Literacy In The United States Research Articles

The sanctity of decoding: Reframing Hebrew literacy in the United States and Europe

Aims and Objectives: This article explores the challenges Jewish children face in educational programs teaching about Judaism and Jewish culture located in the United States and Europe. Students learn to decode Hebrew but not to read for comprehension, which conflicts with other types of literacy learning they encounter throughout their education in school and at home. Methodology: The study is based on long-term participant observation at two religious education programs, one in the United States and one in Luxembourg. Data and Analysis: A language socialization lens was applied to coded fieldnotes to bring findings into conversation with each other. Findings: Following initial frustrations stemming from a mismatch between American and European schooled literacy expectations and Hebrew decoding, students came to understand Hebrew as a distinctive sacred language. This allowed them to reconceptualize decoding as a successful and meaningful form of literacy and to see themselves as competent Hebrew users and members of a broader Jewish community. Originality: Existing studies primarily focus on sacred languages and literacies oriented around supporting connections with the divine. This study contributes to the existing body of work by illustrating religious literacy education aimed at cultivating communal and religious identification. Implications: This study provides evidence that decoding of sacred texts without comprehension of lexico-semantic content can be a meaningful form of literacy that enables religious members to affirm and do community without explicit reference to divine relations. It argues for a distinctive form of bilingualism in which the sacred language and talk about it work together to create meaningful religious learning.

Knowledge and Perceptions about Curative Therapies for Sickle Cell Disease and Hydroxyurea Among Caregivers and Patients at a Large Tertiary Care Center: A Survey Study

Background: Sickle Cell Disease (SCD) affects approximately 100,000 individuals in the United States. Patients require regular follow-up and monitoring to prevent serious complications. Even with rigorous monitoring, health outcomes can be poor due to pain-seeking stigma and other social determinants of health, namely racial, social, and economic disparities. According to the National Assessment of Health Literacy published in 2006, 36% of adults have limited health literacy in the United States. Among SCD populations, disease-specific knowledge can play a vital role in improving pain control and access to appropriate maintenance therapies. Aims:The purpose of this study is to investigate the knowledge and perceptions of patients with SCD and their caregivers attending The Valerie Fund Pediatric Hematology-Oncology Center at the Children's Hospital of New Jersey in Newark, NJ regarding their disease, complications, genetic impact, general anticipated course of treatment or natural history of disease. Hydroxyurea (HU) and curative therapies include bone marrow transplant (BMT) and gene therapy (GT). Methods: We surveyed 85 participants, accounting for 79 patients as some surveys were completed by each the patient and caregiver. Sixty-six (83.5%) participants were caregivers and 13 (16.5%) were children with sickle cell disease between 12- and 20-years-old. Most patients identified as black, African, or African American (76; 96.2%) with 2 (2.5%) Hispanic patients, and 1 (1.3%) white patient. Forty-three patients (54.4%) were female and 36 (45.6%) were male. The average age of the patients was 10.9 years with a standard deviation of 5.7 years. More than half of patients were HbSS genotype (51; 64.6%). Remaining genotypes were HbSC (21; 26.6%), HbS-β 0-thalassemia (5; 6.3%), and HbS-β +-thalassemia (2; 2.5%). Forty-six (58.2%) of patients had received HU and 33 (41.8%) had not. Results: When assessing background knowledge of sickle cell and heritable risk, most participants could correctly identify the patient's sickle cell genotype (74; 87.1%) and most caregivers could correctly identify their own genotype (49; 74.2%). However, many caregivers exhibited limited understanding of genetic risk with only 18 (27.2%) correctly identifying the one in four chance of having a subsequent child with SCD when both parents are carriers. The results revealed participants could not distinguish between treatment for SCD and sickle cell trait; few participants correctly identified that sickle cell trait is not an indication for treatment with HU (8; 10.1%), BMT (4; 5.1%) or GT (6; 7.6%). Baseline knowledge about BMT and GT was limited. Only 27 (34.1%) participants correctly identified that BMT is indicated for treating patients with HbSS or HbS-b 0-thalassemia, and only 9 (11.4%) participants correctly identified this treatment population for GT. BMT knowledge was slightly greater than GT knowledge, namely that 60.1% (48) correctly identified the benefits of BMT for SCD patients, including decreased pain, decreased need for pain medication, decreased length of hospital stay, and cure, and that either bone marrow, stem cells, or blood could be transplanted materials. Most patients did not correctly identify these benefits of GT (55; 70%), nor could they identify the source of blood or stem cells for GT (65; 82.3%). The ability to correctly identify the benefits of HU for sickle cell disease (48; 60.8%) was positively associated with the ability to correctly identify the benefits of BMT (p-value 0.0091) and GT (p-value 0.0438) using Fisher's exact test with 95% confidence interval. Conclusion: These results suggest that dedicated teaching about HU, a common treatment for SCD, can result in greater patient knowledge about newer and curative treatment options of bone marrow transplant and gene therapy. These findings underscore the necessity of implementation of comprehensive patient teaching that is inclusive of population education levels, literacy rates, health literacy rates, and other cultural and societal factors.

