National Network of Libraries of Medicine
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Teaching Health Literacy to Underserved Youth

Background: Low health literacy has been associated with poor health outcomes and socioeconomic factors. Milwaukee has a lower educational attainment and diverse medically underserved populations within the city. Health literacy is a national concern and is part of the mission of the National Library of Medicine and its network of Regional Medical Libraries. Youth health literacy has not been measured; many health education programs have been cut or reduced in primary and secondary schools and health literacy is not mandated or funded. It has been determined that youth needs to learn how to best search for and evaluate online health information. Objective: This project will Implement a sustainable youth health literacy curriculum in a health education course at Vel R. Phillips Juvenile Justice Center in Wauwatosa School District in Milwaukee County Wisconsin. Methods: MCW librarians will provide train-the-trainer sessions to current teaching personnel at Vel R. Phillips Juvenile Justice Center on how to access quality health information using Medline Plus, Google search techniques and website evaluation skills. “Youth Health Literacy: A Toolkit to Strengthen Health Literacy” (YHL), developed at the New Mexico Department of Health Office of School and Adolescent Health, will be integrated into the current Health Education course at the Vel R. Phillips Juvenile Justice Center. YHL instruction will include interactive exercises and the use of a Chromebooks available onsite. The YHL curriculum will be taught over 4 weeks and repeated 6 times during the school year. Each class is expected to include 20-30 students. The pre-and-post evaluation tool built into the YHL curriculum will be utilized to assess student learning. The project will develop a print collection of consumer health materials suitable for the target population. A LibGuide with relevant information resources will be developed for future reference for participants. Results: A local community partnership aimed at improving youth health literacy will be forged; Underserved youth will acquire sustainable health information seeking skills; Quality health information available from the National Library of Medicine will be promoted; the NNLM and GMR mission and aims to improve access to health information to diverse populations and improve health literacy will be met. Conclusion: Medical librarians in the NNLM can participate in bridging a gap in health education by building a sustainable youth health literacy program, a step towards improving health outcomes in the population.
Identify any specific population(s) this project will serve: 
Teens
Medically Underserved Areas/Populations
Behavioral/Social Determinants of Health
Identify roles of participants this project will serve: 
Student, K-12
Project Lead:
Ellen N Sayed
Funding Source: 
GMR
Project Funding:
Federal Fiscal Year: 
2018
Funding Amount: 
$9511
Funding Period:
Jun 18, 2018 to Apr 30, 2019
Project Status:
Completed

Activities

Teaching Health Literacy Skills to Underserved Youth
Activity Description:
The program is a six week program, with one module a week, each running from 30 to 40 minutes. Each module contains a stand alone lesson plan to help teachers align this information with their school’s program goals, 1 to 3 interactive activities, a discussion guide, and the evaluation tools of a pre-survey and post-survey. Each weekly module focuses on different areas of health.
Activity Dates:
10/16/2018
Activity Type:
Classes/Courses/Trainings/Workshops
Partner Organization(s):
Vel R. Phillips Juvenile Justice Center (Partner Organizations)
Achievements:
The program is a six week program, with one module a week, each running from 30 to 40 minutes. Each module contains a stand alone lesson plan to help teachers align this information with their school’s program goals, 1 to 3 interactive activities, a discussion guide, and the evaluation tools of a pre-survey and post-survey. Each weekly module focuses on different areas of health.
Researching Your Diagnosis Online: What You Need to Know
Activity Description:
An introduction to consumer health resources offered to a bladder cancer support group.
Activity Dates:
10/24/2018
Activity Type:
Presentations
Partner Organization(s):
Achievements:
An introduction to consumer health resources offered to a bladder cancer support group for 14 people. Many NNLM resources were presented.
MCW Libraries: An Introduction to Consumer Health - Cancer Support Group
Activity Description:
An introduction to consumer health resources offered to a general cancer support group.
Activity Dates:
11/08/2018
Activity Type:
Presentations
Partner Organization(s):
Achievements:
An introduction to consumer health resources offered to a general cancer support group of six people. Presented many NNLM resources.
Final Report
Approaches and Interventions Used:

The project required hands on training for the health teachers by a librarian from the Medical College of Wisconsin Libraries. The content for the classes were created by the library staff and then sent in advance of the class to the teachers. The teachers had 2 weeks to review the class material. The teachers and library staff met in person to review the material and discuss approaches for teaching the content. These “train the trainer” sessions were held 3x over the course of the year. Evaluation of the sessions were taken.
 
