| The purpose of this study was to examine the relationship between language proficiency and health literacy and use sociometric testing to explore the selection of informal health leaders by Spanish speaking adults in ESL classrooms. There were three specific topics of interest: health literacy, English language acquisition/proficiency, and informal leadership.;Health literacy incorporates the traditional idea of functional literacy (reading, writing, and speaking) with Simond's definition, "[to] understand and act on health care information" (Simonds, 1974, p. 6). The ability to understand and act on health care information is critically important to non-native English speakers and most adult ESL learners understand that a new language gives them access to the culture around them and power within their new surroundings.;Leadership styles influence access to health literacy and this study specifically investigated informal leadership. Informal leadership evolved from non-traditional leadership models and social learning theory also provides a foundation for the emerging informal leader through communities of practice and legitimate peripheral participation.;A mixed method designed was used that involved three different instruments: the CASAS Reading and Listening evaluation, SAHLSA health literacy assessment, and sociometric identification of informal health leaders within each class. The participants in the study included 27 men and women enrolled in three evening ESL classes. The majority of the participants were from various parts of Central and South America and Spanish was their first language. The qualitative portion of the study incorporated sociometric questioning of the students which identified the informal health leader in each class.;The results of the study suggest that the combination of reading and listening proficiency seems to be a stronger predictor of health literacy scores than either of the CASAS scores alone, suggesting that listening skills are an important part of understanding health information. The students in this study chose the informal health leaders for three reasons: the informal leader's personality, his/her perceived knowledge of the topic, and his/her status as an acquaintance or friend. While personality was a major reason for selection as an informal leader, all of the informal health leaders also had the highest SAHLSA scores in their respective classes. |