Home and preschool influences on early literacy and numeracy development in England, Estonia, and the United States

ABSTRACT This study considered the influences of socioeconomic status (SES), home learning environment, and age of enrollment in early childhood education and care (ECEC) on early literacy and numeracy development of 5-year-olds in England (N = 2,577), Estonia (N = 2,110), and the United States (N = 2,234) by leveraging data from the International Early Learning and Child Well-being Study (conducted by the Organization for Economic Cooperation and Development in 2018). Structural equation modeling indicated that, in all three countries, SES was positively associated with earlier ECEC enrollment, emergent literacy and numeracy. Earlier ECEC enrollment was positively related to emergent literacy and numeracy in England. The home learning environment was positively related to emergent literacy in the United States and emergent numeracy in England and the United States. Overall, SES had a positive indirect effect on emergent literacy and numeracy through ECEC enrollment age in England. Findings are interpreted against country-specific ECEC policies.

Financial literacy and financial well-being: Evidence from the US

AbstractThis paper examines financial literacy in the United States, using the 2021 National Financial Capability Study data. A large volume of papers have demonstrated the importance of financial knowledge and documented the low level of financial literacy in America. Using recent data collected during an unusual time when inflation was rising and the country was in the midst of the COVID-19 pandemic, we show that the knowledge of fundamental financial concepts continues to be low in the US, especially among people who are young, less educated, female, or not employed. Our analysis also highlights people’s lack of inflation knowledge and identifies the subgroups that are particularly vulnerable. Finally, we examine how financial literacy affects financial well-being and behaviors. Responses to the Big Three financial literacy questions are linked to important financial behaviors and outcomes, including planning for retirement, financial resilience, and not carrying too much debt.

Health Literacy in the United States: Enhancing Assessments and Reducing Disparities

Health Literacy in the United States: Enhancing Assessments and Reducing Disparities

Acceptance, Confidence, and Time: Exploring Dynamics of Middle and Secondary Science Teacher Autonomy in Teaching Evolution in the Southeastern United States

Evolution education represents the greatest challenge to scientific literacy in the United States. Long accepted as the foundational concept of biology, in the public realm evolution elicits controversy. The Southeastern United States is a breeding ground for this, and other, anti-science thinking that has far-reaching implications as seen during the 2020 pandemic and anti-science legislation from the region. One approach to close gaps in understanding evolution is to ensure that it is taught in schools in a way that is robust and accurate, as teachers are the front lines in the fight for scientific literacy. For that to happen, teachers must overcome their own barriers and concerns about teaching this so-called “controversial” topic. This quantitative study found that despite experience, certification, confidence in teaching evolution, and high levels of acceptance, teachers spent minimal time (less than three days) teaching evolution but there are factors that impact time and confidence that can be used to combat the problem. Identifying these fundamental interactions builds a starting point for targeted preparation and support to ensure that teachers have the tools, confidence, and content needed to teach evolution adequately.

