The effect of a literacy training program on family medicine residents

Robert Wood Johnson Clinical Scholars Program and the Division of Community Pediatrics, University of North Carolina, Chapel Hill, NC 27599-7105, USA.
Family medicine (Impact Factor: 1.17). 10/2004; 36(8):582-7.
Source: PubMed


Pediatric literacy promotion programs carried out in the primary care setting, such as Reach Out and Read (ROR), have been associated with improved language skills for preschool children. Primary care physicians have frequent contact with young families and may be well situated for a literacy promotion program for both children and adults. We examined whether introducing ROR and an adult literacy intervention improves family medicine residents' literacy knowledge, attitudes, and practices.
We conducted a single group pretest/posttest evaluation design study of residents in a family medicine residency program serving low-income families. Residents completed self-administered questionnaires assessing literacy knowledge, attitudes, and practice. Then, through educational conferences, precepting, and ROR, residents were trained to assess and counsel patients about literacy. The same questionnaire was readministered 8 months later.
All 24 (100%) residents completed both the pre- and post-intervention questionnaires. Literacy knowledge mean scores increased from 74.5% to 83.1%. After the intervention, residents reported a greater sense of comfort in counseling about childhood and adult literacy. After the intervention, a greater proportion of residents reported usually or always asking about literacy milestones (30.2% to 79.2%) and parent-child reading (65.2% to 97.8%) during well-child visits.
A family literacy promotion program improved family medicine residents' self-reported literacy knowledge, attitudes, and practices. Such interventions can be incorporated into the education of family medicine residents with meaningful results.

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Available from: Marjorie S Rosenthal, Jun 23, 2015
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    • "In a second study involving resident training, Rosenthal, Werner, and Dublin (2004) investigated whether presenting ROR training would improve family medicine resident's knowledge, attitudes, and practices in a family medicine program serving low-income families. Rosenthal et al. (2004) administered a pre-post questionnaire to 24 residents to assess the effect of a four-hour educational training focused on teaching residents to counsel adults and children about literacy. Residents selfreported increases in literacy knowledge and practices, as well as improvements in attitudes toward the ROR intervention. "
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    ABSTRACT: Reach Out and Read (ROR), a pediatric literacy intervention, is widely disseminated, yet there has been a paucity of research on training of intervention agents and no published research on the fidelity of intervention component delivery or identifying the amount of literacy counseling (LC) delivered during an intervention. In this evaluation study, data was collected for four resident physicians after three phases of training, by direct observation during 45 well-child exams. Data was examined to (a) evaluate the fidelity of implementation of the intervention components and (b) report the frequency of occurrence of literacy counseling delivery by 10-second intervals during well-child exams. Other measures included an evaluation of resident knowledge and attitudes pre-training and post-study, and parent report post-intervention. Results demonstrated that: (a) during 93% of well child-visits at least 1 ten-second interval of LC was delivered and books were distributed during 91% of visits, (b) the amount of literacy counseling delivered during a ROR intervention was small; a mean of 49 seconds per well-child visit, (c) resident knowledge and attitudes remained constant pre-training and post-intervention, (d) parents may not have been aware of receiving LC; 7% reported receiving LC, and (e) 85% of parents did recall receiving a book. Future ROR research needs to address fidelity of ROR implementation, amount of literacy counseling delivered, and identify a threshold amount of literacy counseling needed to influence parents to deliver home literacy activities.
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    ABSTRACT: The Practicum Project is a supervised service-learning experience that integrates curriculum with hands-on experience in a public health setting. All 2nd year students are expected to work collaboratively in assessing the extent, causes and public health responses to a selected public health problem confronting citizens of Connecticut. The focal topic for the 2006 Project was Health Literacy in Connecticut.During this past spring, 17 students of our program, working alongside and in partnership with more than 75 community-based stakeholders across Connecticut, completed over 1800 hours of service-learning in pursuit of answers to 3 questions:Can the present and future burden of health literacy be estimated for Connecticut? What is the current capacity of Connecticut's health and social service system to halt the crisis we confront today? Can new policy and regulatory strategies be put forth to reduce the severity and scope of the problem?This occasion and the accompanying report mark the completion of their project and acknowledge the considerable contributions that many have made to the success of this educational experience. Through those combined efforts, students gained experience and skill addressing one of the most significant public health issues of our time; also, they gained insight into the breadth and capacity of our public health system and established invaluable relationships with public health practitioners, agencies and institutions around the state. Their report documents a rich campus-community partnership to advance public health goals.
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    ABSTRACT: As many as 90 million Americans have difficulty understanding and acting on health information. This health literacy epidemic is increasingly recognized as a problem that influences health care quality and cost. Yet many physicians do not recognize the problem or lack the skills and confidence to approach the subject with patients. In this issue of Family Medicine, several articles address health literacy in family medicine. Wallace and Lennon examined the readability of American Academy of Family Physicians patient education materials available via the Internet. They found that three of four handouts were written above the average reading level of American adults. Rosenthal and colleagues surveyed residents and found they lacked the confidence to screen and counsel adults about literacy. They used a Reach Out and Read program with accompanying resident education sessions to provide a practical and effective means for incorporating literacy assessment and counseling into primary care. Chew and colleagues presented an alternative to existing health literacy screening tests by asking three questions to detect inadequate health literacy. Likewise, Shea and colleagues reviewed the prospect of shortening the Rapid Estimate of Adult Literacy in Medicine (REALM), a commonly used health literacy screening tool. Both the Chew and Shea articles highlight the need for improved methods for recognizing literacy problems in the clinical setting. Further research is required to identify effective interventions that will strengthen the skills and coping strategies of both patients and providers and also prevent and limit poor reading and numeracy ability in the next generation.
    Full-text · Article · Oct 2004 · Family medicine
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