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Short Assessment of Health Literacy-Spanish & English (SAHL-S&E) (2)

SAHL-S Short Assessment of Health Literacy-Spanish & English (SAHL-S&E) (2) Shoou-Yih Lee

Lee, S.Y., Stucky, B.D., Lee, J.Y., Rozier, R.G., & Bender, D.E. (2010, August). Short assessment of health literacy-Spanish and English: a comparable test of health literacy for Spanish and English speakers. Health Serv Res, 45(4):1105-20.

 2010

General medical word recognition and matching test, shortened (18 items)

 2 18

2 categories: <15 is inadequate

 0 minutes 403 2 minutes

Word recognition test: Spanish version of the test to SAHLSA and Spanish TOFHLA

Convergent (SAHL-S): SAHLSA r=0.88 and TOFHLA-S r=0.62

English TOFHLA r=0.68 in the English-speaking sample.

 0.80 Spanish; 0.89 English sylee@umich.edu Department of Health Management and Policy, The University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, United States of America http://www.ncbi.nlm.nih.gov/pubmed/20500222 http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tool… Prose: Pronunciation, Numeracy, Information seeking: Interactive media navigation United States of America Yes Paper and pencil, Face-to-face General Adults: 18 to 64 years Spanish Objective 0.900

The Role of Numeracy in Understanding the Benefit of Screening Mammography

Schwartz (1997) The Role of Numeracy in Understanding the Benefit of Screening Mammography Lisa Schwartz

Schwartz, L.M., Woloshin, S., Black, W.C., & Welch, G. (1997). The role of numeracy in understanding the benefit of screening mammography. Annals of Internal Medicine, 127(11):966-972.

 1997

Goal of the article was to assess the relation between numeracy and the ability to make use of typical risk reduction expressions about the benefit of screening mammography.

 1 3

0-3

 0 minutes 500 Lisa.schwartz@dartmouth.edu The Dartmouth Intsitute for Health Policy and Clinical Practice, WTRB, 1 Medical Center Drive, Lebanon, NH, United States of America http://www.ncbi.nlm.nih.gov/pubmed/9412301 /sites/default/files/webform/suggest-measure/26/numeracy20questions.pdf Numeracy United States of America Paper and pencil, Mailed survey General Adults: 18 to 64 years English Objective

Comprehension of 50 Medical Terms

comprehens Comprehension of 50 Medical Terms Julian Samora

Samora, J., Saunders, L., & Larson, R.F. (1961). Medical vocabulary knowledge among hospital patients. Journal of Health and Human Behavior, 2(2):83-92.

 1961

A list of 50 words, each of which was placed in a simple sentence. Understanding of each word was assessed in context (50 items).

 4 50

Interview responses categorized into 1 of 4 categories from no understanding to complete understanding

 125

Content validity, supported based on feedback from patients, doctors, medical residents, and medical students

Interrater reliability of 96%

 Katherine.waite@bmc.org http://www.jstor.org/stable/2948804?seq=1#page_scan_tab_contents Prose: Comprehension United States of America Face-to-face Health Promotion Adults: 18 to 64 years English Objective

Rapid Estimate of Adult Literacy in Medicine

REALM Rapid Estimate of Adult Literacy in Medicine Terry Davis

Davis, T.C., Crouch, M.A., Long, S.W., Jackson, R.H., Bates, P., George, R.B., & Bairnsfather, L.E. (1991). Rapid assessment of literacy levels of adult primary care patients. Fam Med, 23(6):433-5

 1991

Quick screening tool to assist physicians in identifying patients with limited reading skills and in estimating patient reading levels

 1 125

Sum score (0–66) converted to 4 grade categories: 3rd grade or less, 4th through 6th grade, 7th or 8th grade, 9th grade or more

 207 2 minutes

Words selected from education. Face validity — based on physician, staff, and patient receptivity to the test and its applicability to medical settings.