The Rise and Fall of the Tide: Ocean Literacy in the United States

The words “Ocean Literacy” roll off the multilingual tongues of scientists, educators, and policy makers worldwide who understand the essential role of the ocean on this planet. However, this was not always the case. The Ocean Literacy campaign in the United States (US) was founded by individuals and institutions focused on raising awareness of the influence of the one global ocean on every living being on the planet. The original grassroots effort became a well-funded, well-organized campaign that spawned global initiatives that thrive to this day. Faced with a lack of critical resources, the US campaign currently relies on the services of dedicated members of the National Marine Educators Association (NMEA) whose vision of making known the world of water is part of their collective DNA.

Exploring the Assessment of Technology and Engineering Literacy in the United States

The purpose of this study is to explore the structure of the Technology & Engineering Literacy(TEL) assessment conducted in the United States, the types of evaluation questions, and the results of the evaluation. The conclusions of the study are as follows. First, the TEL assessment for 8th grade students was supervised by NAEP and was conducted twice in 2014 and 2018. The schools sampled for this assessment were more than 600 and more than 15,000 students. Second, the TEL assessment is computer-based test, the items are composed of scenario-based assessment and discrete item sets, and the data is provided with longitudinal analysis. Third, according to the TEL evaluation results, there was a statistically significant improvement in students’ scores. Fourth, as a result of the TEL evaluation, there is a significant improvement in the content area and the practice area. Fifth, the NAEP Proficient category of NAEP achievement level increased significantly from 43% to 46%. Finally, TEL assessments are influencing the increasing proportion of students taking technology and engineering-related courses or programs.

Health Literacy in the United States of America: Cost Perspectives

Health Literacy in the United States of America: Cost Perspectives

This doi for the item has been retracted by the publisher---

<p style="text-align: justify;">Evolution education represents the greatest challenge to scientific literacy in the United States. Long accepted as the foundational concept of biology, in the public realm evolution elicits controversy. The Southeastern United States is a breeding ground for this, and other, anti-science thinking that has far-reaching implications as seen during the 2020 pandemic and anti-science legislation from the region. One approach to close gaps in understanding evolution is to ensure that it is taught in schools in a way that is robust and accurate, as teachers are the front lines in the fight for scientific literacy. For that to happen, teachers must overcome their own barriers and concerns about teaching this so-called “controversial” topic. This quantitative study found that despite experience, certification, confidence in teaching evolution, and high levels of acceptance, teachers spent minimal time (less than three days) teaching evolution but there are factors that impact time and confidence that can be used to combat the problem. Identifying these fundamental interactions builds a starting point for targeted preparation and support to ensure that teachers have the tools, confidence, and content needed to teach evolution adequately.</p>

Multi-Site Case Studies About Zoo and Aquarium Visitors’ Perceptions of the STEM Learning Ecology

Informal learning institutions like zoos, aquariums, science centers, and botanic gardens are popular among the American public. Many offer science-related activities, suggesting an “ecology” of sites varying in degree with regards to science and STEM (science, technology, engineering, math) learning in general. Understanding public perceptions of the STEM learning ecology can inform decisions about increasing STEM literacy in the United States. The current qualitative study used interactive workshops to understand the public’s perceptions of zoos and aquariums (Z/As) in particular, compared to other settings, for their potential to support STEM learning. Visitors identified a wide range of settings in institutions and their everyday lives where they experienced STEM learning opportunities. The primary STEM discipline they encountered was science, even though the opportunities were not explicit. They also recognized that these settings offer the potential for learning about technology, engineering, and math through staff facilitation. They distinguished Z/As from other cultural organizations because of opportunities to learn about science as it related to animals. Implications for STEM learning in informal settings are discussed for its potential to engage the public in STEM outside of the formal education context.

