for adult education teachers, tutors, counselors, job developers, program managers, executive directors, students, researchers, funders, and policy makers. The LAC is the adult education resource for the State of New York and offers student information systems and technical support, a professional development center, a family literacy resource center, and published and online resources.

At the time the health literacy initiatives were being developed in New York, Rudd was a scholar and coinvestigator at the National Center for the Study of Adult Learning and Literacy (NCSALL). The individual scholars and universities comprised by NCSALL were focused on research related to adult learning and literacy. Rudd was the only investigator at NCSALL who conducted research focused on the intersection of health and literacy. Although the level of funding through the U.S. Department of Education was modest, it supported work for 12 years, from 1996 to 2008. The goal for NCSALL was to build and develop research within the adult education field and then translate research into practice.

Throughout her work with NCSALL, Rudd attempted to understand the expectations that health systems had for participating adults and the literacy skills of U.S. adults. She then examined the match (or mismatch) between the expectations and skills. Rudd collaborated with adult education researchers and practitioners, state directors of adult education, teachers and learners, and with representatives of the public health and medical care systems, such as researchers and practitioners in chronic disease specialties, dentistry, mental health, and environmental health. She engaged in a series of studies of health-related activities of adult education programs within states, in programs for adult educators, and in materials and programs for learners to identify the need for collaborative work. Furthermore, Rudd assembled a team of experts across the education and health fields to undergo a “deconstruction” process. This involved an analysis of health-related activities to break down activities (e.g., improving nutrition) into component tasks (e.g., reading food labels, figuring out portion size) and to understand the literacy-related skills people needed to accomplish the tasks as well as to use the tools and materials given to them.

Just before the publication of the 2004 IOM report on health literacy, the New York mayor ’s office was becoming interested in health literacy and decided to launch a health literacy initiative. The LAC and a number of stakeholders met. At the time, a team with representatives from medicine, nursing, nutrition, adult education, and public health were working to develop a program of study that would enhance the ability of adult educators to develop and teach health literacy skills. With support from NCSALL, the team was developing a series of training manuals for professionals in the adult education sector to help teachers integrate



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