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W V Med J. 2001 Mar-Apr;97(2):111-4.

Functional health literacy in adults in a rural community health center.

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  • 1Department of Family Medicine, West Virginia University School of Medicine, Charleston Division, USA.


At a rural community health center, 183 adult patients were invited to participate in an unspecified study. In a closed-door session, interested invitees were told the study required taking the Test of Functional Health Literacy in Adults (TOFHLA). After the purpose of the study was privately disclosed, 70 patients agreed to enroll (38.25 percent acceptance rate). Approximately 15 percent demonstrated literacy/numeracy deficits, scoring in the Inadequate and Marginal Functional Health Literacy ranges. Student's t-test comparison of mean scores suggested patients with literacy/numeracy deficits tended to have higher mean ages and completed fewer mean years of school than those scoring in the Adequate range, p = 0.0007 and p = 0.0005, respectively. Pearson's Product Moment Correlations demonstrated a negative correlation between age and TOFHLA score, r = -0.52, a positive correlation between highest year of schooling and TOFHLA score, r = 0.51, and a negative correlation between age and highest grade of schooling, r = 0.39. Regression analysis suggested 27 percent of the variability in TOFHLA score was attributable to age, p = 0.0001, supporting the role of age in cognitive decline. Upon review of these patients' medical records, no information on their literacy/numeracy problems or deficits was identified.

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