Food and Nutrition Information Center
National Agricultural Library/USDA
10301 Baltimore Avenue, Room 105
Beltsville, MD 20705-2351
Nutrition Education for Low-literate Teens & Adults
September 2002
This is a quick guide to articles, books, kits, videos and Web sites that discuss nutrition education for teens and adults with limited reading skills. It also lists resources that will help you create and find easy-to-read print materials. Some English as a Second Language materials are included. However, this is not a major focus of the list.
To find materials, we searched AGRICOLA, ERIC and MEDLINE databases and the Word Wide Web. The resources listed contain accurate nutrition information and are available nationwide. Opinions expressed in the publications do not necessarily reflect the views of the U.S. Department of Agriculture.
Your local library or bookstore can help you find these resources. An "ISBN number" is listed for some of the materials below. This number will help you order it from a bookstore or publisher. Contact information is provided for Web sites and organizations. Resources that are part of the National Agricultural Library (NAL) collection have a "NAL Call Number" listed. For information about NAL lending and copy services, call (301) 504-6041 or visit our Web site at http://www.nal.usda.gov/fnic/general/lending.html. You cannot purchase these materials from NAL. Please contact the publisher or bookstore if you wish to buy any materials on this list.
This resource list is available from the Food and Nutrition Information Center’s (FNIC) Web site at http://www.nal.usda.gov/fnic/pubs_and_db.html.
Table of Contents
Web Sites
Web Sites
Distributors of Easy-to-Read Nutrition Materials
An Updated Overview of Medical and Public Health Literature Addressing Literacy
Issues: An Annotated Bibliography of Articles Published in 2001.
Emily Zobel
Cambridge, MA: Harvard Graduate School of Education, The National Center for
the Study of Adult Learning and Literacy, 2002.
Electronic Version: http://www.hsph.harvard.edu/healthliteracy/literature4.html
Description: Lists 29 citations of health literacy articles published
between January 1, 2001 and December 31, 2001. References are arranged in the
following categories: Literacy Levels of Patients, Clients or Program Participants;
Editorials/Lette rs to the Editor; Materials Assessments; and Health Promotion.
An Updated Overview of Medical and Public Health Literature Addressing Literacy
Issues: An Annotated Bibliography of Articles Published in 2000.
Jennifer Greenberg
Cambridge, MA: Harvard Graduate School of Education, The National Center for
the Study of Adult Learning and Literacy, 2001.
Electronic Version: http://www.hsph.harvard.edu/healthliteracy/annotations.html
Description: Lists 24 citations of health literacy articles published
between January 2000 and January 2001. References are arranged in the following
categories: Literacy Levels of Patients, Clients or Program Participants; Materials
Assessments; a nd Health Promotion.
An Overview of Medical and Public Health Literature Addressing Literacy
Issues: An Annotated Bibliography
Rima E. Rudd, Tayla Colton & Robin Schach
Cambridge, MA: Harvard Graduate School of Education, The National Center for
the Study of Adult Learning and Literacy, 2000. 61 p.
Electronic Version (PDF): http://www.hsph.harvard.edu/healthliteracy/litreview.pdf
Description: Contains 241 citations of works published from 1990-1999.
References are arranged into the following categories: Links Between Literacy
and Health; Literacy Levels of Patients, Clients, or Program Participants; Match
Between Reading A bility and Written Materials; Functional Literacy and Institutional
Settings; Materials Assessments; Research Tools for Assessing Health Literacy;
Program Descriptions; and Guidelines for Practice.
Current Bibliographies in Medicine: Health Literacy
Catherine R. Selden, et al.
Bethesda, MD: United States Department of Health and Human Services, National
Institutes of Health, National Library of Medicine, 2000. 33 p.
Electronic Version(s): http://www.nlm.nih.gov/pubs/cbm/hliteracy.html
Description: Includes 479 health literacy citations of works published
between January 1990 through October 1999. The references are arranged in four
categories: Background, Strategies in Health Literacy, Tactics and Ideas.
Readability analysis of consumer health materials
Dixie Jones.
In: Consumer Health: An Online Manual
Houston, TX: National Network of Libraries of Medicine, South Central Region,
July 17, 2001.
Electronic Version: http://nnlm.gov/scr/conhlth/read.htm
Description: Contains books, journals and Web resources that address
readability of print materials, literacy assessment and general health literacy.
Health communications
Chapter 11 in: Healthy People 2010, 2nd edition.
Washington, DC: United States Department of Health and Human Services, Office
of Public Health and Science, 2000. Volume 1.
NAL Call Number: RA395 A3 H43 2000 (conference edition).
Electronic Version: http://web.health.gov/healthypeople/Document/HTML/Volume1/11HealthCom.htm
Description: Covers the United State’s national health objectives related
to health communications. The section entitled "Disparities" and Objective
11.2 focus on health literacy.
Developing strategies to communicate about health. Pfizer Journal,
2(1): 27-32. 1998.
Electronic Version (PDF): http://www.thepfizerjournal.com/TPJ04.pdf
Abstract: Not available.
In Plain Language
Rima Rudd & William DeJong, Harvard School of Public & the Health Literacy
Studies Group
Boston, MA: World Education, National Center for the Study of Adult Learning
and Literacy, not dated.
1 videocassette (15 min.) (VHS)
NAL Call Number: Videocassette no. 3110
Electronic Version: http://www.hsph.harvard.edu/healthliteracy/video.html
Description: Provides information for medical and public health professionals
on health literacy and its impact on public health and medicine. Includes testimonials
from low-literate adults.
You Can’t Tell by Looking
Chicago, IL: American Medical Association, not dated.
1 videocassette (18 min.) (VHS)
NAL Call Number: Pending
Description: Features a series of interviews conducted with individuals
who are unable to read, understand, and act on health care information.
Health Literacy Toolbox
Health Literacy Month, Health Literacy Consulting, August 29, 2000.
Web Site: http://www.prenataled.com/healthlit/hlt2k/script/index.asp
Description: Features articles on health literacy statistics, laws and
regulations and the costs of low health literacy.
II. Nutrition Education and Literacy (in alphabetical order)
Factors influencing nutrition education for patients with low literacy skills.
Everly Macario, et al. Journal of the American Dietetic Association,
98:559-564. 1998.
NAL Call Number: 389.8 Am34
Abstract: Although there has been increasing attention to cancer prevention
among low-income and minority populations, only a few nutrition interventions
have addressed the special needs of people with low literacy skills. To determine
the best pr ovider and the most effective format for a nutrition intervention
targeting patients with low literacy skills, we conducted interviews with literacy
experts and health care providers and focus groups with members of adult basic
education classes. Thirty-f ive literacy experts and health-center-based physicians,
nurses and nutritionists in Boston, Massachusetts, were interviewed. In addition
50 volunteer clients from 4 Boston-based adult basic education programs participated
in 6 focus groups. Results sugge sted that health care providers consider nutrition
to be a fundamental health education topic, but that its successful inculcation
in patients with limited literacy skills is hindered mostly by insufficient
provider time. Almost all providers agreed that patients need referrals to nutritionists
for nutrition education. Although most providers and patients acknowledged that
patients perceive physicians to be the authorities on health, patients with
low literacy skills turned first to family members and fri ends for health information.
These results suggest that effective nutrition interventions must build on patients'
social networks; appear in a visually based, interactive format; and be culturally
appropriate.
Helping consumers with low literacy interpret the new food label. Ardith
R Brunt. Journal of Nutrition Education, 29:224A. 1997.
