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Promoting Health Literacy at Hawthorne Education Center


Promoting Health Literacy at Hawthorne Education Center Jennifer P. Rho, MD, MPH – PowerPoint PPT presentation

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Title: Promoting Health Literacy at Hawthorne Education Center

Promoting Health Literacy at Hawthorne Education
  • Jennifer P. Rho, MD, MPH

Hawthorne Education Center Rochester, MN
  • Rochester Public Schools facility dedicated to
    adult and family literacy
  • Serves 3000 learners per year, 700 per day
  • Employs 60 teachers and staff members
  • 100 volunteers per week
  • Highly committed learners, staff and volunteers

Hawthorne Education Center Rochester, MN
  • Courses of study English as a Second Language,
    Adult Basic Education, GED, High School Diploma,
    Hand in Hand, Citizenship preparation
  • Ages 15-80, average age 25-30
  • Represents 30 countries including U.S. born
  • gt80 living below federal poverty level

Health at Hawthorne A Challenge
  • At least one ambulance per month at school prior
    to health promotion activities (pre-2005)
  • Obvious health disparities among learners
  • Pervasive problems with health care access
  • High uninsurance
  • 34 of Hawthorne learners are uninsured vs. 3
    uninsured in Rochester area (2007)
  • Low health literacy - many those who have
    insurance act functionally uninsured

Literacy Levels
Health at Hawthorne An Opportunity
One of the main reasons Hawthorne learners say
that they are learning English is so that they
can talk with their doctor.
The Early Days
  • Environment was ripe for health promotion at
  • Eager public health student
  • Helped in whatever way I could

Hawthorne Health Services
  • Opened Sept 2005
  • Collaborative among Hawthorne Education Center,
    Migrant Health Services, Olmsted County Public
    Health and Winona State University
  • Open 4 days per week
  • Free to Hawthorne learners and family members
  • 4 providers, public health nurse, office
    assistant, Americorps VISTA volunteer
  • Funded through donations

Hawthorne Health Services
  • Promote health literacy through
  • Providing health education
  • Providing limited health services at Hawthorne
  • Identifying and accessing sources for health
    insurance and primary health care
  • Collaborating with others in the community
  • Providing case management for learners with
    ongoing health concerns

What We Have Accomplished
  • 5500 patient visits at the clinic since opening
  • Additionally
  • Annual health fair serves 400 learners/year
  • Annual flu shot clinic provides gt200
  • Multiple other community partnerships-Mayo Breast
  • Multiple health ed programs
  • Introduced hundreds of health professionals to
    health literacy
  • Jobs skills to community members - medical
  • Very few ambulance visits to Hawthorne since
    clinic opened

  • Provides opportunity for reciprocal learning
    about health literacy
  • Train the next generation to provide
    patient-centered care
  • Provides manpower to implement health promotion
  • Great opportunity to build relationships
  • gt50 nursing students/yr
  • Varying number of med students
  • Health fair, flu shot, screenings, exercise
    class, book club

Annual Health Fair
  • 400 learners
  • Great community participation
  • Guide for participants
  • Follow-up survey
  • Nutrition
  • Weight loss
  • Exercise
  • Dental Care
  • Blood pressure
  • (Stress)

Annual Cold and Flu Clinic
  • Education-focused
  • Service-learning
  • Classroom based
  • Video
  • Posters
  • Flu shot clinic

Health Literacy Book Club
  • Taught by nursing students and medical students
  • ESL level 5
  • Small groups
  • Health Literacy Special Collection
  • http//
  • Staying Healthy Florida Literacy Coalition
  • Culture and Health
  • Ask Me 3

Mayo Patient Ed Pilot
  • Field test Mayo Patient Ed materials with
    Hawthorne learners
  • Goals
  • To increase the health literacy of Hawthorne
    learners through the process of systematically
    evaluating patient ed materials
  • To empower the Hawthorne learners to advocate for
    themselves when they do not understand health
    info that has been provided to them
  • To utilize the expertise of the Hawthorne
    community (teachers and learners) to improve the
    quality of Mayo patient ed materials developed
    for Mayo patients

Participatory Methods
  • Hawthorne teachers and administrators
    participated in every aspect of development and
  • Classroom based
  • Picked topic and individual materials to review
  • Chose methods
  • Gave input on the eval tools
  • ESL, GED, Diploma

How we included everyone
  • Initial meeting
  • Chose topic - healthy living
  • Chose items to review
  • Chose evaluation methods (Doak Doak)
  • SAM
  • Individual and group review for learners
  • Met with teachers (ESL, Reading, GED, Diploma).
    Reviewed items and SAM. Did SAM together on food
  • Teachers chose which items they wanted to review
    with their class
  • Reviewed 1 item per week for 4 weeks

Healthy living
  • Topic has been consistently important to adult

In The Classroom
  • 8-10 classrooms per item
  • Lead by a patient educator
  • Introduction - This is your chance to be the
    teacher, to teach us how we can make health
    information easier to understand for you and your
  • Individual Evaluation
  • Read designated pages
  • Circle words that they did not understand
  • Multiple choice questions to assess understanding
    of content
  • Group review/teaching
  • Debriefing with teachers, learner feedback

  • Teachers and learners were VERY engaged and
  • Strong interest in healthy living info
  • All of the materials were beyond the literacy
    levels of the learners
  • Positives mutually beneficial, collaboration,
    community expertise, group interaction, valuable
  • Negatives Too much data, too much time

  • Rewrite the 4 tested items to match ESL level 4
  • Establish process to selectively test pt ed
    materials with adult learners during development
  • Tie into CASAS - develop lesson plan

What have we learned over the past 6 years?
  • Hawthorne learners utilize available health
    services when health education is provided
  • Hawthorne learners participate more when the
    health topic is important to them
  • Health activities should be guided by the
    community as much as possible

A Note about Research
  • Research has never been the guiding force behind
    our health activities
  • Concerns about vulnerable population
  • Community-led research
  • Action-oriented
  • Education-focused
  • Marcia Drew Hohn, Ed. D.
  • Literacy Leader Fellow 1996-1997

Why We Have Been Successful
  • Health literacy has been a topic of mutual
  • Spirit of cooperation
  • Hawthorne remains in control
  • Reciprocal learning
  • Individual agendas are minimized - careful
    selection of partners
  • Efforts are a combination of civic engagement,
    community organizing, service learning
  • Grass roots, bottom up approach, flexible,
  • No money to argue over

Community Engagement Strategies
  • Use existing community infrastructure when
  • Get involved in your community
  • Work with organizations not institutions-one
    exists to effect change, the other to maintain
    the status quo
  • Asset-mapping
  • Few organizations want another needs assessment
  • Win-win situations - can help offset lack of
  • Service-learning/Reciprocal learning
  • Face time is very important
  • The process is the product

Tips for getting started
  • Look for unique opportunities
  • Be humble - be a leader without being the
  • Utilize the practical expertise of community
    organizations and community members
  • Relationships take time - start small and get to
    know the community (all levels)
  • Minimize agenda setting
  • Recognize that the community way is different
    than the academic way
  • Plan to sustain the program

Future Plans
  • More collaboration
  • Mayo Med School
  • Mayo Ophthalmology
  • Mayo Dermatology
  • Public Health Immunizations
  • Revamped health fair
  • Healthy eating class
  • Expand offerings for health literacy book clubs
  • Work with Mayo Pat Ed to develop pt ed materials
  • Hopefully some funding