 Test–retest reliability of 0.98 and 0.99

Interrater reliability of 0.99 (p < .0001)

 Terry.davis@lsuhs.edu 1501 Kings Highway, Shreveport, LA, United States of America http://www.ncbi.nlm.nih.gov/pubmed/1936717 /sites/default/files/webform/suggest-measure/36/realm20word20list20normal20print.pdf Prose: Pronunciation United States of America Face-to-face General Adults: 18 to 64 years English Objective

Rapid Estimate of Adult Literacy in Medicine Short Form

REALM-SF Rapid Estimate of Adult Literacy in Medicine Short Form Ahsan Arozullah

Arozullah, A.M., Yarnold, P.R., Bennett, C.L., Soltysik, R.C., Wolf, M.S., Ferreira, R.M., Lee, S.Y., Costello, S., Shakir, A., Denwood, C., Bryant, F.B., & Davis, T. (2007). Development and validation of a short-form, rapid estimate of adult literacy in medicine. Med Care, 45(11):1026-33.

 2007

Health word recognition and pronunciation

 3 7

Possible range: 0-7 with 0: ≤ 3rd grade, 1-3: 4th-6th grade, 4-6: 7th-8th grade, and 7: ≥ 9th grade

 1500 1 minutes

Convergent: REALM r=0.96 and WRAT-R€ r=0.83. CFA£: R2=0.92.1% and X2=14.54 (p=0.41)

 arozulla@uic.edu Jesse Brown Veterans Affairs Medical Center, 820 S. Damen Avenue, Chicago, IL, United States of America http://www.ncbi.nlm.nih.gov/pubmed/18049342 Prose: Pronunciation United States of America Face-to-face Health Promotion Adults: 18 to 64 years English Objective

Rapid Estimate of Adult Literacy in Medicine (Short)

REALM-R Rapid Estimate of Adult Literacy in Medicine (Short) PF 3rd Bass

Bass, P.F., 3rd, Wilson, & J.F., Griffith, C.H. (2003). A shortened instrument for literacy screening. J Gen Intern Med, 18(12):1036-8.

 2003

General list of medical words in descending levels of difficulty, shortened (8 items)

 3 8

Possible range: 0-8, ↑scores = ↑HL

 157 2 minutes

Convergent: WRAT-R€ r=0.64

 pbassi@lsuhsc.edu Department of Internal Medicine, Louisiana State University Health Science Center, Shreveport, LA, United States of America http://www.ncbi.nlm.nih.gov/pubmed/14687263 Prose: Comprehension United States of America Face-to-face General Adults: 18 to 64 years English Objective

Abbreviated version of the Test of Functional Health Literacy in Adults

S-TOFHLA Abbreviated version of the Test of Functional Health Literacy in Adults David Baker

Baker, D.W., Williams, M.V., Parker, R.M., Gazmararian, J.A., Nurss, J. (1999). Development of a brief test to measure functional health literacy. Patient Educ Couns, 38(1):33-42.

 1999

Shortened version of the TOFHLA, with 36 comprehension questions and 4 numeric calculations, shortened

 2 40 1

Possible range: 0-100 (2 points for each numeracy score, 7 points for each comprehension score) with 0-53: inadequate HL, 54-66: marginal HL, and 67-100: adequate HL

 12 minutes 211

Measure of patients' ability to read the materials they are likely to encounter in the health care setting. This is a shortened version of the TOFHLA by reducing the TOFHLA from 17 numeracy items and 3 prose passages to 4 numeracy items and 2 prose passages.

Correlation between S-TOFHLA and REALM is 0.80.