NAL Call Number: TX341 J6
Abstract: Not available.
Literacy and body fatness are associated with underreporting of energy intake
in US low-income woman using the multiple-pass 24-hour recall: A doubly labeled
water study.
Rachel K. Johnson, Rebecca P. Soultanakis and Dweight E. Mathews. Journal
of the American Dietetic Association, 98:1136-1140. 1998.
NAL Call Number: 389.8 Am34
Abstract: Objective: The accuracy of the multiple-pass 24-hour recall
method for estimating energy intake in low-income women in the United States
was ascertained by comparing the method with measurements of total energy expenditure.
The multiple-p ass 24-hour recall is designed to provide respondents with multiple
cues and opportunities to report their food intake. It consists of 3 distinct
passes: the quick list, detailed description, and review. Predictors of energy
intake misreporting (energy in take--total energy expenditure) in the sample
were determined. Design: Four multiple-pass 24-hour recalls (2 in person, 2
by telephone) were obtained over a 14-day period to estimate energy intake.
Total energy expenditure was measured over the same 14-da y period using the
doubly labeled water method. Body composition was measured using dual energy
x-ray absorptiometry, and the Wide Range Achievement Test (WRAT) for reading
and spelling measured literacy. Subjects/settings: Thirty-five low-income women
be tween the ages of 19 and 46 years were tested at the General Clinical Research
Center at the University of Vermont, Burlington. Low income was defined as a
household income at or below 130% of the federal poverty level. Statistical
analysis: Pearson produ ct moment correlation coefficients, t tests, paired
t tests, and stepwise multiple regression analysis were used to test the relationships
among study variables. Results: Mean energy intake was significantly lower than
mean total energy expenditure (2,197 +/-607 vs. 2,644+/-503 kcal, P=.001) and
the correlation between the 2 measures was poor (r=.22, P=.20). Percentage body
fat and the combined age-adjusted reading and spelling WRAT scores were the
best predictors of misreporting of energy intake (R=.52, P =.006). Conclusions:
The multiple-pass 24-hour recall did not generate a group measure of energy
intake that was accurate or unbiased in this sample. Underreporting was strongly
associated with increased body fatness. The ability to read and spell as meas
ured by the WRAT improved the accuracy of the women's recall of their food intake.
Applications: Dietetics professionals should take into consideration the problem
of underreporting whenever conclusions are made about associations between diet
and health and/or when evaluating the impact of food assistance programs on
dietary intake.
Overview of reading and literacy research and applications in nutrition
education. Susan Nitzke and Jane Voichick. Journal of Nutrition Education,
24:261-266. 1992.
NAL Call Number: TX341 J6
Abstract: Literacy requires information-processing skills in addition
to the ability to read and write. Estimates of the prevalence of illiteracy
in the United States vary according to the criteria used. Economic, social and
cultural factors contri bute to higher rates of illiteracy in some population
subgroups. Tools for quantitative and qualitative measures of literacy skills
have been developed. Nutrition education materials are often written at levels
that are too difficult for low-literate read ers. Educational materials are
more effective when they are tailored to the cognitive abilities and learning
styles of the intended audience. The readability of a given text can be crudely
estimated by several formulas that use sentence length and multi-s yllable words
to indicate complex syntax and difficult vocabulary. Techniques such as Cloze
and signaled stopping provide more direct measures of readability. The Language
Experience Approach has been adapted to aid in developing materials for specific
lo w-literate target groups. Examples of existing low-literacy materials and
guides for educators interested in developing materials for low-literate audiences
are cited. Practical techniques are needed for measuring literacy skills of
target clientele aid r eadability of nutrition education materials.
Readability of printed sources of diet and health information. Jamie
Dollahite, Cecelia Thompson and Ronald McNew. Patient Education and Counseling,
27:123-134. 1996.
Abstract: This study surveyed nutrition education materials, which are
low in cost, brief, and the type most used in patient education, to determine
which might be useful with low literacy clients. Readability of 209 pamphlets
from professional hea lth organizations, commercial organizations, government
agencies, and educational institutions was assessed using three different tests.
Using the Flesch and Raygor tests, materials from educational institutions had
significantly lower reading levels than materials from professional organizations
and government agencies. No significant differences were seen among the sources
using the Fry test. Sixty-eight percent (142) of the publications were written
at ninth grade level or higher. Eleven percent (24) s cored at sixth grade or
below on either the Fry or Raygor scale. Only two publications were written
at the third grade level. Many of the publications reviewed can be read and
understood by many Americans, but there were few for the millions that have
lim ited literacy skills.
Readability of recommended nutrition sources. Ruthann B. Swanson and
Cathy A. Birklid. Home Economics Research Journal. 20(3):187-197. 1992.
NAL Call Number: TX1 H63
Abstract: In this study, the readability of books recommended to consumers
by professional nutrition and dietetics organizations was determined. Representative
text samples from 32 publications were evaluated. Writing style and Flesch reading
ease scores were assessed with microcomputer analysis. Two evaluators calculated
Flesch human-interest scores. The grade level required to read the recommended
books was 10.3 (+/- 2.7). More than 40% of the recommendations required a reading
level that exceed s that of popular magazines. Only one recommended book was
written at a level that was understandable by adults with low literacy skills.
Mid-range human-interest scores reflect the use of how-to information and examples
preferred in nutrition print mater ials by consumers. Publications containing
more passive sentences tended to be more difficult to understand and were slightly
less personalized. For many consumers, the comprehension and application of
the concepts presented in these recommended books wil l probably require interaction
with professionals.
Readability of American Cancer Society patient education literature.
Cathy D. Meade, Judy Diekmann, and Darlene G. Thornhill. Oncology Nursing
Forum, 19(1): 51-55. 1992.
Abstract: American Cancer Society (ACS) literature commonly used to inform
patients about cancer-detection methods, life-style risks, and treatment modalities
was examined for readability. Fifty-one booklets obtained from a regional ACS
office were evaluated. According to the SMOG formula, the reading level estimates
of the booklets ranged from grade 5.8-15.6 (SD = 2.2), with a mean reading level
of grade 11.9. The sampled cancer materials may be too difficult for many Americans
to read and underst and since most of the booklets (55%) were written for individuals
with grade 12 or higher reading skills. Only one booklet was written at less
than a grade six reading level. Booklets produced since 1985 were written at
significantly lower reading levels (p less than 0.05) than those published in
earlier years. The nurse's role in cancer education encompasses awareness of
patients' diverse reading skills and formulation of a systematic method to develop
materials that meet the needs of low-literacy groups .
Development of a curriculum to lower dietary fat intake in a multiethnic
population with low literacy skills. Cheryl L. Albright, et al. Journal
of Nutrition Education, 29:215-223. 1997.
NAL Call Number: TX341 J6
Abstract: Low-literate, low-income populations face unique issues as
they attempt to modify their diet to lower risk of chronic disease. The goal
of the Stanford Nutrition Action Program (SNAP) was to design a curriculum that
would address such iss ues and stimulate reduction of dietary fat. Initial focus
groups and pilot tests were conducted to assess nutrition knowledge, interests,
and dietary habits of a multiethnic, low-literate population. These investigations
revealed that a nutrition educatio n curriculum tailored to a population with
low literacy skills would need to address the taste, cost, and convenience of
low-fat foods, and teach participants how to incorporate low-fat foods and cooking
methods into their family's diet with minimal disru ption. These findings, combined
with published data on food intake and preferences, were used to design the
SNAP curriculum. The SNAP classroom curriculum operationalized principles of
adult education, constructs from social learning theory, and followed established
national guidelines on how to develop appropriate print materials for low-literate
adults. Each of its six lessons included role modeling, goal setting, problem
solving, group activities, and skills building tasks; many included SNAP videotape
s, food demonstrations, and posters that enhanced group discussions. Print materials
were written at or below the 5th grade reading level. The SNAP curriculum combined
interactive teaching techniques and behavior change methods to successfully
teach and s timulate the interest of low-literate, low-income population to
overcome barriers to reducing fat.
