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Ann Fam Med. 2005 Nov-Dec;3(6):514-22.

Quick assessment of literacy in primary care: the newest vital sign.

Author information

  • 1University of Arizona College of Medicine, Department of Family and Community Medicine, Tucson 85719, USA. bdweiss@u.arizona.edu

Erratum in

  • Ann Fam Med. 2006 Jan-Feb;4(1):83.

Abstract

PURPOSE:

Current health literacy screening instruments for health care settings are either too long for routine use or available only in English. Our objective was to develop a quick and accurate screening test for limited literacy available in English and Spanish.

METHODS:

We administered candidate items for the new instrument and also the Test of Functional Health Literacy in Adults (TOFHLA) to English-speaking and Spanish-speaking primary care patients. We measured internal consistency with Cronbach's alpha and assessed criterion validity by measuring correlations with TOFHLA scores. Using TOFLHA scores <75 to define limited literacy, we plotted receiver-operating characteristics (ROC) curves and calculated likelihood ratios for cutoff scores on the new instrument.

RESULTS:

The final instrument, the Newest Vital Sign (NVS), is a nutrition label that is accompanied by 6 questions and requires 3 minutes for administration. It is reliable (Cronbach alpha >0.76 in English and 0.69 in Spanish) and correlates with the TOFHLA. Area under the ROC curve is 0.88 for English and 0.72 for Spanish versions. Patients with more than 4 correct responses are unlikely to have low literacy, whereas fewer than 4 correct answers indicate the possibility of limited literacy.

CONCLUSION:

NVS is suitable for use as a quick screening test for limited literacy in primary health care settings.

PMID:
16338915
[PubMed - indexed for MEDLINE]
PMCID:
PMC1466931
Free PMC Article
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