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Clinics, Classrooms, and Communities Abstracts
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Colloquium Organizer: Maricel G. Santos

A Call for Rigorous Research in Applied Linguistics to Reduce Health Disparities
Holly E. Jacobson, University of New Mexico

Limited English health literacy among U.S. language minority communities is strongly linked to reduced healthcare access, poorer health outcomes, and health disparities. However, little research has examined the role of human interaction and language in intercultural/interlinguistic communication in healthcare settings. In-depth analyses of turn-taking and other interactional variables are needed to specify the factors that shape the impact of provider communicative practices versus patient health literacy levels on patient comprehension of health information. This paper critically analyzes the research linking health care access to health literacy, and makes recommendations for more rigorous research that explores interaction and language more systematically.

Health Literacy and the Question of Whose Knowledge Counts in Health Care
Uta Papen, Lancaster University

This paper examines a fundamental question of health literacy: whose knowledge counts in the interaction between patients and health care providers? Health literacy, when defined as an individual skill, focuses on patients’ inability to understand and act upon information from their doctor. Knowledge here is seen primarily from the perspective of the trained health professional. If health literacy is conceptualised as social practice, however, the question of whose knowledge has authority in healthcare contexts moves centre stage. Applied linguists can help explore the dynamics of knowledge construction in medical contexts and how this affects inequitable access to health care.

New Challenges for Training Providers: How Can Applied Linguists Help?
Julie McKinney, Institute for Healthcare Advancement

In this session we will describe how the concept of health literacy has moved beyond its original focus on reading and understanding health information to include people’s ability to act, and healthcare providers’ ability to present information clearly. We will look at how providers are now being trained in health literacy awareness and clear written and oral communication techniques. Then we will explore ways in which applied linguists can help them to better understand and address the challenges that their lowest skilled clients face. We will also examine some health literacy resources for educating the public, providers, and materials developers.

Understanding Patients’ Voices: Applied Linguistics, Health Literacy, and Adherence
Ulla M. Connor, Indiana University-Purdue University, Indianapolis

This presentation describes the application of a linguistic analysis of diabetes patients’ own language concerning health literacy and self-care. The results of the analysis have been used in clinical interventions among chronically ill patients. This linguistically-based communication intervention informs health care providers about how to talk with patients in a language and style that more closely reflects patients’ own worldviews and health beliefs.

I’m Here to Get Obamacare:” Health Literacy Practices for Community-Based Insurance Navigators
Donald Rubin, University of Georgia

Rendering the complexities of health insurance comprehensible is a major challenge for the Affordable Care Act. The ACA establishes a corps of community-based insurance navigators to provide in-person enrollment assistance. Principles of interactive health literacy—and the related construct of listenability--have been harnessed to help these navigators provide meaningful verbal assistance to consumers. One consortium of community-based organizations thus trains navigators in health literacy strategies such as “living room language,” “metaphor spinning,” eliciting questions, selecting information for small “packages,” and teach-back. One evaluation showed that consumers especially benefit when navigators integrate graphic representations of complex terms in a deictic fashion.

Literacy, Language and Culture: Developing Health Literacy Curriculum for English Learners
Sabrina Kurtz-Rossi, Tufts University School of Medicine

Health and access to health care are immediate concerns for English language learners. For this reason the topic of health as authentic content for language learning is of high value to teachers and adult learners. In this session, the presenter will discuss the development of health literacy curricula in collaboration with teachers and learners across the United States and review lessons learned about integrating health literacy into English language classes. Common issues across projects include teaching multilevel classes, what health literacy competencies to cover, and the role of the teacher as facilitator of learning rather than health content experts.

Health Literacy 3.0
Christina Zarcadoolas, City University School of Public Health and Hunter College
Into its third decade, the field of health literacy still contends with essentially unchanged and dismal statistics about the public’s abilities to understand and use health and science information. Yet seismic shifts have occurred. First generation models of health literacy privileged the doctor–patient relationship; while the second generation elaborated health literacy of specific diseases. Today life has essentially moved online and mobile; we face new and emerging infectious diseases, while yawning disparities in health grow alongside a health industry driven by the bottom line, in a society struggling to redefine privacy. So what will health literacy 3.0 need to be?

Discussant: Maricel G. Santos, San Francisco State University

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