Page 327 - Nutrition Counseling and Education Skills: A Guide for Professionals

Numeracy and Literacy Considerations

The level of numeracy and literacy skill affects how learners remember and process information. Educational
materials must be understandable to the people for whom they are intended. Printed materials in other
languages may be needed for those with limited ability in English. Other materials need to be adapted to
reading, writing, and math skills. Therefore, nutrition educators need to select or develop instructional
materials that are easily comprehended.

Numeracy is defined as the ability to use numbers and math in ordinary life situations. The tasks involved
may include correlations between measuring cup volume and portion size, relationships between time and
intensity, or merely understanding what a number means on a glucose meter in relation to health risk.
Numeracy commonly involves multistep processes. For example, diabetic clients must be able to use math to
calculate the number of grams of carbohydrate they have eaten during a day by adding up the content of all
foods consumed. In turn, they must apply this math to calculate sliding insulin doses. Numeracy is an essential
component of correlating appropriate instructional materials with desired education outcomes.24–26

Literacy is the basic level of reading and writing that is required to understand basic information. Written
materials can be assessed for the readability or grade level by measuring word and sentence length and
difficulty. Several readability formulas are available, both as software programs and in print, to help assess the
audience’s readability, grade level, or both. The SMOG, FOG, Flesch, Raygor, and Fry tests are examples.
The SMOG criteria are listed in Table 14-1. Because of the scientific and technical nature of health
communications, vocabulary and wording of patient education materials may be incomprehensible to many
adults. Readability formulas should be used to assess the approximate educational level a person must have to
understand the material. Readability formulas, however, are only part of the process; developers should also
“pilot-test,” or try out materials on sample clients, or use more formal focus groups to find out if they will be
understood by the target audience.12 The overriding principle to remember is to be sensitive to the fact that
many clients may have literacy and numeracy problems they may attempt to hide during the assessment
process. Addressing literacy, especially health literacy, as a primary component of communication skills will
dramatically increase the chances of successful counseling.24–26

1. Count 10 consecutive sentences near the beginning, in the middle, and near the end of the text. If the
text has fewer than 30 sentences, use as many as are provided.

2. Count the number of words containing three or more syllables (polysyllabic) including repetitions of the
same words.
a. Hyphenated words are considered as one word.
b. Numbers that are written out should be counted. If written in numerical form, they should be
pronounced to determine if they are polysyllabic.
c. Proper nouns, if polysyllabic, should be counted.
d. Abbreviations should be read as though unabbreviated to determine if they are polysyllabic. However,
abbreviations should be avoided unless commonly known.

3. Look up the approximate grade level on the SMOG conversion table:

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