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The purpose of this study was to (a) examine the underlying assessment structure of the Derivational Morphology Task (DMORPH) and (b) investigate the relation of the DMORPH to vocabulary and reading comprehension outcomes with a sample of struggling adult readers. Specifically, participants included 218 struggling adult readers enrolled in adult literacy classes. We used item-level analyses to evaluate the underlying structure of the DMORPH. Items with phonological (e.g., “music” to “musician”) and non-phonological transformations (“teach” to “teacher”) were examined in relation to adult literacy students’ vocabulary and reading comprehension skills. A bifactor model was the best fit to the data, suggesting that the DMORPH measured a single factor of derivational morphological awareness with some variation due to phonological and non-phonological change items. Follow-up analyses revealed that the DMORPH can essentially be considered unidimensional, which justified the use of a single scoring system for the DMORPH with adult literacy students. However, after controlling for word reading and phonological awareness, the phonological change items uniquely predicted vocabulary knowledge and reading comprehension, whereas the non-phonological change items were not significant. The results support the structural validity of the DMORPH and the need to use both phonological and non-phonological change items with adult literacy students. The present findings also provide insight into potential intervention targets for instructors in adult literacy programs who are interested in improving students’ vocabulary and reading comprehension skills.

The purpose of the present study was to investigate and rank order by importance the contributions of various cognitive predictors to reading comprehension in third, seventh, and tenth graders. An exploratory factor analysis revealed that for third grade, the best fit was a four-factor solution including fluency, verbal reasoning, nonverbal reasoning, and working memory factors. For seventh and tenth grade, three-factor solutions with fluency, reasoning, and working memory factors were the best fit. The three and four-factor models were used in separate dominance analyses for each grade to rank order the factors by predictive importance to reading comprehension. Results indicated that fluency and verbal reasoning were the most important predictors of third grade reading comprehension. For seventh grade, fluency and reasoning were the most important predictors. By tenth grade, reasoning was the most important predictor of reading comprehension. Working memory was the least predictive of reading comprehension across all grade levels. These results suggest that inferential reasoning skills become an important contributor to reading comprehension at increasing grade levels.

The purpose of this study was to examine the construct of morphological awareness and its relations to vocabulary knowledge in Adult Basic Education (ABE) students. Morphological awareness has emerged as an important predictor of children's and ABE students' reading comprehension abilities; however, there has been a dearth of research investigating the construct and potential multidimensionality of morphological awareness. First, we examined three sets of distinctions among morphological awareness measures: inflected versus derived, real words versus pseudowords, and contextual cues versus no contextual cues. A series of confirmatory factor analyses (CFAs) revealed that the construct of morphological awareness could be multidimensional, as evidenced by a breakdown of tasks including only real words versus tasks with only pseudowords. Second, we investigated whether morphological awareness and vocabulary knowledge were best represented as distinct constructs or the same underlying ability. CFAs indicated that real-word and pseudoword morphological awareness were separate factors from vocabulary knowledge. These results have important implications for morphological and vocabulary instruction in ABE programs. Moreover, the results have practical implications for researchers assessing morphological awareness because the findings indicate that different morphological awareness measures may be tapping disparate facets of the construct.

The transmission of health information from in-person communication to web-based sources has changed over time. Patients can find, understand, and use their health information without meeting a health care provider and are able to participate more in their health care management. In recent years, the internet has emerged as the primary source of health information, although clinical providers remain the most credible source. The ease of access, anonymity, and busy schedules may be motivating factors to seek health information on the web. Social media has surfaced as a popular source of health information, as it can provide news in real time. The increase in the breadth and depth of health information available on the web has also led to a plethora of misinformation, and individuals are often unable to discern facts from fiction. Competencies in health literacy (HL) can help individuals better understand health information and enhance patient decision-making, as adequate HL is a precursor to positive health information-seeking behaviors (HISBs). Several factors such as age, sex, and socioeconomic status are known to moderate the association between HL and HISBs. In this study, we aimed to examine the relationship between HL and HISBs in individuals living in a southern state in the United States by considering different demographic factors. Participants aged ≥18 years were recruited using Qualtrics Research Services and stratified to match the statewide demographic characteristics of race and age. Demographics and source and frequency of health information were collected. The Health Literacy Questionnaire was used to collect self-reported HL experiences. SPSS (version 27; IBM Corp) was used for the analysis. A total of 520 participants met the criteria and completed the survey (mean age 36.3, SD 12.79 years). The internet was cited as the most used source of health information (mean 2.41, SD 0.93). Females are more likely to seek health information from physicians than males (r=0.121; P=.006). Older individuals are less likely to seek health information from the internet (r=-0.108; P=.02), social media (r=-0.225; P<.001), and friends (r=-0.090; P=.045) than younger individuals. Cluster analysis demonstrated that individuals with higher levels of HISBs were more likely to seek information from multiple sources than those with lower levels of HISBs (mean range 3.05-4.09, SD range 0.57-0.66; P<.001). Age and sex are significantly associated with HISB. Older adults may benefit from web-based resources to monitor their health conditions. Higher levels of HL are significantly associated with greater HISB. Targeted strategies to improve HISB among individuals with lower levels of HL may improve their access, understanding, and use of health information.