Literacy assessment in a cardiovascular nutrition setting. Thomas R.
TenHave, et al. Patient Education and Counseling, 31:139-150. 1997.
Abstract: We assessed functional literacy of hypercholesterolemic or
hypertensive African Americans (n = 339) prior to their participation in a nutrition
education program. A word pronunciation and recognition test using 20 common
cardiovascular or nutrition terms was first developed based on correlations
with standardized reading achievement test scores, then administered to program
participants. Nearly half (48%) had word recognition scores equivalent to a
< or = 8th grade reading level. Lower scores were associated with less education,
lower income, unemployment, heavier work activity if employed, less healthy
diets, history of heart disease or diabetes, and higher depression scores (all
P < 0.01); several of these associations were indepe ndent of education.
The educational materials were geared to a 5th to 8th grade reading level. However,
when both audio taped and printed instruction were provided, individuals with
reading scores < or = 8th grade preferentially used the tapes. This br ief
and relatively unobtrusive literacy assessment may help to identify persons
who can benefit most from audiovisual approaches to cardiovascular nutrition
education.
Low-literacy audio intervention for lowering fat intake. Kim M. Gans,
et al. Journal of Nutrition Education, 30:410B. 1998.
NAL Call Number: TX341 J6
Abstract: Not available.
Nutrition education for cardiovascular disease prevention among low-income
populations- description and pilot evaluation of a physician-based model.
Alice S. Ammerman, et al. Patient Education and Counseling, 19:5-18.
1992.
Abstract: Low income Americans are at greatest risk for coronary heart
disease but have least access to health promotion programs for life style modification.
Primary care physicians may represent one of the few sources of preventive care
available to the poor. However, the majority of physicians feel unprepared to
help patients achieve dietary change, and few existing nutrition intervention
programs address the special needs of low literacy populations. The Food for
Heart Program was developed to facilitate dietary counseling experienced by
primary care physicians who care for low literacy patients and to overcome barriers
to behavior change faced by patients. The program consists of three components:
(1) a validated dietary risk assessment that r apidly identifies atherogenic
eating habits and requires no nutritional expertise to administer or interpret,
(2) a structured diet treatment program that is culturally specific for a southern
patient population and links practical behavior change recomme ndations with
results of the diet assessment, and (3) a system for monitoring and reinforcement
that prompts physicians to review progress, reinforce prior messages, and reward
positive change. Behavior change theory is used to guide the intervention and
readability of the material has been assessed at the 5-6th grade level. An evaluation
study of the Food for Heart Program suggests that it has a positive impact on
physician counseling and that patients are responding favorably to these efforts.
Pilot study of a cafeteria program relying primarily on symbols to promote
healthy choices. Sarah Levin. Journal of Nutrition Education, 82(5):282-285.
NAL Call Number: TX341 J6
Abstract: Not available.
Readability and content analysis of print cholesterol education materials.
Karen Glanz and Joel Rudd. Patient Education and Counseling, 16:109-118.
1990.
Abstract: This article reports the results of an analysis of the readability
levels and content of 38 print cholesterol education materials available from
government, health agency, professional association, university and industry
sources. Each it em was characterized according to the primary intended audience
(general public, public and screening participants, or those identified with
elevated cholesterol and patients in treatment), size, length and appearance.
Readability analysis was done using the SMOG and Fog Grading formulas and content
analysis examined the presence of messages in each of nine key areas. The readability
assessment revealed that the average reading grade level was close to Grade
11, which is too difficult for many adults. Con tent analysis suggested a need
to better address other heart disease risk factors, portion size and the use
of brand name food recommendations. Further practice and research needs are
identified.
Readability levels of selected hypercholesterolemia patient education literature.
Sharon L. Merritt, Mary Anne Gates and Karen Skiba. Heart & Lung,
22:415-20. 1993.
Abstract: Objectives: To assess the readability of selected hypercholesterolemia
print materials, summarize the limitations of readability formulas, describe
how expert judgment can be used to enhance readability determinations of printed
materials , and discuss indirect and direct methods for assessing patient literacy
levels. Design: Descriptive, retrospective, convenience sample Outcome Measures:
Readability of four AHA/NLHBI hypercholesterolemia patient education pamphlets
by use of three readab ility formulas and the Reading Materials Checklist. Results:
The FOG, Fry, and SMOG formulas were used to calculate reading levels by two
raters who independently applied the formulas to the same word passages chosen
from the beginning, middle, and end of the pamphlets. The mean reading grade
levels were 14.4, 15.8, 14, and 14.4, demonstrating that all four pamphlets
were written for people with college level reading skills. The limitations of
readability formulas such as variations in reading estimates w ere demonstrated.
When expert judgment was applied with the Reading Materials Checklist, all pamphlets
were found lacking in the areas of legibility, usability, and motivational appeal.
Conclusions: The results indicate that the pamphlets may not be appro priate
for use with most of the adults in the United States who may be candidates for
hypercholesterolemia patient education. Because reading formulas are limited
in the information they provide, expert judgment regarding readability of print
materials sh ould also be applied. Additionally, indirect and direct techniques
need to be used to assess the literacy level of the patient population who will
be using the printed materials.
The Stanford Nutrition Action Program: A dietary intervention for low-literacy
adults. Beth Howard-Pitney, et al. American Journal of Public Health,
87(12):1971-1976. 1997.
Abstract: Few comprehensive nutrition programs for cardiovascular disease
risk factor reduction have been developed specifically for adults with low literacy
skills despite a growing awareness of the need for such programs. The Stanford
Nutrition A ction Program curriculum, tailored to the cultural, economic, and
learning needs of low-literacy, low-income adults, was found to be significantly
more effective than the general nutrition curriculum in achieving fat-related
nutritional changes.
What works best for worksite cholesterol education? Answers from targeted
focus groups. Pamela R. McCarthy, et al. Journal of the American Dietetic
Association, 92(8):978-981. 1992.
NAL Call Number: 389.8 Am34
Abstract: Focus group discussions are an effective way to determine the
needs and interests of a target population. In August 1989, eight focus group
discussions were conducted with municipal employees in Phoenix, Arizona, to
determine the needs an d interests of potential participants in a worksite cholesterol
education program. Employees were selected for the focus groups on the basis
of an initial screening that determined their motivation to change customary
eating habits. Individuals categorize d as "somewhat motivated" were invited
to participate in the focus groups because researcher thought they would best
represent the motivation level of the majority of potential participants in
the cholesterol education program. The focus group participant s indicated that
they preferred educational formats and approaches that appealed to diverse learning
styles and recognized individual differences. Several of the program features
identified by the focus groups are consistent with principles of adult educa
tion, especially active participation in the learning activity. The focus group
participants wanted information presented in a simple, easy-to-understand manner,
and they asked for behavioral directives rather than background information
or medical jargon . Release time from work and employer commitment to the program
were viewed as important to the success of the program. We conclude that employees
respond best to worksite wellness programs that are simple, practical, and relevant
and that allow them to p articipate actively in the learning activity during
work time.
