Recruiting Participants with Low Literacy Skills

Recruiting Participants with Low Literacy Skills Angela Colter (@angelacolter) UPA 2010 Munich

In the United States 44 % % of adults have low literacy skills 2003 National Assessment of Adult Literacy

Rate of adults with low literacy skills Sweden 25% Netherlands 36% Germany 42% Australia 44% Switzerland 47% United Kingdom 50% Ireland 57% Hungary 67% Portugal 80% 1998 International Adult Literacy Survey (OECD)

People with low literacy skills likely: • are older • have less education • work low-paying jobs • are ashamed of their poor reading skills • hide their reading difﬁculties from others

Reading, like typing, is a skill

Do you have low literacy skills? Sorry, you can’t ask that

Recruiting Process ➊ ➋ ➌ FIND SCREEN CONFIRM

NEVER tell participants you’re looking for people with low literacy skills

Adult Basic Education ≠ Adult Literacy 7th grade & above 6th grade & below Groups One-on-one Associated with Free-standing public schools/ volunteer community colleges May have to go No IRB through school’s institutional review board

Working with adult education • Find a program on proliteracy.org • Build relationships • Be respectful • Pay participants • Pay the literacy program

SCREEN

How conﬁdent are you ﬁlling out medical forms by yourself? Extremely Quite a lot Somewhat A little bit Predicts low literacy 83% of the time Not at all Wallace L, Rogers E, et al Screening items to identify patients with limited health literacy skills Journal of General Internal Medicine. 2006; 21: 874-877

CONFIRM

REALM Rapid Estimate of Adult Literacy in Medicine • Word recognition test fat ﬂu fatigue pelvic allergic menstrual • Quick and easy to administer pill dose jaundice infection testicle colitis • Participant says each word out eye stress exercise behavior emergency medication loud. Scored on number smear prescription occupation pronounced correctly nerves germs notify gallbladder sexually alcoholism 61-66: not low lit meals calories irritation disease depression constipation 45-60: grade 7-8 cancer miscarriage gonorrhea 19-44: grade 4-6 caffeine pregnancy inﬂammatory 0-18: grade 3 or below attack arthritis diabetes kidney nutrition hepatitis • Doesn’t matter if they know hormones menopause antibiotics the word’s meaning herpes appendix diagnosis seizure abnormal potassium bowel syphilis anemia asthma hemorrhoids obesity Davis T, Long S, et al rectal nausea osteoporosis Rapid estimate of adult literacy in medicine: a shortened screening instrument Fam Med. 1993; 25: 391-395 incest directed impetigo

Two incentives • One to qualify ($25) • One to participate ($25 + $75)

To sum up: • Recruit from sources likely to include low lit users • Screen for low lit characteristics • Conﬁrm literacy level in person • Pay separate incentives for conﬁrmation and participation

Q&A Angela Colter angelacolter.com/lowliteracy acolter@gmail.com

Recruiting Participants with Low Literacy Skills

by Angela Colter

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