Internal consistency: α = 0.68 for numeracy items, α = 0.97 for cloze passages

 dwb@po.cwru.edu Department of Medicine, Department of Epidemiology and Biostatistics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States of America http://www.ncbi.nlm.nih.gov/pubmed/14528569 http://www.peppercornbooks.com/catalog/product_info.php?products_id=2514&osCsid… Prose: Comprehension United States of America Paper and pencil General Adults: 18 to 64 years English Objective

Short Test of Functional Health Literacy in Adults - German Version

Ger-STOFH LA Short Test of Functional Health Literacy in Adults - German Version Melanie Connor

Connor, M., Mantwill, S., & Schulz, P.J. (2013). Functional health literacy in Switzerland--validation of a German, Italian, and French health literacy test. Patient Educ Couns,90(1):12-7.

 2013

German, Italian, and French version of the Shortened version of the TOFHLA, with 36 comprehension questions and 4 numeric calculations

 1 40 1

Possible range: 0-100 (2 points for each numeracy score, 7 points for each comprehension score) with 0-53: inadequate HL, 54-66: marginal HL, and 67-100: adequate HL

 249 12 minutes

The original English S-TOFHLA was translated by native speakers of German, Italian, and French into the respective languages following the standard methodologies for questionnaire translation.

Concurrent: Age (p<.001), Education (p<.001)

 melanie.connor@usi.ch Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano, Lugano, Switzerland http://www.ncbi.nlm.nih.gov/pubmed/23089240 /sites/default/files/webform/suggest-measure/56/german20stofhla20-20last.pdf Prose: Comprehension, Numeracy Switzerland Paper and pencil, Face-to-face Health Promotion Adults: 18 to 64 years German Objective

Short Test of Functional Health Literacy in Adults - Italian Version

Ity-STOFHLA Short Test of Functional Health Literacy in Adults - Italian Version Melanie Connor

Connor, M., Mantwill, S., & Schulz, P.J. (2013). Functional health literacy in Switzerland--validation of a German, Italian, and French health literacy test. Patient Educ Couns, 90(1):12-7.

 2013

German, Italian, and French version of the Shortened version of the TOFHLA, with 36 comprehension questions and 4 numeric calculations

 1 40

Possible range: 0-100 (2 points for each numeracy score, 7 points each comprehension score) with 0-53: inadequate HL, 54-66: marginal HL, and 67-100: adequate HL

 273 12 minutes

The original English S-TOFHLA was translated by native speakers of German, Italian, and French into the respective languages following the standard methodologies for questionnaire translation.

Concurrent: Age (p<.001), Education (p<.001)

 melanie.connor@usi.ch Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano, Lugano, Switzerland http://www.ncbi.nlm.nih.gov/pubmed/23089240 /sites/default/files/webform/suggest-measure/61/italian20stofhla20-20last.pdf Prose: Comprehension, Numeracy Switzerland Paper and pencil, Face-to-face Health Promotion Adults: 18 to 64 years Italian Objective

Short Test of Functional Health Literacy in Adults - French Version

Fren-STOFHLA Short Test of Functional Health Literacy in Adults - French Version Melanie Connor

Connor, M., Mantwill, S., & Schulz, P.J. (2013). Functional health literacy in Switzerland--validation of a German, Italian, and French health literacy test. Patient Educ Couns, 90(1):12-7.

 2013

German, Italian, and French version of the Shortened version of the TOFHLA, with 36 comprehension questions and 4 numeric calculations

 1 40 1

Possible range: 0-100 (2 points for each numeracy score, 7 points for each comprehension score) with 0-53: inadequate HL, 54-66: marginal HL, and 67-100: adequate HL

 137 12 minutes

The original English S-TOFHLA was translated by native speakers of German, Italian, and French into the respective languages following the standard methodologies for questionnaire translation.

Concurrent: Age (p<.042) Education (p<.335)

 melanie.connor@usi.ch Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano, Lugano, Switzerland http://www.ncbi.nlm.nih.gov/pubmed/23089240 /sites/default/files/webform/suggest-measure/66/french20stofhla20-20last.pdf Prose: Comprehension, Numeracy Switzerland Paper and pencil, Face-to-face Health Promotion Adults: 18 to 64 years French Objective

Medical Achievement Reading Test

MART Medical Achievement Reading Test E.Christine Hanson-Divers

Hanson-Divers, E.C. Developing a medical achievement reading test to evaluate patient literacy skills: a preliminary study. J Health Care Poor Underserved, 8(1):56-69.