Enhancing compliance in the child and adult care food program using digitized
photographs. Susan Martin Gould and Jennifer Anderson. Journal of Nutrition
Education, 28:47A. 1996.
NAL Call Number: TX341 J6
Abstract: Not available.
Comprehension assessment of diabetes education program participants.
Belinda McNeal. Diabetes Care, 7(3):232-235. 1984.
NAL Call Number: RC660 A1D53 F&N
Abstract: A study of reading and comprehension skills of 39 diabetics
participating in a diabetes education program revealed a significant mismatch
between these skills and the level of oral and printed instruction used in the
program. It was deter mined that over 50% of the participants could not fully
comprehend 5th grade material while the program's oral instructions and written
materials were at 9th grade level or higher. Problems caused by this observation
are discussed.
Factors influencing diabetic clients’ ability to read and comprehend printed
diabetic diet material. Jana R. Kicklighter and Melissa A. Stein. The
Diabetes Educator, 19(1):40-46.
NAL Call Number: RC660 A1D522
Abstract: Factors related to diabetic clients' abilities to read and
comprehend printed diabetic diet material were explored by collecting data on
social and demographic variables, prior knowledge, reading ability (using the
Nelson-Denny Test), and comprehension of the diet (using the cloze technique)
from 58 outpatient diabetic clients. A mean estimated reading grade level of
8.9 was obtained for the printed material, based on the use of three readability
formulas. Analysis of cloze scores reveale d that 62% of the clients scored
less than 40%, indicating that the material was too difficult for them to comprehend;
21% scored between 40% and 59%, suggesting the need for supplemental instruction;
and 17% scored 60% or above, indicating ability to ful ly comprehend. Clients
scoring less than 40% tended to be older and obtained lower scores on the Nelson-Denny,
as compared with those in the highest cloze category. Results of a stepwise
regression analysis indicated that the Nelson-Denny vocabulary score , client
age, and duration of diabetes were the strongest predictor variables for comprehension
of the diet material.
Focus group responses of potential participants in a nutrition education
program for individuals with limited literacy skills. Terryl J. Hartman,
et al. Journal of the American Dietetic Association, 94:744-748. 1994.
NAL Call Number: 389.8 Am34
Abstract. Objective: To obtain information to direct the design and development
of a nutrition intervention program targeted at a low-literacy audience Subjects:
Thirty-nine female and two male clients of the Expanded Food and Nutrition Education
P rogram (EFNEP) participated in five focus-group discussions. The focus groups
included 23 African American, 9 white, 4 Southeast Asian, 1 American Indian,
2 Hispanic American, and 2 Middle Eastern EFNEP participants. Design: All focus
groups were moderate d and co-moderated by University of Minnesota staff members.
The focus groups were tape- recorded and transcribed. A written report was generated
based on the independent evaluation of two staff members. Results: We learned
that EFNEP participants thought they would be motivated to change their eating
habits for health concerns, including weight loss, and to help their families
develop healthful eating habits. They mentioned several barriers to making changes,
including extra time and money needed to purc hase and prepare healthful foods,
food preferences of family members, lack of interest and skills in cooking,
and insufficient knowledge about which foods are healthful. Participants shared
ideas for program content and delivery. Conclusions: Clients with limited literacy
skills have valuable opinions and insights that program developers targeting
this hard-to-reach group should hear. The EFNEP participants wanted simple,
practical, and relevant information about what foods to eat and how to prepare
them. They considered lectures an ineffective way to receive nutrition information,
and they expressed a preference for hands-on activities that were enjoyable
and allowed participants to share ideas and experiences.
Interactive evaluation using the "Learning Tool". Gayle Coleman
and Bruce Haas. Journal of Nutrition Education, 32:353A. 2000.
NAL Call Number: TX341 J6
Abstract: Not available.
Effect of literacy on breast-feeding outcomes. Holly Kaufman, et al.
Southern Medical Journal, 94(3):293-293. 2001.
Electronic Version: http://www.sma.org/smj2001/marsmj01/kaufman.pdf
Abstract: We studied the effect of functional health literacy on the
initiation and continuance of breast-feeding in women at a public health clinic.
Subjects were 61 first-time mothers aged 18 years or older who spoke English
as their first langua ge. They were divided into two groups, one who exclusively
breast-fed for at least the first 2 months and one who never initiated breast-feeding
or did not exclusively breast-feed for at least 2 months. The Rapid Estimate
of Adult Literacy in Medicine (RE ALM) was administered, providing reading grade-level
estimates for each subject. An association between functional health literacy
and breast-feeding was seen, with only 23% of the women in the lower literacy
group exclusively breast-feeding during the fi rst 2 months compared with 54%
of women in the higher literacy group. Many patients need simpler health education
materials encouraging breastfeeding. These materials are needed both before
and during pregnancy.
Evaluation of the readability of ACOG patient education pamphlets. Margaret
Comerford Freda, Karla Damus and Irwin R. Merkatz. Obstetrics & Gynecology,
93(5):771-774. 1999.
Abstract: Objective: To evaluate whether ACOG's patient education pamphlets
comply with the recommended readability level for health education materials
intended for the general public. Methods: All 100 English-language pamphlets
available during 1 997 (created or revised between 1988 and 1997) were evaluated
using four standard readability formulas. Results: Mean readability levels of
ACOG's pamphlets were between grade 7.0 to grade 9.3, depending on the formula
used. Analysis of readability over t he 10 years showed a trend toward lower
readability levels. Analysis by category of pamphlet found that the lowest readability
levels were in "Especially for teens" pamphlets. Conclusion: Our data suggested
that most of ACOG's patient education pamphlets currently available are written
at a higher readability level than recommended for the general public. The readability
of those pamphlets improved in the 10 years since the organization published
its first pamphlet, but the goal of sixth-grade readability level has not been
reached.
Reading skill and comprehension of the Dietary Guidelines by WIC participants.
Karen M Busselman and Carol Ann Holcomb. Journal of the American Dietetic
Association, 94:622-625. 1994.
NAL Call Number: 389.8 Am34
Abstract: Objective: The purpose of this study was to examine the match
between reading skills and comprehension of the 1990 Dietary Guidelines in a
Special Supplemental Food Program for Women, Infants, and Children (WIC) group
(n=32) compared with a non-WIC group and to determine which selected factors
affected cloze scores. Subjects/Samples: The WIC group consisted of volunteers
from WIC voucher pick-up sites, and the non-WIC group comprised women who met
the qualification criteria for WIC, excep t income. Methods: Reading skills
were assessed using the Wide-Range Achievement Test-Revised Level II (WRAT-R).
Comprehension skills were measured using the cloze technique. Materials: The
introductory section of the Dietary Guidelines, originally writte n at the 10th-grade
level, was simplified to the 7th-grade level for comprehension comparison. Results:
The WIC group had a significantly (P<.001) lower reading skill (WRAT-R score=60.1;
11th-grade level) than the non-WIC group (WRAT-R score=70.8; coll ege level).
Cloze scores from all subjects tested at the 10th-grade level indicated that
75% (n=24) would be frustrated or need instructional assistance to understand
the Dietary Guidelines. Simplification contributed to higher cloze scores. The
WRAT-R sc ore was one factor that significantly affected the cloze score (P<.001).
Both education level and WRAT-R scores varied significantly between groups;
however, analysis of covariance revealed that the effects were identical within
both groups. Implicatio ns: WRAT-R can be used as a quick screening method for
reading-skill level of individuals in WIC programs and other counseling situations.
