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Background Providing health care to migrants and refugees can be difficult due to language discordance, divergent cultural preferences and low levels of health literacy (HL). To improve it, experts suggest promoting newcomers' HL in second language courses (SLC). Yet, little empirical evidence exists on the promotion HL in SLC exist, and the HL debate ignored the plurilingual and pluricultural competencies defined in the Common European Framework of Reference for Languages. In the project SCURA, funded by the German Federal Ministry of Education and Research, we explored the role of HL in SLC and developed interventions to promote it. This study's purpose was to understand how HL is addressed in SLC, what teachers contribute and how first language and culture are used to promote HL. Methods In our multi-method study, we conducted a realist review of SLC (N = 13 interventions), document analyses of SLC teaching materials worldwide (N = 22) and of German textbook-series (N = 8*3), participant observation in two language courses (N = 100 hours), interviews (N = 15) and focus group discussion (N = 14) with German SLC teachers and an online survey (N = 25) among SLC teacher and triangulated our results. Results Four topics emerged: SLC material include various units on health stimulating HL development. Newcomers possess many assets (experiences, language and cultural skills) and show various strategies for using these assets to acquire new HL skills such as translanguaging, digital devices, social support. Teachers play a crucial role in promoting HL in informal conversations, by modelling and in developing interactive, asset-valuing HL-promoting activities. Conclusions HL interventions in SLC can draw from a wealth of assets and can be more promising by strengthening translanguaging and transculturing skills and providing discussion stimulating materials. Key messages Migrants’ health literacy practices are characterized by a unique use of translanguaging and transculturing. Second language teachers can promote migrants’ health literacy especially by facilitating learning opportunities that encourage them to use their assets.

Neglected assets in migrants’ health literacy promotion: Translanguaging and second language teacher