 1997

General medical word recognition test modeled after the WRAT, with small font size and glossy covering to resemble prescription bottles

 4 42

Raw scores tabulated by adding the number of words correctly pronounced with the number of letters correctly pronounced; possible range: 0-42. Converted into grade level equivalences similar to the WRAT.

 405 5 minutes

The MART's content validity was established in the word placement used to formulate the test. Since the WRAT had already been determined to have content validity, the word placement of the MART was based on the WRAT's word placement. To ensure the same content validity, the words on the MART were set up to have the same length and syllables as the corresponding words on the WRAT.

Convergent: WRAT€ r=0.98

 Katherine.waite@bmc.org Division of Pharmaceutical Policy and Evaluative Sciences, School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America http://www.ncbi.nlm.nih.gov/pubmed/9019026 Prose: Comprehension United States of America No Face-to-face Health Promotion Adults: 18 to 64 years, Adolescents: 10 to 17 years English Objective

Numeracy Scale

numeracysc Numeracy Scale Isaac Lipkus

Lipkus, I.M., Samsa, G., Rimer, B.K. General performance on a numeracy scale among highly educated samples. (2001). Med Decis Making, 21(1):37-44.

 2001

Numeracy scale that includes 3 general calculation questions and 7 calculation questions in the context of health risks

 3 10

Possible range: 0-10, ↑scores = ↑HL

 0 minutes 463 8 minutes isaac.lipkus@duke.edu Duke University School of Nursing, 307 Trent Dr., Durham, NC, United States of America http://www.ncbi.nlm.nih.gov/pubmed/11206945 Numeracy United States of America No Paper and pencil Adults: 18 to 64 years, Adolescents: 10 to 17 years English Objective

Health Activities Literacy Scale of NALS

HALS Health Activities Literacy Scale of NALS Rima Rudd

Rudd, R., Kirsch, I., & Yamamoto, K. (2004). Literacy and health in America. Policy Information Report.

 2004

Used to estimate the distribution of literacy on health-related tasks among U.S. adults

 4 191

Sum score (0–5 each item), categorized as inadequate, marginal, or adequate (scale 0-500)

 988

191 items derived from NAALS

Concurrent: ↑HL, r/t ↑education, ↑HL, r/t ↑newspaper read, ↑HL, r/t birth in U.S., ↑HL, r/t full-time employment, and ↑HL, r/t type of occupation

IRT analysis: internal consistency of Index of Expectation = 0.935

 rrudd@hsph.harvard.edu http://eric.ed.gov/?id=ED486416 Prose: Comprehension, Numeracy, Information seeking: Document United States of America Yes Computer-based Health Promotion Adults: 18 to 64 years, Adolescents: 10 to 17 years English Objective

Brief Health Literacy Screener (Chew Items)

Chew Items Brief Health Literacy Screener (Chew Items) Lisa Chew

Chew, L.D., Bradley, K.A., & Boyko, E.J. (2004). Brief questions to identify patients with inadequate health literacy. Family Medicine, 36(8): 588-594.

 2004

Survey items with Likert-type responses to identify inadequate health literacy

 2 3

Sum score (0–5 each item), categorized as inadequate, marginal, or adequate

 332 1 minutes

Content of questions was based on five domains identified in a qualitative study of patients with limited health literacy: navigating the health care system, completing medical forms, following medication instructions, interacting with providers, and reading appointment slips.

 lchew@u.washington.edu 325 Ninth Avenue, Campus Box 359780, Seattle, WA, United States of America http://www.ncbi.nlm.nih.gov/pubmed/15343421 http://www.ncbi.nlm.nih.gov/pubmed/15343421 Information seeking: Document United States of America Yes Face-to-face General Adults: 18 to 64 years English Self-reported

Brief Health Literacy Screening Tool

BRIEF Brief Health Literacy Screening Tool Jolie Haun

Haun, J., Luther, S., Dodd, V., & Donaldson, P. (2012). Measurement variation across health literacy assessments: implications for assessment selection in research and practice. J Health Commu,17 Suppl 3:141-59. doi: 10.1080/10810730.2012.712615.