The cloze techniques may be useful for assessing comprehension of specific printed
materials. Assessment of reading skill and comprehension by nutrition educators
is recommended to increase the likelihood of selecting and/or developing effective
materials.
Communicating effectively with pregnant adolescents who have limited literacy
or comprehension skills.
Chapter 19 (p181–190) in: Nutrition and the Pregnant Adolescent: A Practical
Reference Guide
Mary Story and Jamie Stang, editors.
Minneapolis, MN: Center for Leadership, Education, and Training in Maternal
and Child Nutrition, University of Minnesota, c2000. 247 p.
NAL Call Number: RG556.5 N88 2000
Electronic Version: http://www.epi.umn.edu/let/nmpabook.html
Abstract: A resource for health professionals on nutrition and adolescent
pregnancy. The overall goal of this book is to promote the health and nutritional
status of pregnant adolescents and to achieve optimal pregnancy and infant outcomes.
Focuses on clinical application of current knowledge on adolescent pregnancy
emphasizing assessment, management, counseling approaches and strategies to
promote dietary change and adequate weight gain.
Nutrition Education Opportunities: Strategies to Help Patients with Limited
Reading Skills. Report of the Second Ross Roundtable on Current Issues in Public
Health.
Columbus, OH: Ross Laboratories, c1989. 77 p.
NAL Call Number: TX364 R67 1988
Description: Addresses how to create nutrition education materials for
low-literate persons. Includes discussions on illiteracy, reading levels of
existing nutrition education materials and efforts to reach low-literate audiences.
Development and evaluation of a pictorial version of a WIC allowable foods
list. Susan Martin Gould and Jennifer Anderson. Journal of the American
Dietetic Association, 99(8):978-980. 1999.
NAL Call Number: 389.8 Am34
Abstract: Not available.
Developing written nutrition information for adults with low literacy skills.
Jaime Ruud, Nancy M. Betts and John Dirkx. Journal of Nutrition Education,
25(1):11-16. 1993.
NAL Call Number: TX341 J6
Abstract. The purpose of this project was to develop nutrition materials
based on bulletins HG 232(1-11), "The Dietary Guidelines and Your Diet", for
use by adults with low literacy skills. A booklet testing at the fifth grade
level was designed an d tested using qualitative research methods. Participants
included 131 women and 21 men, 16 to 60 years of age (mean age 30 years). Sixteen
percent were African American, 3% were Native American, 1% were Hispanic, and
the remaining 80% were Caucasians. Al l possessed reading skills from the third
to eighth grade levels, and years of education completed ranged from sixth grade
to high school graduate (mean of tenth grade). Two sets of interviews were conducted.
The booklet was revised based upon results fro m the first set of interviews.
Participants were especially interested in "how to" and "did you know" information,
and calorie and nutrient contents of food. Topics of interest included, "Tips
on Feeding Young Children", "Eat Less Fat", and "Watch Your We ight". Findings
from the interviews provide evidence of the need for nutrition information among
these low literate adults. Further research with low literate adults is needed
to define typical dietary practices, beliefs and perceptions, and barriers to
c hange.
Improving the effectiveness of nutrition education materials for low literacy
clients. Susan Nitzke. Nutrition Today, 24(5):17-23. 1989.
NAL Call Number: RA784 N8
Abstract. Communicating nutrition information in a meaningful way is
an ever present challenge for educators. Reaching low literacy adults, more
than 13% of the population, requires special skills and techniques. Some of
these are addressed in this article.
Instrument development for low literacy audiences: Assessing extension program
personnel teaching effectiveness. Laryssa Lackman, Robert D. Nieto and Rosemary
Gliem. Journal of Extension, 35(1). 1997.
NAL Call Number: LC45.4 J682
Electronic Version: http://www.joe.org/joe/1997february/rb1.html
Abstract: Not available.
National Cancer Institute's Ethnic and Low Literacy Nutrition Education
Project. Chariklia Tziraki, et al. Journal of Nutrition Education,
26(2):101-106. 1994.
NAL Call Number: TX341 J6
Abstract: Not available.
Nutrition education materials from the National Institutes of Health: Development,
review and availability. Jean A.T. Pennington and Van S. Hubbard. Journal
of Nutrition Education and Behavior, 34(1):53-58. 2002.
NAL Call Number: TX341 J6
Abstract: Many of the institutes, centers, and offices (ICOs) within
the National Institutes of Health (NIH) develop and disseminate nutrition education
materials for the general public. These materials provide information about
the relationship of diet to health and about associations between diet and specific
diseases. The materials, which are drafted by the NIH or contract science writers,
go through pretesting (for literacy level and appropriateness for target audiences)
and ICO clearance (for scientific accuracy). To further ensure scientific and
technical accuracy and consistency with the Dietary Guidelines for Americans,
the materials then go through a two-tiered governmental review system. The first
review is through the Nutrition Education Subcommittee (NES) of the NIH Nutrition
Coordinating Committee. The second review, which is required for federal nutrition
education materials, is conducted jointly by the Department of Health and Human
Services (DHHS) Nutrition Policy Board Committee on Dietary Guidance and by
the US Department of Agriculture (USDA) Dietary Guidance Working Group. The
review process helps ensure consistency in nutrition messages within the NIH
ICOs and among government agencies. The pretesting, ICO clearance, NES review
, and joint DHHS/USDA review result in materials for nutrition educators that
are high in quality, low in cost or free, easily accessible, appropriate for
the intended target audience, and consistent with the Dietary Guidelines for
Americans.
Reader’s Responses to Language Experience Approach Materials. Betty
Aderman, et al. Adult Literacy and Basic Education, 11(1):13-22. 1987.
Abstract: Not available.
Research into practice example: Reaching low-literate adults with printed nutrition
materials. Susan Nitzke. Journal of the American Dietetic Association,
87 (Suppl. 9):S73-77. 1987.
NAL Call Number: 389.8 AM34
Abstract: (Extract from article) A receiver-assisted pamphlet featuring
snack information written in the language of the target audience was developed
using the language experience approach and compared to a standard sender-produced
version writte n by nutrition professionals. Information garnered through free
recall, main idea, content continuation, and signaled stopping statements suggests
that the receiver-assisted pamphlet was more easily understood and the perception
of personal relevance was improved, although content recognition and oral miscue
analyses indicated that some of the wording in the receiver-assisted version
tended to be more difficult. Subjects who read semantic differential passages
gave the receiver-assisted pamphlet more favo rable ratings on the neighborly,
helpful, sensible, and informative scales. Semantic differential scores of white
and nonwhite respondents favored the receiver-assisted version, indicating that
the materials are appropriate for use with a racially mixed t arget audience.
Strategies to improve cancer education materials. Leonard G. Doak, Cecilia
C. Doak and Cathy D. Mead. Oncology Nursing Forum, 27(10):1305-12. 1996.
Electronic Version: http://www.ons.org/xp6/ONS/Library.xml/ONS_Publications.xml/ONF.xml/ONF1996.xml/September.xml/Article_8.xml
Abstract: Purpose/objectives: To highlight the benefits of creating effective
materials for cancer education; to describe strategies to enhance the suitability
of materials for all readers, including those with limited literacy skills.
