of comprehension may be recruited differently as a function of literacy development-even in spoken language.

Rapid Estimate of Adult Literacy in Medicine and Dentistry-20 and oral health status among adolescents, India: A cross-sectional study.

INTRODUCTION: Health literacy is an important issue in public health. Individuals with low health literacy skills often have poorer health knowledge and health status than those with higher literacy level. Research documented on the assessment of oral health literacy in health settings and its association with oral health outcomes for adolescents was scarce. AIMS AND OBJECTIVES: The aim of this study is to assess oral health literacy about oral health status among adolescents attending pre-university colleges in Mysore, India. MATERIALS AND METHODS: A cross-sectional study was conducted over a period of 2 months among 401 adolescents attending pre-university colleges. Rapid Estimate of Adult Literacy in Medicine and Dentistry-20 (REALMD-20) and the WHO oral health assessment pro forma for adults (2013) were used. Data were analyzed using SPSS version 22 and tests employed were Chi-square test, ANOVA, and multiple linear regression. RESULTS: Mean REALMD-20 score was 10.31 ± 5.7. The study participants belonging to science course (12.69 ± 5.0) and private pre-university colleges (11.76 ± 5.8) had significantly higher REALMD-20 scores. Mean decayed, missing, and filled teeth among the study participants was (0.42 ± 0.9). Type of college, course, dental history, and number of dental visits was significantly associated with oral health literacy while oral health parameters were not significantly associated. CONCLUSION: Oral health literacy was not significantly associated with oral health status. However, long-term studies are recommended to validate the results of the present study.

Readers in Adult Basic Education.

The present study explored the reading skills of a sample of 48 adults enrolled in a basic education program in northern Florida, United States. Previous research has reported on reading component skills for students in adult education settings, but little is known about eye movement patterns or their relation to reading skills for this population. In this study, reading component skills including decoding, language comprehension, and reading fluency are reported, as are eye movement variables for connected-text oral reading. Eye movement comparisons between individuals with higher and lower oral reading fluency revealed within- and between-subject effects for word frequency and word length as well as group and word frequency interactions. Bivariate correlations indicated strong relations between component skills of reading, eye movement measures, and both the Test of Adult Basic Education ( Reading subtest) and the Woodcock-Johnson III Diagnostic Reading Battery Passage Comprehension assessments. Regression analyses revealed the utility of decoding, language comprehension, and lexical activation time for predicting achievement on both the Woodcock Johnson III Passage Comprehension and the Test of Adult Basic Education Reading Comprehension.

Vocabulary does not complicate the simple view of reading.

Gough and Tunmer's (1986) simple view of reading (SVR) proposed that reading comprehension (RC) is a function of language comprehension (LC) and word recognition/decoding. Braze et al. (2007) presented data suggesting an extension of the SVR in which knowledge of vocabulary (V) affected RC over and above the effects of LC. Tunmer and Chapman (2012) found a similar independent contribution of V to RC when the data were analyzed by hierarchical regression. However, additional analysis by factor analysis and structural equation modeling indicated that the effect of V on RC was, in fact, completely captured by LC itself and there was no need to posit a separate direct effect of V on RC. In the present study, we present new data from young adults with sub-optimal reading skill (N = 286). Latent variable and regression analyses support Gough and Tunmer's original proposal and the conclusions of Tunmer and Chapman that V can be considered a component of LC and not an independent contributor to RC.