 2009

3 screening items from Chew et al, with a 4th item added that assesses understanding of what was told to the individual about his/her health

 1 4

Scores range from 2-20, with 2-12 = inadequate HL, 13-16 = marginal HL, and 17-20 = adequate HL

 378 2 minutes

Convergent: STOFHLA r=0.42 and REALM r=0.40; ROC¥ analysis: vs. TOFHLA: AUROC= .68 vs. REALM: AUROC= .68; cut-off score = 12; 79% sensitivity

 Jolie.Haun@va.gov 13000 Bruce B Downs Boulevard, Tampa, FL, United States of America http://www.ncbi.nlm.nih.gov/pubmed/23030567 Information seeking: Document United States of America Yes Face-to-face General Adults: 18 to 64 years English Self-reported

Medical Data Interpretation Test

MDIT Medical Data Interpretation Test Lisa Schwartz

Schwartz, L.M., Woloshin, S., & Welch, H.G. (2005). Can patients interpret health information? An assessment of the medical data interpretation test. Med Decis Making, 25:290–300.

 2005

Measures individual’s ability to make sense of and compare medical statistics about disease risk and risk reduction

 1 18

Possible range: 0-100, ↑scores = ↑HL

 178

Items were based on medical literature. Feedback was collected from a wide variety of experts from different fields (statistics, education, cognitive psychology, etc). Items were revised based on feedback received.

Concurrent: Education p<.05, Numeracy p<.05, Quan Literacy p<.05, and Expertise p<.05

 Lisa.schwartz@dartmouth.edu The Dartmouth Intsitute for Health Policy and Clinical Practice, 35 Centerra Parkway, Lebanon, NH, United States of America http://www.ncbi.nlm.nih.gov/pubmed/15951456 /sites/default/files/webform/suggest-measure/96/medical_data_test202.pdf United States of America No Mailed survey Health Promotion Adults: 18 to 64 years English Objective

Newest Vital Sign - English

NVS Newest Vital Sign - English Barry Weiss

Weiss, B.D., Mays, M.Z., Martz, W., Castro, K.M., DeWalt, D.A., Pignone, M.P., Mockbee, J., & Hale, F.A. (2005). Quick assessment of literacy in primary care: the newest vital sign. Ann Fam Med, 3(6):514-22
.

 2005

General health literacy test using an ice cream nutritional label; Spanish version also available

 1 6

Sum score (0–6) categorized, with (0–1) high likelihood limited literacy, (2–3) possibility of limited literacy, and (4–6) adequate literacy
NOTE: There is no time limit, but most individuals complete the assessment in about 3-4 minutes.

 0 minutes 148 3 minutes

The development of the new instrument involved serially testing candidate scenarios and candidate questions on more than 1,000 patients. The original scenarios were developed by a panel of health literacy experts based on the concepts and types of scenarios used in health literacy research and in general literacy (reading and writing) assessments. The scenarios and questions were refined after feedback from patients, interviewers, and data analysts about the clarity and ease of scoring of items.

