The power of feedback.

Objectives To update a 2004 systematic review of health care service use and health outcomes related to differences in health literacy level and interventions designed to improve these outcomes for individuals with low health literacy. Disparities in health outcomes and effectiveness of interventions among different sociodemographic groups were also examined. Data sources We searched MEDLINE®, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, PsychINFO, and the Educational Resources Information Center. For health literacy, we searched using a variety of terms, limited to English and studies published from 2003 to May 25, 2010. For numeracy, we searched from 1966 to May 25, 2010. Review methods We used standard Evidence-based Practice Center methods of dual review of abstracts, full-text articles, abstractions, quality ratings, and strength of evidence grading. We resolved disagreements by consensus. We evaluated whether newer literature was available for answering key questions, so we broadened our definition of health literacy to include numeracy and oral (spoken) health literacy. We excluded intervention studies that did not measure health literacy directly and updated our approach to evaluate individual study risk of bias and to grade strength of evidence. Results We included good- and fair-quality studies: 81 studies addressing health outcomes (reported in 95 articles including 86 measuring health literacy and 16 measuring numeracy, of which 7 measure both) and 42 studies (reported in 45 articles) addressing interventions. Differences in health literacy level were consistently associated with increased hospitalizations, greater emergency care use, lower use of mammography, lower receipt of influenza vaccine, poorer ability to demonstrate taking medications appropriately, poorer ability to interpret labels and health messages, and, among seniors, poorer overall health status and higher mortality. Health literacy level potentially mediates disparities between blacks and whites. The strength of evidence of numeracy studies was insufficient to low, limiting conclusions about the influence of numeracy on health care service use or health outcomes. Two studies suggested numeracy may mediate the effect of disparities on health outcomes. We found no evidence concerning oral health literacy and outcomes. Among intervention studies (27 randomized controlled trials [RCTs], 2 cluster RCTs, and 13 quasi-experimental designs), the strength of evidence for specific design features was low or insufficient. However, several specific features seemed to improve comprehension in one or a few studies. The strength of evidence was moderate for the effect of mixed interventions on health care service use; the effect of intensive self-management inventions on behavior; and the effect of disease-management interventions on disease prevalence/severity. The effects of other mixed interventions on other health outcomes, including knowledge, self-efficacy, adherence, and quality of life, and costs were mixed; thus, the strength of evidence was insufficient. Conclusions The field of health literacy has advanced since the 2004 report. Future research priorities include justifying appropriate cutoffs for health literacy levels prior to conducting studies; developing tools that measure additional related skills, particularly oral (spoken) health literacy; and examining mediators and moderators of the effect of health literacy. Priorities in advancing the design features of interventions include testing novel approaches to increase motivation, techniques for delivering information orally or numerically, "work around" interventions such as patient advocates; determining the effective components of already-tested interventions; determining the cost-effectiveness of programs; and determining the effect of policy and practice interventions.

/pdf/health-literacy-interventions-and-outcomes-an-updated-chswt8nilu.pdf

Health literacy interventions and outcomes: an updated systematic review.

Preservice teachers’ culturally responsive teaching self-efficacy and outcome expectancy beliefs

Exploring the factors that influence preservice teachers' culturally responsive teaching self -efficacy and outcome expectancy beliefs

The Journal of Experimental Education

/pdf/introduction-le-developpement-professionnel-des-enseignants-si4erh615l.pdf

Introduction : Le développement professionnel des enseignants : apprendre à enseigner pour soutenir l’apprentissage des élèves

Cette recherche-action vise le developpement et la mise a l’essai d’une strategie d’integration des technologies de l’information et de la communication au primaire. Elle a aussi pour objectif l’analyse de son impact sur le sentiment d’autoefficacite des enseignants (volet quantitatif) et sur l’adoption de cette innovation chez ces derniers (volet qualitatif). Huit enseignants du primaire ont participe a cette recherche-action d’une duree de deux ans, tandis que neuf enseignants ont constitue le groupe temoin. Aucune difference significative concernant le sentiment d’autoefficacite chez les enseignants participants n’a ete relevee. La strategie mise a l’essai a toutefois permis a ces derniers de franchir au moins une etape dans le processus d’adoption d’une innovation.

/pdf/impact-d-une-strategie-d-integration-des-tic-sur-le-2jisn90h9k.pdf

Impact d'une stratégie d'intégration des TIC sur le sentiment d'autoefficacité d'enseignants du primaire et leur processus d'adoption d'une innovation

Cet article examine l’evolution des pratiques et des conceptions relatives a l’enseignement, a l’apprentissage et aux technologies. Deux perspectives principales de l’apprentissage s’imposent chez 40 enseignants du primaire participant a une recherche-action-formation : le behaviorisme social et le neoconstructivisme. Les donnees ont ete recueillies au moyen des entrevues et des observations, au debut et a la fin de la formation continue. L’analyse de ces donnees revele des pratiques relevant davantage du behaviorisme social, alors que les conceptions sont plutot associees a des perspectives multiples. La discussion analyse les resultats a la lumiere du contexte de la recherche, des travaux sur le changement conceptuel et la pratique des enseignants. Des pistes de formation et de recherche sont suggerees.

/pdf/evolution-des-pratiques-et-des-conceptions-de-l-enseignement-3udtvsg74g.pdf

Évolution des pratiques et des conceptions de l’enseignement, de l’apprentissage et des TIC chez des enseignants du primaire en contexte de développement professionnel

This study examines the formative evaluation practices of 13 experienced elementary school teachers in Quebec, Canada at the level of teacher–student interaction. The qualitative study is based on both semi-structured and stimulated recall interviews as well as videotapes of classroom activities. The participating teachers were found to be using formative evaluation in a spontaneous, informal way and focussing more often on the product rather than the learning process, although differences were seen between approaches used by teachers of grade one students as opposed to approaches used by teachers of older elementary students. The study demonstrates a link between teacher conceptions and their evaluation practices, and raises questions about how experienced teachers interpret and integrate formative evaluation in their classroom routines.

Elementary teachers’ formative evaluation practices in an era of curricular reform in Quebec, Canada

/pdf/conclusion-un-portrait-caracteristique-de-la-recherche-sur-3tvg5qjw89.pdf

Colette Deaudelin

Papers

Introduction : Le développement professionnel des enseignants : apprendre à enseigner pour soutenir l’apprentissage des élèves

Impact d'une stratégie d'intégration des TIC sur le sentiment d'autoefficacité d'enseignants du primaire et leur processus d'adoption d'une innovation

Évolution des pratiques et des conceptions de l’enseignement, de l’apprentissage et des TIC chez des enseignants du primaire en contexte de développement professionnel

Elementary teachers’ formative evaluation practices in an era of curricular reform in Quebec, Canada

Conclusion : Un portrait caractéristique de la recherche sur le développement professionnel des enseignants et sur la formation à l’enseignement