The materials used for the classes are available online at the Medical College of Wisconsin Libraries’ LibGuide website. (https://mcw.libguides.com/c.php?g=936588&p=6750260)
 

Problems or Barriers Encountered:

The project did encounter some issues. Scheduling between the library staff and teachers was hard because of both parties having busy schedules. The main issue arose early on in that many of the target population have a low literacy level so the reading material included with the classes was not comprehensible for the students. Under this same issue, the students did not understand the post-class survey, so they did not complete them or did not take the time to genuinely answer the questions. This led to a significant revision of the class materials as well as the post-survey. The follow up feedback was positive with the changes.
 

Evaluation:

To evaluate the program's success, three types of evaluations were used. 

1) The librarian from the Medical College of Wisconsin Libraries observed the classes in real-time to see the reaction of students to the material and activities. This helped mold the course content by being able to hear the questions being asked by students and assess the student's proficiency and understanding of the content. This helped to determine if each individual module or class met the goals for the program.

2) The librarian from the Medical College of Wisconsin interviewed the heath teachers in person for direct feedback on the success and failures of the class material as well as the adaptability to different classes. They also provided written feedback on the "train the trainer" session.

3) Each of the 6 sessions had anonymized student feedback via written survey on their understanding and thoughts on the material presented in class. 

The program goals were successfully accomplished. There is an ongoing program for students to learn health literacy skills in place.

Continuation Plans:

The course will continue to be taught to students by the trained health teachers annually. The teachers have access to the libguide (https://mcw.libguides.com/c.php?g=936588&p=6750260) with all the current material from the classes available for download. They also have built a relationship with the librarians of the Medical College of Wisconsin and have access to the librarian who held the “train the trainer” sessions for them. The continuation of the program should be self sufficient in that no more funds would need to be invested for teachers to implement in their own schools.

Lessons Learned:

When implementing this program, we were surprised to find the level of literacy to be lower than expected. This translated directly into the health literacy skills of the students. The students were generally enthusiastic about the topics, asking poignant questions. The results weren’t very unexpected. If another school was looking to implement this program from the material, a suggestion would be to assess the content of the course with their own students level of literacy. This would allow for the material to be structured in a way that their students will understand.
 
The interactive parts of the classes received the best feedback. Students liked being able to get out of their seats and move around while learning.

Impact:
The primary goal of this project was to provide underserved youth who have low health literacy with sustainable information seeking skills. These students are a high risk population. During one of the classes, part of the topic is your family tree. This section discusses how your family’s health can impact your own. This is information that may be taken for grated by some adults who received this knowledge through their family or doctors. The students that were the target of this program did not and do not have the support to learn information like this in their homes. One student in particular, during the section of class talking about how disease can carry though families, became concerned. He did not know previously that because his mother had breast cancer, his newly born daughter would also be at risk for this disease as she got older. There was a visible moment where the information “clicked” and he realized the importance of telling this information to his doctors and the importance of being able to find information on this disease. The impact of this information will change not only this young man’s life, but also his daughter’s because this is knowledge he will chare with her in order to help keep her healthy. This project will hopefully be shared with medical libraries across the country via a publication in the the next 12 months.
Other:
The Medical College of Wisconsin Libraries worked together with the Wauwatosa Public School District with the primary goal to provide underserved youth who have low health literacy with sustainable information seeking skills. This was achieved through the creation of class content that can be individually taught by health teachers as a normal and ongoing part of the health curriculum for high school aged students. The feedback from both teachers and students was positive. The program builds a good foundation for health literacy by discussing: • what makes reliable health information • the different aspects of health that make for a healthy whole individual • how to find reliable health information These foundations can lead to life-long learning and support of a healthy life.