Managing Personal Finance Literacy in the United States: A Case Study

This study investigates the perspectives and impact that personal finance education had on participants in Western Pennsylvania. The researchers begin with a literature review of personal finance courses in the United States (U.S.). The U.S. housing market collapse is also discussed as a key component of the financial crisis that is often overlooked and can be partly attributed to the lack of financial literacy. The findings of this study indicate that participants want personal finance courses offered in K-12 schools and at the collegiate level. They also want personal finance elements to be co-curricular in the K-12 setting. A recommendation based on responses from participants is that co-curricular teaching of personal finance should be tied in with math courses. The participants of this study either have benefited from personal finance lessons themselves or are a strong advocate for the teaching of personal finance in the future. The financial future does also bring worry to the different generations. Generation X is more worried about the financial choices of the upcoming generations, while Millennials and Generation Z are concerned about the future of the economy and how this will affect them.

3D КАРТУВАННЯ ЦИФРОВОЇ КОМПЕТЕНТНОСТІ В СИСТЕМІ ОСВІТИ УКРАЇНИ

The article introduces the developed 3D mapping of digital competency. The necessity of radical changes aimed at improving the quality and competitiveness of education, changing the role of scientific and pedagogical staff in Ukraine in accordance with world requirements is substantiated. The analysis of the state policy and regulatory framework in the field of digital skills and competencies in Ukraine, research on information and communication competency in the European educational space, in particular UNESCO recommendations, the digital competency framework for citizens DigComp 2.0 and the digital competency framework for educators DigCompEdu, requirements for digital literacy in the United States, in particular the standards of the International Society of Technology in Education (ISTE), as well as development of digital competency in Ukraine. As a result of the analysis of these documents, questionnaires were developed for three groups of respondents – pedagogical staff and students of institutions of higher education and teachers of general secondary education institutions - and questionnaires were conducted in six Ukrainian universities within the framework of the international project Erasmus + MoPED. The developed 3D mapping reflects the trends of understanding by pedagogical staff and students of institutions of higher education and teachers of secondary education institutions of the main modern educational trends, the use of innovative pedagogical technologies and digital instruments in the educational process. The attitude of the three groups of respondents to the actual educational trends, innovative pedagogical technologies and the level of interest in mastering digital tools and their ability to use them effectively in the educational process according to the results of the questionnaire has been highlighted, which made it possible to compare the attitude of pedagogical staff of institutions of higher education, teachers and students to the above categories at the present stage.

Social Disparities in Health Literacy in the United States.

Health literacy has been identified as a contributor to both health disparities and social determinants of health. There is significant overlap in demographic characteristics of those who are at risk for health disparities and low health literacy. This study expanded the research on health literacy and disparities by quantifying the social disparities within health literacy using a relatively new methodology. We analyzed data from the 2013 Health Information National Trends Survey (N = 1,675). The Extended Gastwirth Index was used to determine the disparities in health literacy. Participants who were female, age 18 to 34 years, White, highly educated (postbaccalaureate), and with incomes ≥$200,000 had the highest health literacy and served as the reference groups. Males, age 35 to 49 years, who had high school graduates, and people who were Hispanic and with incomes between $50,000 and $74,999 had the highest disparities in health literacy. Income (∼30%) and education (∼37%) were the highest contributors to overall disparities in health literacy, whereas sex (∼3%) was the lowest contributor. The overwhelming contribution of income and education to disparities in health literacy and the range of disparities within these demographic characteristics highlight populations that could benefit from tailored interventions to improve their health literacy. [HLRP: Health Literacy Research and Practice. 2019;3(1):e47–e52.]

Adult literacy: a perspective from the United States

Although low adult literacy has a long history in the United States, it continues to be very prevalent. Low literacy skills impact adults’ abilities to read, write, compute, use technology, and successfully engage in functional areas such as health. Adults in the United States who have literacy difficulties are a heterogeneous group. As an example of a skill considered difficult by those who struggle with literacy, health literacy is discussed. This article describes the landscape of adult literacy in the United States, with a highlighted focus on health literacy. It concludes with the notion that more research is needed in all areas of literacy to better understand how to interact with and teach adults in the United States who have low literacy skills.

