Life Skills to Life Saving: Health Literacy in Adult Education.

The first time I went to the doctor, I had an accident and I was scared because I never had been.... I felt very sad because nobody was with me, and then I started to worry about my family because I was out of work for three weeks. (Felix) As a telehealth nurse, I get calls from patients who do not understand the written instructions given to them by their doctor, the emergency department, and/or discharge instructions after hospitalization. This may include how to take their medication or manage chronic diseases, such as diabetes or asthma. (RN) I work for an adult literacy program and see many people who do not read.... They talk about the stack of papers you get to fill out the minute you walk into the doctor's office. --(Reading Center Manager) As the educational environment becomes increasingly diverse, adult educators are poised to serve as invaluable resources to adult learners, both as links to reliable health information and builders of skills. My introduction to this role was in response to requests from students for information about HIV and AIDS. This was in 1992, a time when there was an "urgent [commitment] to search for a cure to the AIDS epidemic" and the world was described as divided and frightened (Clinton, 1992, [paragraph] 1). My English as a second language (ESL) class had just finished a brief activity called, "Dealing with AIDS" from an ESL textbook, which focused on the social stigma of the disease (Hamel, 1990). a 19-year old Romanian student named Adrian approached me with the request to teach more information about how AIDS is transmitted. I carefully considered how to address such a sensitive topic. The class was comprised of students from various cultures, countries, and age groups. While I thought it would be best to invite a guest speaker to share this information, I did not know whether expert resources were available in our community to give a free presentation to an evening class. However, when the idea was suggested, students gave enthusiastic approval, which encouraged me to find out more. My students wanted the facts about HIV and AIDS. They wanted to know how to protect themselves, and had limited access to this important health information. I arranged for a health educator from our local health department to visit, and 'the facts' were delivered a few classes later in an engaging, humorous, and sensitive way to a frilly-attended classroom. The health educator used a combination of ESL-friendly verbal, written, and pictorial information, and created an open environment for dialogue and discussion. The class was a success--interesting, responsive to student needs, and immediately practical. One month ago my child almost died choking on a piece of hot dog. Everything happened very fast ... my wife and I ran to the car to rush him to the emergency room ... we had to wait a long time.... The bills have started to come. The visit was very expensive. (Carlos) My most recent request was for first aid training. It came in response to a choking emergency one of my students, Carlos, experienced with his 3-year-old child the previous weekend. Carlos recounted to our class the panic that started the moment he and his wife realized their son was choking, the fruitless efforts of their attempts to dislodge the food, the tense car ride to the emergency room, and the confusion which resulted from the process of registering, consenting, and completing paperwork for their son's medical treatment. The panic and confusion continued as medical bills later arrived for this uninsured family. Carlos, a construction worker, was surprised at the high cost of medical treatment, and admitted that he signed papers (in Spanish) without fully understanding their meaning. His son recovered, and Carlos' family has spent a long time recovering from the experience and expense. Students in our class wanted to learn life-saving skills that could prepare them for unanticipated situations like Carlos experienced. …