Research with school-age readers suggests that the contributions of reading and language skills vary across reading comprehension assessments and proficiency levels. With a sample of 168 struggling adult readers, we estimated the explanatory effects of decoding, oral vocabulary, listening comprehension, fluency, background knowledge, and inferencing across three reading comprehension tests and across low, average, and high levels of performance. OLS regression models accounted for 66% of the variance in WJ Passage Comprehension scores with all competencies except listening comprehension as significant predictors; 43% of the variance in RAPID Reading Comprehension scores with decoding and listening comprehension as significant predictors; and 31% of the variance in RISE Reading Comprehension scores with decoding as a significant predictor. Quantile regression models and between-quantile slope comparisons showed that the effects of some predictors on reading comprehension varied across performance levels on one or more tests. Implications for instruction, assessment, and future research are discussed.

We report results from two studies on the underlying dimensions of morphological awareness and vocabulary knowledge in elementary-aged children. In Study 1, 99 fourth-grade students were given multiple measures of morphological awareness and vocabulary. A single factor accounted for individual differences in all morphology and vocabulary assessments. Study 2 extended these results by giving 90 eighth-grade students expanded measures of vocabulary and morphology that assessed (a) definitional knowledge, (b) usage, (c) relational knowledge, and (d) knowledge of morphological variants, with each potential aspect of knowledge assessed using an identical set of 23 words to control for differential knowledge of specific vocabulary items. Results indicated that a single-factor model that encompassed morphological and vocabulary knowledge provided the best fit to the data. Finally, explanatory item response modeling was used to investigate sources of variance in the vocabulary and morphological awareness tasks we administered. Implications for assessment and instruction are discussed.

Morphological awareness, which is an understanding of how words can be broken down into smaller units of meaning such as roots, prefixes, and suffixes, has emerged as an important contributor to word reading and comprehension skills. The first aim of the current study was to investigate the contribution of morphological awareness independent of phonological awareness and decoding to the reading comprehension abilities of adults with low literacy. Results indicated that morphological awareness was a significant unique predictor of reading comprehension. A second aim of the study was to investigate the processing of morphologically complex words of adults with low literacy in both an oral reading passage and a single-word naming task. Adults’ accuracy and response times were measured on different types of morphologically complex words and compared with control words matched on frequency in both the passage and the naming tasks. Results revealed that adults were vulnerable to morphological complexity: they performed more accurately and faster on matched control words versus morphologically complex word types. The educational implications for Adult Basic Education programs are discussed.

