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Four focus groups with Pashto, Dari, Burmese, and Spanish speakers assessed alignment with health literacy guidelines and long-term change goals. Findings include improved participant confidence in engaging health care providers with questions after viewing the videos. Results inform expanding language access across health care systems and integrating health literacy into adult education language learning classrooms.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/empowering-refugees-and-immigrants-through-transformational-home-language-health-education/588313/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/empowering-refugees-and-immigrants-through-transformational-home-language-health-education/588313.png","ImageObject",300,407,{"name":92,"@type":93},"Putri","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-16","2026-10-15",true,{"@type":102,"interactionType":103,"userInteractionCount":8},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the study’s main focus regarding the videos?","Question",{"text":112,"@type":113},"The study focuses on whether language-specific diabetes education videos are understandable, actionable, and culturally and linguistically sustaining for refugees and immigrants, supporting transformational change.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was participant feedback gathered?",{"text":117,"@type":113},"The researchers conducted four separate focus groups with speakers of Pashto, Dari, Burmese, and Spanish to examine patients’ experiences with the videos.",{"name":119,"@type":110,"acceptedAnswer":120},"What outcomes did participants report after viewing the videos?",{"text":121,"@type":113},"Participants reported feeling more confident approaching their health care provider with questions, a behavioral shift linked to improved health outcomes.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},588313,1792122260,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":8,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},962085571259,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","ADULT LITERACY EDUCATION SPRING 2025  \n| [http://doi.org/10.35847/LMcHolme.IFeinberg.7.2.18](http://doi.org/10.35847/LMcHolme.IFeinberg.7.2.18) |  |\n| --- | --- |\n|  | Research Article |\n\nEmpowering Refugees and Immigrants Through Transformational Home Language Health Education  \nLindsay McHolme and Iris Feinberg, Georgia State University  \nAbstract  \nThis study focuses on the importance of providing health education materials that are understandable, actionable, and linguistically and culturally sustaining, and therefore transformational for refugees and immigrants. We explored refugee and immigrant patient experiences with language specific diabetes education videos by conducting four separate focus groups with speakers of Pashto, Dari, Burmese, and Spanish to understand if and how the videos align with the health literacy guidelines of understandability and actionability, and the tenets of culturally sustaining pedagogy with a focus on long-term change. In addition to cultural and linguistic findings, we note that participants felt more confident in approaching their health care provider with questions after viewing the videos, a transformational behavior to achieve greater health outcomes for themselves. This study has implications for expanding language access within and across health care systems and for the way health literacy can be integrated into adult education language learning classrooms.  \nNote: We are grateful to Suad Ali and Mary Helen O’Connor for support with outreach, access to facilities, recruitment, organization, and coordination; to Coco Lukas for her contribution to data analysis and triangulation; and to Marhaba Alkozai, Esther Hau Dim, and Gabriela Durán for providing interpretation and recruitment services.  \nKeywords: health literacy, diabetes education, understandability, actionability, culturally sustaining pedagogy  \nThis study is a formative evaluation of multilingual health literacy videos that were designed to educate about diabetes. The evaluation seeks to understand the functioning of the videos for the end users (James Bell Associates, 2018) who are multilingual refugee and immigrant patients living in Clarkston, Georgia. For this study, program functioning refers to whether “theresources needed to implement [the videos], including personnel, materials, space, time, and organizational supports” are in place (James Bell Associates, 2018, n.p.) . Developed using a community-based participatory  \nframework (CBPF) (Feinberg, O’Connor et al., 2023), these videos were designed in collaboration with multilingual physicians and community members in Clarkston, Georgia.  \nConceptual Framework  \nIt is well documented that an individual’s literacy and  \nnumeracy skills correlate with their self-rated health outcomes (MacDonald et al., 2022; Prins & Monnat, 2019; Ronson & Rootman, 2012) . For example, a report based on the recent Programme for the International Assessment of Adult Competencies (PIAAC) results reveals that “individuals with high numeracy skills are 11 percentage points more likely to report very good or excellent health compared to those with low numeracy skills”(Organization for Economic Cooperation and Development, 2024, n.p.) . In fact, Prins and Monnat (2019) conclude based on previous PIAAC findings, that educational attainment is a social determinant of health:  \nfor U.S.-born adults and immigrants, literacy and numeracy are related to health both directly and through socioeconomic resources, particularly educational attainment, employment, parental education and, in the case of immigrants, speaking English well. As such, there may be potential health benefits to helping adult learners  \nCorrespondence: [lmcholme@gsu.edu](lmcholme@gsu.edu) 18  \nand immigrants who are most disadvantaged to develop their literacy and numeracy capabilities (p. 330) .  \nIn short, adult literacy and education are key components in building prosperous, healthy lives for individuals who are disadvantaged ","cbCaijHcojsk4svn","https://ap.wps.com/l/cbCaijHcojsk4svn","pdf",184055,14,"English","# Abstract\n# Conceptual Framework\n## Literacy and health outcomes\n## General literacy vs. health literacy\n## Designing multilingual health education materials","[{\"question\":\"What is the study’s main focus regarding the videos?\",\"answer\":\"The study focuses on whether language-specific diabetes education videos are understandable, actionable, and culturally and linguistically sustaining for refugees and immigrants, supporting transformational change.\"},{\"question\":\"How was participant feedback gathered?\",\"answer\":\"The researchers conducted four separate focus groups with speakers of Pashto, Dari, Burmese, and Spanish to examine patients’ experiences with the videos.\"},{\"question\":\"What outcomes did participants report after viewing the videos?\",\"answer\":\"Participants reported feeling more confident approaching their health care provider with questions, a behavioral shift linked to improved health outcomes.\"}]","Empowering Refugees and Immigrants Through Transformational Home Language Health Education | PDF",1792064993,35]