Project Background

Project Description:
Expecting the Best is a program that teaches adults with limited English language skills about health and well-being through English as a Second Language (ESL) classes. Because low literacy and English language proficiency are frequently cited as barriers that prevent individuals from receiving the health care they need, ESL classes were selected as a natural environment for implementing the Expecting the Best curriculum.  Over 40,000 adults attend community college ESL classes in North Carolina annually, with additional adults receiving English instruction through community-based and literacy organizations.  Expecting the Best is North Carolina’s first statewide program that addresses health literacy and health communication issues, and it started its development with seed funding from the North Carolina March of Dimes in July, 2001.  It grew out of a rapidly growing foreign-born population and concerns from health care providers who expressed frustration with the level of counseling and health education they could give to their patients with limited English proficiency.  English as a Second Language instructors echoed similar concerns about their students who had limited cultural information about seeking health care, limited skills to negotiate the health system, and communication barriers.  Expecting the Best addresses the need for an innovative approach to serve this growing multicultural, multilingual population in North Carolina.  The curriculum creates a strong foundation for positive health outcomes through improved communication skills, functional literacy, and health knowledge.  
Expecting the Best is currently undergoing extensive pilot testing by ESL instructors across North Carolina. Community college classrooms, community-based organizations, and literacy councils are using the materials with their ESL students.  The project has been guided by a multidisciplinary advisory board.   Medical professionals review materials to ensure their technical accuracy, and the curriculum is expected to be released in 2004.  If you would like to be notified of its release, please sign up here!
Health Literacy:
The national set of health objectives, Healthy People 2010, defines health literacy as: “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health-related decisions.”
A low level of health literacy often prevents individuals from receiving the health care and information they need. Individuals with limited English proficiency are especially at risk for having low levels of health literacy. Daily activities such as shopping, working, and caring for a family require English proficiency to carry out health-conscious decisions. Navigating the health care system, arranging and participating in health visits, and understanding treatment orders depend on an individual’s ability to understand the local language and culture. 
 Read our article, “High Expectations for Expecting the Best” 
Connect to “The Challenge of Health Promotion & Health Literacy in North Carolina’s Latino Population” from the North Carolina Institute of Medicine’s Report, NC Latino Health, 2003