title: Health communication in multilingual contexts: a study of reading preferences, practices, and proficiencies among literate adults in Zambia.
abstract: Comprehension of health materials and messages is a necessary, though not sufficient, condition for the development of health literacy; in the case of print materials, reading comprehension is elemental. Assessments of the population's ability to read and comprehend written materials are complex and highly salient in multilingual countries, such as Zambia, particularly when an excolonial language is but one of multiple official languages. Yet no study has contrasted adult Zambians' reading comprehension of health materials in the major Zambian languages with comparable English-language materials. This article reports the results of a survey of 2,009 literate Zambian adults who were tested for reading comprehension of health materials written at fourth- and eighth-grade levels. The analysis found that respondents who had not gone beyond primary school scored significantly higher on Zambian- than on English-language reading comprehension tests. Respondents with at least an eighth-grade education scored equally well or better on English-language compared with Zambian-language tests. Overall, respondents were more likely to pass the grade-four than the grade-eight reading comprehension tests. In the multilingual context of Zambia it is vital to produce health communication print materials written at or near a grade-four readability level in English and, when warranted, in appropriate Zambian languages.
authors.affiliation: Center for Communication Programs, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21202, USA. cunderwood@jhuccp.org
authors.forename: Carol
authors.initials: C
authors.lastname: Underwood
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Serlemitsos
authors.forename: Mubiana
authors.initials: M
authors.lastname: Macwangi
mesh_terms: D000293:Adolescent; D000328:Adult; D004522:Educational Status; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D033181:Information Dissemination; D007407:Interviews as Topic; D007807:Language Tests; D008297:Male; D019303:Multilingualism; D010353:Patient Education as Topic / Q000379:methods*; D015024:Zambia