Cooperative Extension and Health Literacy: A National Focus

Health literacy is often defined as the degree to which an individual has the capacity to obtain, communicate, process and understand basic health information and services to make appropriate health decisions. Research shows that 30 million Americans have Below Basic health literacy skills. People with low health literacy skills contribute to higher utilization of health care services. This equates to an excess of $230 billion a year in health care costs linked to low literacy in the United States. The primary responsibility for improving health literacy lies with public health professionals and the health care and public health systems. However, studies find that interventions using principles of health literacy, applied in community-based settings, can result in improved outcomes at the population level. In this article, the Health Literacy Action Team members consider the role of Extension in this important area, and suggest practices in incorporating health literacy into existing Extension programs and educational materials, and future resources for Extension and community partners.

A shift from bibliographic instruction to information literacy in the United States

A shift from bibliographic instruction to information literacy in the United States

Promoting Health Literacy for Children and Adolescents.

Only 12% of American adults have proficient health literacy, defined as a set of skills needed to effectively function in the health care system.1 This is troubling given that health literacy is a stronger predictor of health than age, income, employment status, educational level, or race.2 A growing body of research also shows that low health literacy is associated with worse child health outcomes,3 higher health care costs, and elevated mortality rates.1Although Americans are increasingly expected to be knowledgeable consumers of health care, it is clear that many individuals lack the core health literacy skills needed to understand their health insurance.4 This inadequate understanding of health care information creates challenges beyond the selection of a health insurance plan or payment calculations. Poor health literacy, including health numeracy, extends into one’s ability to seek care at an appropriate time, navigate through the health system, and share in important medical decisions.In this Perspective, we describe national efforts to combat low health literacy rates and argue that they fail to adequately prepare children and adolescents to be health-literate adults. We then propose several steps for educators, health care providers, and policymakers to improve health literacy among children and adolescents in the United States.The US Department of Health and Human Services, the National Academy of Medicine (NAM), and state consortiums have developed sweeping proposals to improve health literacy.1 These proposals provide an evidence-based framework for policymakers, organizations, and individuals who are interested in improving health literacy in their communities. Nevertheless, it remains unclear whether these recommendations have changed practice in educational, health care, or community settings or have led to improved health literacy.The National Action Plan to Improve Health Literacy, developed by the Department of Health and Human Services, and recommendations from the NAM encourage diverse sectors to play a role in improving health literacy in the United States. However, most programs designed to improve health literacy are isolated within health care settings and narrowly focus on individuals who are already enrolled in a health insurance plan or who have already developed at least 1 chronic condition.5 Furthermore, interventions targeted at adults who are actively trying to navigate the health care system and may already have chronic illness may be timed too late for optimal impact.The NAM suggests that initiatives to improve health literacy through primary and secondary education could lead to better health and decrease the cost of health care in the United States. Unfortunately, many states have removed health education requirements or reduced the requirement to ≤1 credit in high school. If states do require health curricula in public schools, a health literacy component is not typically mandated. This weakening of health education has occurred despite the near certainty that future generations will experience a complex and increasingly expensive health care system.Efforts to improve health literacy will have a greater national impact if they start before adult-onset chronic diseases are established, ideally while children and adolescents