ESL Participation as a Mechanism for Advancing Health Literacy in Immigrant Communities

Abstract

A reliance on the conceptualization of health literacy as functional skill has limited researchers’ views of the adult English-as-a-second-language (ESL) context as a site for health literacy interventions. To explore the contributions of alternative views of literacy as social practice to health literacy research, the authors examined teacher survey data and learner outcomes data collected as part of a multiyear collaboration involving the California Diabetes Program, university researchers, and adult ESL teachers. The survey results (n = 144 teachers) indicated that ESL teachers frequently model effective pedagogical practices that mediate social interaction around health content, the basis for acquiring new literacy skills and practices. In the classroom pilot (n = 116 learners), the majority of learners reported they had learned about diabetes risk factors and prevention strategies, which affirmed existing healthy behaviors or prompted revision of unhealthy ones. About two thirds of the learners reported sharing preventive health content with members of out-of-school social networks. This study represents a first step in research efforts to account more fully for the mechanisms by which social interaction and social support facilitate health literacy outcomes in ESL contexts, which should complement what is already known about the development of health literacy as functional skill.

Acknowledgments

The authors thank the many adult ESL teachers and learners, whose participation made this project possible. Acknowledgements also go to graduate research assistants at San Francisco State University (Adam Reid, Aaron Sponseller, Sonya Worthy, Shoko Kita, Amanda Chapman) who assisted in data collection and analysis.

Notes

^a No respondents indicated non-Hispanic Black.

^b Beginning and literacy levels categorized together because only 2.1% of the sample reported teaching at the literacy level.

^c Recently arrived refers to length of residence in the United States 2 years or less.