Data Sources : Published research and education articles, health education models
and theories, the National Cancer Institute Office of Cancer Communications,
and personal experiences. Data Synthesis: Written materials, including visuals,
commonly are used to convey c ancer life-style risks, detection methods, treatments
and procedures, and informed consent information. Such materials are relevant
and suitable only when they can be read and understood and are matched to patients'
reading abilities. A systematic process to achieve effective written materials
includes assessing the target audience, limiting the educational objectives,
focusing the content on the desired behaviors, presenting the context of the
message first, and planning for reader interaction. The final step is verification
of comprehension and suitability with the target audience. Conclusions: The
creation of effective cancer education materials can be achieved by employing
strategies that aim to enhance patient understandability, usability, relevancy,
and motivation. Learner verification is a quality control process and a technique
that helps ensure that materials are suitable for the intended audience and
better matched to patients' learning needs. Nursing Implications: Nurses can
improve the underst andability of cancer education by using a variety of learning
enhancement techniques and a set of organized planning steps. Such strategies
can serve to improve the communication of cancer information to target groups
with diverse literacy skills.
Tools for evaluating written and audiovisual nutrition education materials.
Connie Betterley and Brenda Dobson. Journal of Extension, 38(4). 2000.
NAL Call Number: LC45.4 J682
Electronic Version: http://joe.org/joe/2000august/tt3.html
Abstract: Not available.
Using a critical incident technique to develop nutrition information materials
for adults with low literacy skills. Nancy M. Betts, John Dirkx and Jamie
Ruud. Journal of Nutrition Education, 25(4):208-212. 1993.
NAL Call Number: TX341 J6
Abstract: Not available.
Using low-literacy newsletters to provide nutrition education for limited
resource individuals. Barbara J. Struempler and Autumn C. Marshall. Journal
of Nutrition Education, 31:60C. 1999.
NAL Call Number: TX341 J6
Abstract: Not available.
Writing health education material for low-literacy populations. Jane
Meyer and Jacquie Rainey. Journal of Health Education, 25(6): 372-374.
1994.
NAL Call Number: LB3401 A57
Abstract: Not available.
Beyond the Brochure: Alternative Approaches to Effective Health Communication
Denver, CO: AMC Cancer Research Center, 1994. 74 p.
Electronic Version (PDF): http://www.cdc.gov/cancer/nbccedp/bccpdfs/amcbeyon.pdf
Description: This booklet is designed to help educators identify means
of providing education to low-literacy audiences that does not rely upon printed
words. Includes information on adapting, developing, and testing materials.
Clear & Simple: Developing Effective Print Materials for Low-Literate
Readers
Bethesda, MD: National Cancer Institute, National Institutes of Health, 1994.
Electronic Version: http://oc.nci.nih.gov/services/Clear_and_Simple/HOME.HTM
Description: This guide outlines a process for developing publications
for people with limited-literacy skills. Includes information on target audience
research, designing and developing materials and how to pre-test publications.
Developing client education materials
Jo Ellen Shield and Mary C. Mullen
Chapter 10 (pages 91-104) in Communicating as Professionals
Ronnie Chernoff, editor.
Chicago, IL: American Dietetic Association, c1994. 210 p.
NAL Call Number: R118 C6 1994
ISBN: 0880911239
Description: Discusses use of a three-phase process for developing readable
materials: planning, development and evaluation. Includes information on needs
assessment, learning and behavioral objectives, wording, graphics, layout, readability
formul as, and pre-testing.
Communicating with: people who have difficulty reading
Helen Osborne
Chapter 1 (p1-9) in: Overcoming Communication Barriers in Patient Education
Gaithersburg, MD: Aspen Publishers, Inc., c2001. 65 p.
NAL Call Number: R118 O83 2001
ISBN: 083422030X
Description: Provides general health literacy information, and reviews
various communication strategies including writing, graphics and pictographs,
videotapes and audiotapes. Also includes resource lists.
Effective patient education.
Chapter 1 (p1-29) in: Diabetes Patient Education Manual.
Simon Weavers and Judy Marcus, editors.
Gaithersburg, MD: Aspen Publishers, Inc., c1999.
NAL Call Number: RC660 D544 1999
ISBN: 0834212757
Description: Discusses literacy assessment using the Rapid Estimate of
Adult Literacy of Medicine (REALM) instrument, readability assessment using
the SMOG index, layout and design of print materials and how to teach patients
with low-literacy skil ls.
Guidelines: Writing for Adults with Limited Reading Skills.
Nancy Gaston and Pat Daniels.
Alexandria, VA: United States Department of Agriculture, Food and Nutrition
Service, Office of Information, 1988. 23 p.
NAL Call Number: APE1126 A4G8
Abstract: These guidelines are intended to assist writers and editors
in preparation of written materials for adults with limited reading skills.
Basic points in preparing informational material are as follows: know the characteristics
of the audie nce so that the material is appropriate; clearly identify and organize
the message; and present the material in a way to get and hold readers' attention
long enough for them to retain the message. Illustrations, references, and a
high-frequency word list are included.
Teaching Patients with Low Literacy Skills.
Cecilia C. Doak, Leonard G. Doak and Jane H. Root.
Philadelphia, PA: JB Lippincott Co., c1996. 224 p.
NAL Call Number: RT90 D6 1996
ISBN: 0397551614
Description: Provides strategies for improving patient comprehension
and assessing the suitability of materials (SAM method). Reviews use of the
Fry Readability Graph. Also discusses how to teach patients using written materials,
tapes, video, c omputer aided instruction, visuals, and graphics.
Writing and Designing Print Materials for Beneficiaries: A Guide for State
Medicaid Agencies
Jeanne McGee
Baltimore, MD: United States Department of Health and Human Services, Health
Care Financing Administration, 1999. Publication Number 10145. 335 p.
Electronic Version (PDF): Only the 'Guide Checklist for Assessing Print
Materials' is available online. http://www.hsph.harvard.edu/healthliteracy/how_to/guide_cklst.pdf
Description: Guide focused on the development of print materials for
Medicaid beneficiaries. It provides advice and tips for writing, designing,
and pre-testing written materials.
Writing for Reading: Guide for Developing Print Materials in Nutrition for
Low-Literacy Adults
Susan Nitzke et al.
Madison, WI: University of Wisconsin-Madison, c1986. 9 p.
Electronic Version (PDF) (printing not allowed): http://cf.uwex.edu/ces/pubs/pdf/B3545.PDF
NAL Call Number: LB1050.42 W7
Description: Guide for targeting and developing nutrition information
for adults with limited literacy skills.
Writing for a Changing World: Reaching Low Literacy Audiences with Print
Material. North Central Region Extension Publication No. 475.
Ellen Schuster and David W. McAllister.
St. Paul, MN: University of Minnesota Extension, 1993
NAL Call Number: S544 N6
Electronic Version: http://www.extension.umn.edu/distribution/communications/DL6052.html
Description: Brochure featuring writing tips and resources designed to
help Cooperative Extension staff communicate health messages to audiences with
limited literacy skills.
Easy to Read
Oregon State University Extension Family and Community Development, May 4, 2001.
Web Site: http://www.orst.edu/dept/ehe/nu_literacy_wt_et.htm
Description: Covers four ways to improve the layout and readability of
educational materials for low literacy viewers.
Just Say It!
Oregon State University Extension Family and Community Development
Web Site: http://www.orst.edu/dept/ehe/nu_literacy_wt_js_ws.htm
Description: Includes information on how to simplify the words you use
in your materials. Includes a Word Substitution List.
Pictograph Research Project: Developing Ways to Communicate Large Amounts
of Medical Information to Non Literate Persons.
Johns Hopkins Oncology Center, February 8, 1999.