are developing their health behaviors. Such efforts must include the public education system, with particular attention paid to curricula, funding, partnerships, and measurement.Although health education has been cut markedly in many states, the National Health Education Standards (NHES) provide a potential path forward.6 The NHES is a framework that aims to improve students’ comprehension of health promotion and disease prevention and to enhance their ability to access health services and information and advocate for community health. However, most schools have not rigorously enforced the NHES because they are neither mandated nor explicitly funded. If the NHES were mandated, it would ensure that students are exposed to essential health education topics and prepared to make informed health care decisions in the future.The NHES could also be updated to reflect the complexities of navigating health insurance and health care in the Affordable Care Act era. Such an update could offer a novel opportunity for interdisciplinary education. For instance, economics courses could include lessons on financial risk, in which students weigh the risks and benefits of high-deductible plans versus traditional health insurance plans. Students could learn how to calculate out-of-pocket expenses from co-pays and co-insurance in math class. Science teachers could discuss the evidence base for immunization and other public health measures. Social studies classes could include topics on the social determinants of heath and associated health disparities. These topics would broaden the current content typically covered in health education courses (Table 1).Funding for such programs should be provided, in part, by health care institutions that are highly motivated to have patients use health care services in ways that best align with their health conditions and acuity. Government health programs, in particular, have a strong incentive to partner with state and local education systems to develop programs that improve health literacy. We acknowledge that this funding recommendation is a departure from how such programs currently function and fund initiatives, but we believe it would be possible to finance educational opportunities in a manner similar to how some states fund early childhood home-visiting programs (eg, benefits would not be mandatory but could be bundled into Medicaid managed care plans).Opportunities for partnership already exist between health care and education sectors. For example, school-based health centers, which have medically trained professionals, are located in 49 out of the 50 states and are increasingly prevalent in public schools. Supplementary funding for health literacy education could help school-based health centers expand their role and serve as a source of comprehensive health literacy education for students and families.In addition, many health insurance companies now provide families with an incentive when they visit a gym 3 times per week. Similar partnerships could be developed with school systems, so that families receive a discount or incentive when they attend health literacy programs and skill-building sessions. Health care systems and providers could also help school systems develop a health curriculum that presents complicated health policy as more approachable content for young learners.Finally, as efforts to improve health literacy are amplified, successes and failures must be measured. Although public and private stakeholders have invested considerable resources to improve health literacy, rates of health literacy among adolescents have never been measured at the national level. We agree with previous authors who have recommended the incorporation of existing health literacy screens (eg, Newest Vital Sign or REALM-Teen) into national surveys such as the Youth Risk Behavior Surveillance System or the National Survey of Drug Use and Health.7 These surveys, in particular, would allow for both national- and state-level estimates of health literacy.Educational investments earlier in the life span can improve health literacy in the United States. Critical steps toward improving health literacy include mandated and updated health curricula, sustainable funding sources, cross-sector partnerships, and measurement of health literacy among the adolescent population. Encouraging partnerships between health care and education is a novel, yet practical approach to fund and disseminate these efforts. Enhancing health literacy offers great potential to improve the health of children and to provide them with tools to be more informed and capable consumers of expensive and limited medical resources in adulthood.