Convergent: TOFHLA, r=0.56; ROC¥ analysis: vs. TOFHLA: AUROC=0.88 English ver., AUROC=0.72 Spanish ver.; cut-off score = 4; 100% sensitivity; 64% specificity

 bdweiss@u.arizona.edu University of Arizona College of Medicine, Department of Family and Community Medicine, Tucson, AZ, United States of America https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1466931/pdf/0030514.pdf http://www.pfizer.com/health/literacy/public_policy_researchers/nvs_toolkit /sites/default/files/webform/suggest-measure/101/1-20newest20vital20sign20nutrition20label20english.pdf Prose: Comprehension, Numeracy, Information seeking: Document, Comprehension United States of America Yes Face-to-face Nutrition Older Adults: 65+ years, Adults: 18 to 64 years English Objective

Single Item Screener

SILS Single Item Screener Nancy Morris

Morris, N.S., MacLean, C.D., Chew, L.D., & Littenberg, B. (2006).The Single Item Literacy Screener: evaluation of a brief instrument to identify limited reading ability. BMC Fam Pract, 7:21.

 2006

Single survey item to identify inadequate health literacy. The SILS is free for non-commercial use.

 2 1 1

Response recorded on a 5-point Likert-type scale and categorized as inadequate or adequate

 0 minutes 999 1 minutes

ROC analysis: vs. S-TOFHLA, AUROC=0.73; cut-off score = 2; 54% sensitivity; 83% specificity

 Benjamin.Littenberg@uvm.edu Department of Medicine, University of Vermont, Burlington, VT, United States of America http://bmcfampract.biomedcentral.com/articles/10.1186/1471-2296-7-21 http://bmcfampract.biomedcentral.com/articles/10.1186/1471-2296-7-21 Prose: Comprehension, Application/function United States of America Yes Face-to-face General Adults: 18 to 64 years English Self-reported

Subjective Numeracy Scale

SNS Subjective Numeracy Scale Angela Fagerlin

Fagerlin, A., Zikmund-Fisher, B.J., Ubel, P.A., Jankovic, A., Derry, H.A., & Smith, D.M. (2007). Measuring numeracy without a math test: development of the Subjective Numeracy Scale. Med Decis Making, 27(5):672-80.

 2007

Self-assessment of quantitative ability

 1 8

Sum score

 287 5 minutes

Development of a subjective numeracy measure began with 42 items. Participants (N =364) completed both the 42-item SNS and an objective numeracy scale, providing ability to examine the correlations between the 2 scales. By examining correlations between each subjective item and the objective measure of mathematical ability, the questionnaire was shortened and other types of questions were determined to be included in the next round of testing.

Convergent: Numeracy Scale .r=68

 angleung@hku.hk School of Nursing, The University of Hong Kon, 4th Floor, William Mong Block, Li Ka Shing Faculty of Medicine Building, 21 Sassoon Road, Pokfulam, Hong Kong, China http://www.ncbi.nlm.nih.gov/pubmed/17641137 Numeracy United States of America No Paper and pencil Health Promotion Adults: 18 to 64 years English Self-reported

Demographic Assessment for Health Literacy

DAHL Demographic Assessment for Health Literacy Amresh Hanchate

Hanchate, A.D., Ash, A.S., Gazmararian, J.A., Wolf, M.S., & Paasche-Orlow, M.K. (2008). The Demographic Assessment for Health Literacy (DAHL): a new tool for estimating associations between health literacy and outcomes in national surveys. J Gen Intern Med, 23(10):1561-6.

 2008

This measures derives (imputes) a measure of limited health literacy when primary (in-person) evaluation is infeasible. It is also applicable for secondary datasets that do not contain measures of limited health literacy.

 2

This measure is based on use of secondary data of patient demographics. No primary data collection is needed. Statistical score assigned based on regression of TOFHLA and demographics – inadequate health literacy for the 25% lowest DAHL scores.

 9643

This measure is based on use of secondary data of patient demographics. No primary data collection is needed.

 ahanchat@wakehealth.edu Department of Social Sciences and Health Policy, Medical Center Blvd, Winston-Salem, NC, United States of America https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2533384/pdf/11606_2008_Article_699… http://www.ncbi.nlm.nih.gov/pubmed/?term=PMC2533384 Prose: Comprehension, Numeracy, Information seeking: Document United States of America Yes Face-to-face General Older Adults: 65+ years English Objective