Web Site: http://www.med.jhu.edu/cancerctr/ptfamsvc/pict/pictogr.htm
Description: Describes a research project that uses pictographs, pictures
that represents an idea, to communicate health information. Contains 192 pictographs
of actions to manage fever and sore mouth due to cancer treatment and actions
to manage HIV symptoms of nausea, diarrhea, fatigue, depression, and spread
of HIV infections.
Readability formulas: An overview. Chafai Tekfi. Journal of Documentation
43(3) 261-73. 1987.
Abstract: Not Available.
Readability formulas: Caution and criteria. Cathy D. Meade and Cyrus
F. Smith. Patient Education and Counseling, 17:153-158. 1991.
Abstract: Not available.
Readability formulas may mislead you. James W. Pichert and Peggy Elam.
Patient Education and Counseling, 7:181-191. 1985.
Abstract: Not available.
In Other Words...Assessing Readability: Rules for Playing the Numbers Game.
Helen Osborne, Health Literacy Consulting, December 2000.
Web Site: http://www.healthliteracy.com/oncalldec2000.html
Description: Includes a discussion on how to prepare materials before
assessing readability using a computer software program.
Tips on Developing Patient Education: Readability and Reading Tests
University of Virginia Health System, August 28, 2000.
Web site: http://www.med.virginia.edu/patient-ed/provider/read.html
Description: Includes information on the Fry Readability Formula, Flesch-Kincaid
Formula, SMOG Readability Formula, and the REALM reading level test.
A new readability yardstick. Rudolf Flesch. Journal of Applied Psychology,
32:2211-2223.1948.
Abstract: Not available.
A readability formula that saves time. Edward Fry. Journal of Reading,
11:513-516, 575-578. 1968.
Abstract: Not available.
Fry’s Readability Graph: Clarifications, validity, and extensions to level
17. Edward Fry. Journal of Reading, 242-252. 1977.
Abstract: Not available.
Suitability Assessment of Materials: Assessing readability using the Fry
Formula
Pages 44-46 in: Teaching Patients with Low Literacy Skills
Cecilia C. Doak, Leonard G. Doak and Jane H. Root.
Philadelphia, PA: JB Lippincott Co., c1996. 224 p.
NAL Call Number: IPM020313326
ISBN: 0397551614
Description: Reviews use of the Fry Readability Graph.
The Fry Readability Scale
Atlanta, GA: Centers for Disease Control, May 2001.
Web Site: http://www.cdc.gov/od/ads/fry.htm
Description: Offers instructions and graph for calculating readability
using the Fry Formula.
SMOG grading: A new readability formula. G. Harry McLaughlin. Journal
of Reading, 12:639-46. 1969.
Abstract: Not available.
Using the SMOG Index
How to Test for Readability
Appendix B in: Making Health Communication Programs Work: A Planner's Guide
Bethesda, MD: National Cancer Institute, 1989.
Electronic Version: http://oc.nci.nih.gov/services/HCPW/APPEN.HTM#anchor113849
NAL Call Number: RA440.3 U5P82 1989
Description: Provides instructions and an example on how to use the SMOG
formula.
Human Subjects Research: SMOG Readability Formula
Atlanta, GA: Centers for Disease Control, March 14, 2001.
Web Site: http://www.cdc.gov/od/ads/smog.htm
Description: Includes information on the SMOG Readability Formula, Spanish
readability formulas, and a list of replacement words and phrases.
The Food and Nutrition Information Center did not test the readability of these materials. In most cases, distributors identified their materials that are written at the 6th grade level or below. Samples of materials that you can order are listed below. This is not a complete listing.Adaptive Materials, Inc.
American Diabetes Association
Attn: Customer Service
1701 North Beauregard St.
Alexandria, VA 22311
Telephone: (800) 342-2383
Web Site: http://www.diabetes.org/
Booklets:
American Dietetic Association
216 W. Jackson Blvd.
Chicago, IL 60606-6995
Telephone: (800) 877-1600 ext. 5000
Web Site: http://www.eatright.org
Booklets:
Aprendo Press
P.O. Box 51392
Durham, NC 27717
Telephone: (919) 361-1857
Fax: (919) 361-2284
E-mail: aprendopress@mindspring.com
Web Site: http://ww2.choicemall.com/aprendopress/
Photonovelas:
Association of Farmworker Opportunity Programs
AFOP - Publications
4350 North Fairfax Dr., Suite 410
Arlington, VA 22203
Telephone: (703) 528-4141
Fax: (703) 528-4145
Web Site: http://www.afop.org/frames.html
English as a Second Language Curricula:
Attainment Company, Inc.
P.O. Box 930160
Verona, WI 53593-0160
Telephone: (800) 327-4269
E-mail: info@attainmentcompany.com
Web Site: http://www.attainmentcompany.com/home.html
Picture Cookbooks/Recipes:
California Diabetes and Pregnancy Program (CDAPP) Resource Center
4542 Ruffner St, #140
San Diego, CA 92111-2250
Telephone: (858) 467-4990
Fax: (858) 467-4993
Web Site:
http://www.llu.edu/llumc/sweetsuccess/catalog/order.htm
Pamphlets:
Channing Bete Company, Inc.
One Community Place
South Deerfield, MA 01373-0200
Telephone: (800) 628-7733
Fax: (800) 499-6464
E-mail: custsvcs@channing-bete.com
Web site: http://www.channing-bete.com
Booklets:
Diabetes Association of Greater Cleveland
3601 S. Green Road, Suite 100
Cleveland, OH 44122
Telephone: (216) 591-0800
Fax: 216-591-0320
Web site: http://www.dagc.org/infoform.cfm
Pamphlets:
Food Safety and Inspection Service
United States Department of Agriculture
Washington, DC 20250-3700
E-mail: fsis.outreach@usda.gov
Web Site: http://www.fsis.usda.gov/index.htm
Booklet (storyboard):
Health Promotion Council of Southeastern Pennsylvania
260 South Broad St., 17th Floor
Philadelphia, PA 19102-5085
Telephone: (215) 731-6150
Fax: (215) 731-6199
E-mail: hlphpc@libertynet.org
Web site: http://www.hpcpa.org/
Pamphlets:
IDC Publishing
International Diabetes Center
3800 Park Nicollet Blvd.
Minneapolis, MN 55416-2699
Telephone: (888) 637-2675
Fax: (952) 993-1302
E-mail: idcpub@parknicollet.com
Web site: http://www.idcpublishing.com/index.cfm
Booklets:
Iowa State University
Extension Distribution Center
119 Printing and Publications Building
Iowa State University
Ames, IA 50011-3171
Telephone: (515) 294-5247
Fax: (515) 294-2945
Pamphlets:
National Cancer Institute
Publications Ordering Service
P.O. Box 24128
Baltimore, MD 21227
Telephone: (800) 422–6237
Fax: (301) 330–7968
TTY: (800) 332-8615 (US only)
Brochures:
National Center for Farmworker Health, Inc.