Personal Accounts: Becoming the Mother of a Child With Schizophrenia.

Back to table of contents Previous article Next article Personal AccountsFull AccessPersonal Accounts: Becoming the Mother of a Child With SchizophreniaSusan InmanSusan InmanSearch for more papers by this authorPublished Online:1 Dec 2016https://doi.org/10.1176/appi.ps.2016001AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail I never expected to be the mother of someone with a severe mental illness. My undergraduate education (at Swarthmore College) and graduate education (at the University of California, Los Angeles) in the 1970s left me with a comforting notion about child rearing; as long as children had parents who were loving, sensitive, responsible, and supportive, they would not be in danger of developing mental illnesses.My personal ignorance was compounded by the common lack of mental illness literacy in the United States and in Canada, where I lived when I had children. When our younger daughter began to flounder as a teen, we didn’t understand what was happening. Only much later did we learn that our daughter’s puzzling cognitive losses, her strange physical gait, and her growing lack of connection to the world around her were well-known prodromal signs of schizophrenia.Unfortunately, the therapist to whom we took our daughter for over two years knew even less than we did about bipolar disorder and schizophrenia. The program at the university in Vancouver where she had trained for her master’s in counseling psychology hadn’t required any science-based curriculum on psychotic disorders. Only much later did our daughter help us understand that as her symptoms grew worse, this therapist continued to reassure her that once they could finally discover “the family secret,” all these difficulties could be resolved.Although the search for this nonexistent family secret was futile, our daughter developed, with our naïve support, a strong attachment to the therapist. This bond eventually increased the chaos of our situation once our daughter finally had a clear psychotic break. We watched, helpless at that point, as the therapist told our vulnerable daughter not to trust the very experienced psychiatrist who had agreed to work with her. When this psychiatrist gave up, she located a replacement for us who managed to sever the unhealthy relationship with the therapist. At the same time, this psychiatrist restored the close relationship with us that our daughter had relied on for most of her life.However, the new psychiatrist wasn’t experienced in dealing with the schizoaffective disorder our daughter was developing. When our daughter had a new and severe psychotic break, she didn’t receive adequate doses of an antipsychotic medication, and she became ever more psychotic over the next two years.In the second year of her debilitating psychosis, she could not be left alone in our home. If she tried to use the microwave, for instance, she would try to heat something for 40 minutes when it just needed 40 seconds. She liked baths and would turn the faucets on but then wander away unaware while the tub overflowed. She also couldn’t walk places by herself anymore. Not only did she get lost trying to find familiar places, but also she could not remember how to navigate traffic as a pedestrian.Eventually, following a trip to the Menninger Clinic, our daughter received the high dose of an antipsychotic that she needed to escape the horrors of psychosis. During these two years, I had imagined what it might be like if some medication finally worked and how this hell could be just a part of a longer, better story. I hadn’t found any Canadian stories like this, and eventually I wrote a memoir. Sadly, since its publication, I hear from both Canadian and American families that they have made dangerous mistakes similar to mine because they are missing essential information about psychotic disorders.Our daughter was fortunate to receive the brief involuntary hospitalizations in British Columbia that she was too ill to understand she needed. She now tells other families that she hopes never to be left in untreated psychosis in the future.Our daughter was also lucky that once she was no longer psychotic, she had access to extensive, science-based psychoeducation about her illness. This education has helped her and the friends she has made who also live with psychotic disorders to understand, accept, and learn to manage their illnesses.The psychiatrist who got our daughter the help she needed is a Canadian expert on schizophrenia and has worked with our daughter and collaborated with us for the past 13 years. Our daughter was once one of the most severely psychotic teens the local refractory psychosis team had seen, but she has since benefited from years of stability.Unfortunately, our daughter has the well-researched cognitive losses that commonly occur with schizophrenia. Her difficulties with working memory and short-term memory, focusing, sequencing, problem solving, judgment, and social skills make the basic tasks of daily living extremely difficult. Canada has done very little to implement the evidence-based cognitive remediation programs that are now available.One way that I have responded to the lack of cognitive remediation programs has been to write about the problem. For the past four years I’ve been writing for Huffington Post Canada about mental illness policies from the perspective of family caregivers (www.huffingtonpost.ca/susan-inman). When I first wrote about cognitive losses associated with schizophrenia (1), I was inundated with messages from families who had never heard about the extensive research about these problems. They were witnessing the daily confusion caused by family members who forgot to relay phone messages, kept losing keys, and had trouble completing household tasks. However, they had never been told that these problems are a common part of schizophrenia even when other symptoms are well controlled by medications. This knowledge was clearly going to impact how they responded to these problems.Editor’s Note: In August 