BACKGROUND AND OBJECTIVES: The influence of literacy on health and health care is an important area of investigation. Studies with a literacy focus are most valuable when literacy is assessed with psychometrically sound instruments. METHODS: This study used a prospective cohort sample of 1,610 primary care patients. Patients provided sociodemographics and took the Rapid Estimate of Adult Literacy in Medicine (REALM), a 66-item word pronunciation literacy test. RESULTS: The sample was 65% African American; 66% were men; 51% had a high school education or less. REALM scores were significantly related to education, age, and race but not gender. When stratified by education, differences between African Americans and Caucasians remained significant. Using 19 different strategies to shorten the 66-item instrument, reliability coefficients above.80 were maintained. CONCLUSIONS: The REALM is a robust assessment of health literacy. However, the discordance in scores between African Americans and Caucasians with similar educational attainment needs to be further addressed. A much shorter instrument would still have internally consistent scores and potentially be more useful in clinical settings.
BACKGROUND AND OBJECTIVES: The influence of literacy on health and health care is an important area of investigation. Studies with a literacy focus are most valuable when literacy is assessed with psychometrically sound instruments. METHODS: This study used a prospective cohort sample of 1,610 primary care patients. Patients provided sociodemographics and took the Rapid Estimate of Adult Literacy in Medicine (REALM), a 66-item word pronunciation literacy test. RESULTS: The sample was 65% African American; 66% were men; 51% had a high school education or less. REALM scores were significantly related to education, age, and race but not gender. When stratified by education, differences between African Americans and Caucasians remained significant. Using 19 different strategies to shorten the 66-item instrument, reliability coefficients above.80 were maintained. CONCLUSIONS: The REALM is a robust assessment of health literacy. However, the discordance in scores between African Americans and Caucasians with similar educational attainment needs to be further addressed. A much shorter instrument would still have internally consistent scores and potentially be more useful in clinical settings.
Authors: Lisa A Cooper; L Ebony Boulware; Edgar R Miller; Sherita Hill Golden; Kathryn A Carson; Gary Noronha; Mary Margaret Huizinga; Debra L Roter; Hsin-Chieh Yeh; Lee R Bone; David M Levine; Felicia Hill-Briggs; Jeanne Charleston; Miyong Kim; Nae-Yuh Wang; Hanan Aboumatar; Jennifer P Halbert; Patti L Ephraim; Frederick L Brancati Journal: Am J Public Health Date: 2013-09-12 Impact factor: 9.308
Authors: Misty A W Hawkins; Mary A Dolansky; Jennifer B Levin; Julie T Schaefer; John Gunstad; Joseph D Redle; Richard Josephson; Joel W Hughes Journal: Heart Lung Date: 2016 Sep-Oct Impact factor: 2.210
Authors: M Austin Coker; Carrie E Huisingh; Gerald McGwin; Russell W Read; Mark W Swanson; Laura E Dreer; Dawn K DeCarlo; Lindsay Gregg; Cynthia Owsley Journal: JAMA Ophthalmol Date: 2018-04-01 Impact factor: 7.389