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Home > News > News Articles > 2015 > May > California City Solutions: Azusa Creates Program to Boost Health of English as Second Language Adult
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California City Solutions: Azusa Creates Program to Boost Health of English as Second Language Adults, Builds Community Connection

May 8, 2015
This story is part of an ongoing series featuring Helen Putnam Award entries.
The 2014 entries are available on the League’s website as a resource for cities in a searchable database called California City Solutions. Azusa’s English Lessons for a Healthy Life program was submitted in 2014 for the Health and Wellness Programs award category.Azusa-students-teach-letters.jpg
The city of Azusa has a population of more than 46,300 residents with more than one-quarter reporting that they speak English “less than very well.” According to the 2010 U.S. Census Bureau, 31 percent of Azusa’s residents were born outside of the United States. These demographics inspired the Azusa City Library to form a partnership and develop English Lessons for a Healthy Life (ELHL). The program provides adults where English is a Second Language (ESL) classes to learn vocabulary, grammar and communication, while teaching healthy lifestyle choices.
According to the American Medical Association, poor health literacy is “a stronger predictor of a person’s health than age, income, employment status, education level, and race.” Various studies have found that $73 billion is spent annually for health care as a result of low health literacy skills among more than 90 million adults nationwide. A significant number of these patients are unable to read basic health materials, do not comprehend directions for taking medications and cannot understand appointment or informed consent documentation. Research also found that emergency room patients with inadequate literacy were twice as likely to be hospitalized.Azusa-students-take-blood-pressure.jpg
Adults for whom English is a second language are among those most at risk for health-related problems due to low health literacy. They residents face compromised communication skills, as well as cultural barriers related to health care practices and navigating the U.S. health care system.
In June 2012, the library conducted a health literacy assessment developed by the U.S. Department of Health and Human Services with 14 Azusa Neighborhood Wellness Center (NWC) clients. Results indicated that four of the 14 had a “high likelihood” of limited literacy and five had a “possibility” of limited literacy.
Azusa-students-learning-a-healthy-snack.jpgThat fall the Azusa City Library received funding from the Canyon City Foundation to develop and implement English Lessons for a Healthy Life (ELHL) in partnership with the Azusa NWC and the Azusa Pacific University (APU) Department of Teachers of English to Speakers of Other Languages (TESOL). The program was developed to provide ESL adults English reading and writing exercises related to topics such as nutrition, exercise, and preventing diabetes and other chronic diseases. The model enables each agency to collectively leverage its resources while remaining focused on its unique mission. The library provides leadership, program administration and logistics, student recruitment, reporting, and fiscal management.
Azusa’s NWC supervised APU nursing students who regularly visit classes to monitor and document blood pressure readings and steps walked each week (measured on a pedometer), and answer medical questions. In addition to helping program participants learn how to improve their health and the health of their families, nursing students learn strategies to overcome potential language misunderstandings and communication issues which would affect positive health outcomes for patients.Azusa-students-teach-English.jpg
APU’s TESOL Department provides curriculum development and classroom instruction. Graduate students pursuing a Master’s degree are supervised as they teach the ESL classes. This gives the TESOL students direct practice in applying the teaching skills and theories they have learned.
The program objectives are:
  1. Teach basic English listening, speaking, reading and writing skills to adults;
  2. Encourage student application of learning by making better nutritional choices, exercising more frequently, controlling blood pressure, etc.; and
  3. Motivate students to share information they learn with others. 
The first 8-week session began in October 2012 using curriculum developed by the supervising APU assistant professor. The Level 1 curriculum targets beginning level ESL students and includes an introduction to exercising, learning about diabetes, and includes a strong focus on nutrition. Each family is given The Very Hungry Caterpillar book to read with their families to encourage talk about healthy food choices.
Level 2 was developed in September 2013 to include lessons on reading labels and gaining a deeper understanding of how to assess risk and prevent diabetes. They developed a new course in May 2014 focusing on mental health, in response to discussions in earlier classes about depression, stress, and similar issues.
More than 75 students have participated in ELHL. After one round of classes, reports indicated: 
  • Ninety-one percent of students shared the health information they learned with individuals outside of class;
  • All of the students said they improved their health behavior as a result of the class, with changes in eating habits and increased exercise; and
  • TESOL instructors observed a majority of the students improved their English skills. Azusa-students-and-teachers.jpg
APU TESOL Assistant Professor Tasha Bleistein and three graduate students presented the program during the Los Angeles Region TESOL Conference in March 2013. They shared how focusing on health topics can provide a well-rounded environment for improving participants’ English skills and building confidence. Several students were interviewed prior to the presentation and reported that they can now better understand conversations and have improved their vocabulary, while their confidence in speaking English and knowledge about good health has also increased.
One student in particular, Eva Garcia, demonstrated the program’s potential to impact lives. A 30-year resident of the United States, Eva attended previous English classes in the community, but she had never used any of the English covered in those classes. While participating in this program, her daughter noticed that for the first time she began to practice English around the house with her family. She faithfully wore her pedometer and tried to walk more steps each day, adopting healthy behaviors with exercise and eating, and lost weight. Eva’s story illustrates the hope envisioned by the city for the ELHL program, connecting ESL adults with their community.
APU’s TESOL Department has focuses a class course built around each ongoing program. The professor meets regularly with the student teachers and they review, debrief and practice their teaching strategies together. This has increased the effectiveness of the program, and its sustainability.

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