2016, SAMHSA hired Anita Everett, M.D., to serve as the new chief medical officer. Dr. Everett leads a staff of five in SAMHSA’s new Office of the Chief Medical Officer, which is tasked with focusing “on expanding effective, innovative, and science-supported approaches to behavioral health” (4).Figuring out how best to help our daughter deal with her complicated disorder has been only part of the steep learning curve for me. The other part has been trying to understand the dysfunctional mental health systems in both Canada and the United States. Eventually I realized that, in both countries, mental illness policies and services are being informed by two paradigms that are not very compatible with each other.I better understood these differing belief systems after examining the Web sites of the National Institute of Mental Health (NIMH) and the Substance Abuse and Mental Health Services Administration (SAMHSA). I saw the NIMH as offering science- and evidence-based ways of understanding and responding to mental illnesses. Here was the pathway that eventually led my daughter to recover her sanity. On the other hand, SAMHSA’s Web site seemed to barely acknowledge the existence of mental illnesses (2); I was not surprised that their chief medical Officer, Dr. Elinore McCance-Katz, recently resigned and has written about why she left “an agency that, for the most part, refused to support evidence-based psychiatric treatment of mental disorders” (3).During the 16 years that we have been dealing with our daughter’s illness, I have seen more mental health services in Vancouver and elsewhere in Canada offer the alternative practices that SAMHSA has helped cultivate. Our new national guidelines for training peer support workers (5), like SAMHSA’s, don’t recommend providing any information on mental illnesses. Equally problematic, they promote the notion that people must always be free to choose whether they want to be treated. I have now become very cautious about recommending local programs to my daughter. Even with her solid psychoeducation, I know it would not be good for her to be around a group of potential friends who do not believe that the “medical model,” as the alternative “antipsychiatry” movement calls it, can help people understand and manage mental illnesses.I hope that the legislation currently pending in the U.S. Congress can create sensible policies and services for people with severe mental illnesses such as my daughter’s. Enactment can help the many American families I know whose sons and daughters with untreated psychotic illnesses have ended up homeless or incarcerated (6), and I believe that changes in the influential U.S. mental health system could lead to better trends in the delivery of mental health care in Canada.I still don’t really know how to be the mother of an adult daughter whose disabilities prevent her from managing the tasks of daily life. But I do know that her future will be better, especially when her parents are no longer alive, if she can be surrounded by services and a culture that acknowledge the difficult reality of her mental illness.Ms. Inman (e-mail: [email protected]) lives in Vancouver, British Columbia, and has published a memoir, After Her Brain Broke, Helping My Daughter Recover Her Sanity. Jeffrey L. Geller, M.D., M.P.H., is editor of this column.References1 Inman S: The consequences of mental illness that nobody talks about. Huffington Post Canada, Aug 10, 2014. http://www.huffingtonpost.ca/susan-inman/mental-illness-cognitive-loss_b_5664999.htmlGoogle Scholar2 Inman S: Let’s learn from the failures of US mental health policies. Huffington Post Canada, May 13, 2013. http://www.huffingtonpost.ca/susan-inman/mental-health-month-schizophrenia_b_3255843.htmlGoogle Scholar3 McCance-Katz E: The federal government ignores the treatment needs of Americans with serious mental illness. Psychiatric Times, April 21, 2016Google Scholar4 Anita Everett to join SAMHSA as chief medical officer. SAMHSA News, August 23, 2016. http://newsletter.samhsa.gov/2016/08/23/dr-anita-everett-joins-samhsa-chief-medical-officerGoogle Scholar5 Inman S: Peer mental health workers need better training. Huffington Post Canada, Jan 18, 2016. Available at http://www.huffingtonpost.ca/susan-inman/peer-mental-health-workers_b_9009252.htmlGoogle Scholar6 National Helping Families in Mental Health Crisis Day: We are the voices of the 10 million. http://hr2646nationalhelpingfamiliesinmentalhealthcrisisactday.com/hear-our-voices-serious-mental-illness-video.htmlGoogle Scholar FiguresReferencesCited byDetailsCited byNone Volume 67Issue 12 December 01, 2016Pages 1290-1291 Metrics PDF download History Published online 1 December 2016 Published in print 1 December 2016

Images every American should know: developing the Cultural Image Literacy Assessment-USA

This paper describes the evolution of the Cultural Image Literacy Assessment-USA©. This assessment represents an important first step in measuring image literacy within a culture. Visual literacy is an integral part of all cultures. The framework used in creating an assessment of cultural image literacy in the United States could be employed in developing measures of visual literacy for other cultures. In so doing, image literacy can be compared within and across cultures. This survey study explores the effects today’s visual environments have on knowledge levels, and more importantly, knowledge gaps. The study builds on research relating to knowledge gap theory by describing the evolution of cultural image literacy assessment and providing current levels of image literacy within the United States. The final version of the assessment was distributed to undergraduate students (N = 309) at a public university in the Southeast. Overall, respondents correctly identified an average of 68% of the images – a visual literacy grade of D. Respondents did better identifying general images followed by personalities, events and landmarks, and art and social movements. Implications for educators and education are discussed and future directions for this research are described.