1770 FM 967
Buda, TX 78610
Telephone: (512) 312-2700
Fax: (512) 312-2600
Web Site: http://www.ncfh.org/catalog.htm#ordrform
Portfolios:
National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 20892-3560
Telephone: (800) 860-8747
Fax: (301) 907-8906
E-mail: ndic@info.niddk.nih.gov
Web site: http://www.niddk.nih.gov/health/diabetes/ndic.htm
Booklets:
National Digestive Diseases Information Clearinghouse
2 Information Way
Bethesda, MD 20892-3570
Telephone: (800) 891-5389
Fax: (301) 907-8906
E-mail: nddic@info.niddk.nih.gov
Web Site:
http://www.niddk.nih.gov/health/digest/pubs/ddpubs/ddform.htm
Booklets:
National Heart Lung and Blood Institute
Health Information Center
P.O. Box 30105
Bethesda, MD 20824-0105
Telephone: (301) 592-8573
Fax: (301) 592-8563
TTY: (240) 629-3255
Web Site: http://www.nhlbi.nih.gov/health/infoctr/ic_ordr.htm
Booklets:
National Maternal Child Health Clearinghouse
Telephone: (888) ASK-HRSA
E-mail: ask@hrsa.gov
Web Site: http://www.ask.hrsa.gov
Booklets:
National Oral Health Information Clearinghouse
1 NOHIC Way
Bethesda, MD 20892-3500
Telephone: (301) 402–7364
Fax: (301) 907–8830
Web Site: http://www.nohic.nidcr.nih.gov/cgi-bin/ohpubgen_new
Booklets:
Oregon State University
Publication Orders
Extension and Station Communications
422 Kerr Administration
Corvallis, OR 97331-2119
Fax: (541) 737-0817
E-mail: puborders@orst.edu
Web Site:
http://eesc.orst.edu/agcomwebfile/EdMat/EdmatIndexFam.html
Picture Cookbooks/Recipes:
Redwood Coast Regional Center
Attn: Janet Foos, RD, MPH
525 Second St, Suite 300
Eureka, CA 95501
Telephone: (707) 445-0893 ext 324
E-mail: jfoos@redwoodcoastrc.org
Picture Cookbooks/Recipes:
United States Environmental Protection Agency
Region 1
1 Congress Street
Boston, MA 02114-2023
Telephone: (888) 372-7341
Web Site: http://www.epa.gov/region01/eco/lead/index.html
English as a Second Language Curricula:
United States Food and Drug Administration
HFI-40
Rockville, MD 20857-0001
Telephone: (888) 463-6332
Web Site: http://www.fda.gov/opacom/lowlit/7lowlit.html
Booklets:
United States Government Printing Office
Superintendent of Documents
P.O. Box 371954
Pittsburgh, PA 15250-7954
Telephone: (866) 512-1800
Fax: (202) 512-2250
Web Site: http://bookstore.gpo.gov/index.html
Booklets:
University of Connecticut Family Nutrition Program
Department of Nutrition
3624 Horsebarn Hill Rd.
University of Connecticut
Storrs, CT 06269-4017
Phone: (860) 486-3635
E-mail: lphillip@canr.uconn.edu
Web Site: http://www.hispanichealth.com/pana.htm
Fotonovelas:
University of Massachusetts, Amherst
School of Public Health and Health Sciences, Department of Nutrition
210 Chenoweth, 100 Holdsworth Way
Amherst, MA 01003-9282
Phone: (413) 545-0740
Fax: (413) 545-1074
E-mail: ritabo@nutrition.umass.edu
Web Site: http://www.umass.edu/sphhs/nutrition/index.html
Modules:
University of Minnesota Extension Service
Extension Distribution Center
405 Coffey Hall
1420 Eckles Avenue
University of Minnesota
St. Paul, MN 55108-6068
Telephone: (800) 876-8636
Fax: (612) 625-6281
E-mail: order@extension.umn.edu
Web Site: http://www.extension.umn.edu/units/dc/
Brochures:
University of Wisconsin Cooperative Extension
Cooperative Extension Publications
45 North Charter St.
Madison, WI 53715
Telephone: (877) 947-7827
Fax: (608) 265-8052
E-mail: breitzman@admin.uwex.edu
Web Site: http://www.uwex.edu/ces/publishing/distribution.html
Booklets:
VI. Easy-to-Read Nutrition Materials at the National Agricultural Library (in alphabetical order)
Alimentos saludables, bebé saludable: un cuento sobre cómo comer bien cuando estás embarazadaA Taste of English: Nutrition Workbook for Adult ESL Students
Kathleen Flannery Silc and Beth Outterson
Arlington, VA: Association of Farmworker Opportunity Programs, c1994.
NAL Call Number: TX357 S65 1994
ISBN: 1886567050
Description: Teachers manual and student workbook designed to introduce
basic nutrition concepts to adult English as a Second Language students. Features
eight lessons that address healthy lifestyle behaviors, eating a variety of
foods, food safet y, grocery shopping, and food assistance. Also includes recipes.
Healthy Foods Healthy Baby: A Story About How to Eat Right When You Are
Pregnant
Philadelphia, PA: Maternal and Infant Health, Department of Public Health, City
of Philadelphia, 1990. 28 p.
NAL Call Number: RG559 H42 1990
Description: This booklet presents nutrition information for pregnant
teens and young adults at the 4th to 6th grade reading level. Two pregnant teens,
Kim and Maria, meet at the health clinic and learn from one another about how
to make good food choices. Information is conveyed through realistic dialogue,
illustrations, and specific recommendations. Kim and Maria's friendship develops
throughout the book as they discuss the joys and discomforts of their pregnancies,
how much weight to gain, where their advice came from and how to feed their
new babies. They begin to adopt health promoting eating habits that they will
share with their families.
Home Cooking Picture Cookbook
Ellen M. Sudol
Verona, WI: Attainment Company, c1990.
NAL Call Number: TX714 S83 1990
Description: This picture cookbook provides instruction to low literacy
populations for making main and side dishes, vegetables, salads and desserts.
Low Fat Express
Owatonna, MN: Pineapple Appeal, 1995.
NAL Call Number: Kit no. 283
Description: A collection of activities that emphasize simple messages
about eating foods with less fat. Includes a cookbook, leader's guide, calendar,
2 tubes of fat, 1 deck of cards, 1 measuring spoon, 1 jar-opening aid, and a
nutrition fact she et.
Look n’ Cook Microwave
Ellen Sudol
Verona, WI: Attainment Company, Inc, c1999.
NAL Call Number: TX832 S83 1999
Description: Provides 68 simple microwave recipes. Each recipe features
step-by-step illustrations. Also includes an instructor’s guide featuring 32
lesson plans based on the recipes in the cookbook
Radio Nutricion: A Program for Nutrition Education with the Hispanic Community
Arlington, VA: Association of Farmworker Opportunity Programs, 1996.
NAL Call Number: Audiocassette no. 501
Description: Uses novelas and social marketing techniques to reach Hispanic
Farmworkers via the radio. Includes six audiocassette tapes in novela, public
service announcement and "talk show" formats that address diabetes,
high blood pre ssure, heart disease, pregnancy and smart shopping. Also provides
a Provider’s Guide (in English and Spanish) that features information about
the program and social marketing, transcripts of the novelas, and evaluation
instruments.
Shopping Smart: Towards Independence in Shopping
Verona, WI: Attainment Company, Inc. not dated. 230 p.
NAL Call Number: Pending
Description: Includes 288 laminated cards that illustrate food and non-food
items. The cards are used to create a pictorial shopping list that is stored
and carried in a provided wallet/pocketbook. An instructor’s guide includes
lesson plans and illustrates how to shop for groceries in a step-by-step format.
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This resource list was compiled by:Acknowledgment is given to the following FNIC reviewers:
Shirley King Evans, EdM, RD
Elizabeth Hill, RD
Janice Schneider, MS, RD
Desire' Stapley, RD, LD
This publication was developed through a Cooperative Agreement between the
Food and Nutrition Information Center
and the Department of Nutrition and Food Science in the College of Agriculture
and Natural Resources
at the University of Maryland.
***********************************************************************
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