Learners’ experience and perceived impact of a health literacy program in adult basic education: a qualitative study

摘要

Objectives and importance of the study: Adult literacy programs aimto empower learners to participate more effectively in everyday life. Thisincludes programs with health content embedded in curricula to targethealth literacy. Adult learners who attend these programs represent aheterogeneous population, but include a high proportion of hard-to-reachor socially disadvantaged groups in terms of age, ethnicity, educationalbackground, language and prevalence of learning disabilities. In 2014, weconducted a cluster-randomised controlled trial of a health literacy program inadult basic education classes across New South Wales, Australia. This paperreports fndings from a qualitative study exploring learners’ experience of thecourse and its perceived impact on their lives, as well as their understandingand confdence about health.Study type: Qualitative interview study.Method: We conducted semistructured interviews as part of the evaluation ofthe 18-week health literacy program, with participants purposively recruitedfrom six health literacy classes (n = 22). Researchers trained in qualitativemethods interviewed adult learners either face to face or over the phone usinga topic guide. Data was analysed using the Framework method, a matrixbased approach to thematic analysis.Results: The majority of interviewees were female, lived in metropolitanareas and were from non-English–speaking backgrounds. Most had existingself-reported health problems and inadequate functional health literacy.Most participants described positive impacts of the health literacy courseon their language, literacy and numeracy skills, functional health literacyskills, and health knowledge. They also reported being able to translate thisinto health actions including interacting with providers, accessing and usinghealthcare, and managing health and illness (e.g. making healthier foodchoices). Learners also described positive social outcomes of the course,including feelings of connectedness and interpersonal trust within a newnetwork of learners, and reported sharing new knowledge with others in theircommunities.Conclusions: The fndings add value to existing limited evidence that hasdemonstrated the untapped potential of adult basic education to develophealth literacy skills among socially disadvantaged groups. Learners valuedthe opportunity to share experiences in structured group learning, andreported confdence to transfer new knowledge into their home and widersocial network.