Background: Research suggests that younger adult African American people (age 18–35 years) have more than double the risk of having a stroke than White people. Stroke risk education is lacking for this cohort; there is a dearth of materials that are targeted and focused for young adult African Americans. There is also little research on developing and testing age and culturally appropriate health literate materials that may help this population better understand personal risk factors for stroke. Objective: The aim of this study was to understand factors to guide creating and disseminating plain language health messages about stroke risk awareness among young adult African Americans. Methods: African American participants age 18 years and older completed an online survey (N = 413). Descriptive statistics, one-way analysis of variance, and two-step cluster analyses were used to evaluate stroke risk awareness, perceived risk of stroke, message creation factors, and online health information seeking behavior. Open-ended survey items described modifiable and non-modifiable reasons for perceived risk of stroke. Key Results: Participants reported differences on overall stroke risk factor awareness by perceived risk of stroke was significant (F[2, 409] = 4.91, p = .008) with the very low/low group (M = 1.66, p < .01), showing significantly lower overall stroke risk factor awareness compared to the moderate and high/very high groups. Both respondents who thought their stroke risk was very low/low and moderate/high/very high commented about family history (54.1% and 45.9%, respectively) as the reason and 88.2% of very low/low commented that they did not have risk factors for stroke because they were young. Cluster analysis indicated the Mostly Clear Preferences cluster was more likely to select mostly/very on positive, informational, and long-term messages and medical authority sources. The largest of three clusters reported medical sources as the highest rated source for both finding and trusting health information (47.2%, n = 195). Conclusion: Young adult African Americans have a scarce understanding of modifiable stroke risk factors; health education materials should focus on positive information messaging that shows a long-term result and is presented by a medical authority. We did not observe any age or sex differences among the data, which suggests different message modalities may not be needed. [HLRP: Health Literacy Research and Practice. 2024;8(1):e38–e46.] Plain Language Summary: In this study, we collected data to create a targeted stroke risk awareness health education video for young African American adults (age 18 years and older). The video was based on analysis of data from 413 participants focusing on perception of stroke risk, stroke risk knowledge, as well as preference for message type, source credibility, and modality.

This study investigates the shared, independent, and interactive effects of metalinguistic skills (phonological awareness, morphological awareness, and orthographic knowledge) to word reading with a sample of struggling adult readers. Controlling for vocabulary knowledge, a second-order latent factor of metalinguistic awareness accounted for unique variance (62.5%) in adults’ word reading skills. Two-way latent interactions between the metalinguistic skills (phonological awareness × morphological awareness, morphological awareness × orthographic knowledge, and phonological awareness × orthographic knowledge) revealed unique interactive contributions (1%–5.2%) of these skills to word reading controlling for the metalinguistic skill main effects and vocabulary knowledge. In particular, high levels of morphological awareness are critical to word reading irrespective of high or low phonological awareness and orthographic knowledge. In addition, higher phonological awareness skills are critical to word reading irrespective of high or low orthographic knowledge. These results indicate the importance as well as the complexity of the nature of metalinguistic skills underlying word reading for struggling adult readers. The theoretical, empirical, and applied implications of these findings are discussed in the context of researchers and practitioners invested in improving outcomes in adult literacy programs.

Background: How individuals perceive their health literacy may differ based on demographic and individual characteristics. Objective: The purpose of this study was to understand the dispersion of health literacy across demographics in the state of Georgia in 2021 and to determine which factors influence health literacy. Methods: Study participants were age 18 years and older and completed an on-line Health Literacy Questionnaire (N = 520). The participant pool was stratified to mirror state-wide demographics of geography and race. Results were further collapsed into composite scales reflecting basic, communicative, and critical health literacy. Descriptive statistics, bivariate Pearson's correlations, and multiple regression analyses were used. A two-step cluster analysis was performed with the nine health literacy scales. Key Results: Rural county and no health insurance were negatively related to all three composite scales (rs = .093-.254, ps < .05). Demographic predictors accounted for 6.7% of the variance in basic (F[6, 439] = 5.287, p < .001), 10% in communicative (F[6, 438] = 8.154, p < .001), and 6% for critical (F[6, 439] = 4.675, p < .0010. In all scales, health insurance status was the strongest primary unique predictor (βs = .236, .295, .181, ps <.05, respectively). In a two-step cluster analysis only health insurance status differentiated the health literacy level clusters (X2(3) = 9.43, 34.51, ps = 024, <.001 respectively). Conclusion: Lacking health insurance is the most consistent and largest contributor to low health literacy across the state of Georgia; population demographics are not. Health literacy policies and practices should be developed for universal application and not focus on specific populations. [HLRP: Health Literacy Research and Practice. 2022;6(3):e182–e190.] Plain Language Summary: In this study, demographics that are usually associated with low health literacy like age, sex, race, educational attainment, and type of county (rural or urban) were not associated with; the only significant factor was lack of health insurance. This relationship strengthens the case for universal health literacy precautions that go beyond population demographics.