BACKGROUND: Although prior studies used the 66-item Rapid Estimate of Adult Literacy in Medicine (REALM instrument) for literacy assessment, researchers may require a shorter, validated instrument when designing interventions for clinical contexts. OBJECTIVE: To develop and validate a very brief literacy assessment tool, the REALM-Short Form (REALM-SF). PATIENTS: The model development, validation, and field testing validation samples included 1336, 164, and 50 patients, respectively. SETTING: General medicine and subspecialty clinics and medicine inpatient wards. DESIGN: For development and validation samples, indicator variables for REALM instrument items were evaluated as potential predictors of REALM instrument score by stepwise multiple regression analysis with subsequent bootstrap and confirmatory factor analysis of selected items. Pearson correlations compared REALM-SF and REALM instrument scores and kappa analyses compared grade level assignments. For the field testing validation sample, Pearson correlations compared Wide Range Achievement Test and REALM-SF scores. RESULTS: The REALM-SF included 7 items with stable model coefficients and 1 underlying linear factor. REALM-SF and REALM instrument scores were highly correlated in development (r = 0.95, P < 0.001) and validation (r = 0.94, P < 0.001) samples. There was excellent agreement between REALM-SF and REALM instrument grade-level assignments when dichotomized at the 6th grade (development: 97% agreement, K = 0.88, P < 0.001; validation: 88% agreement, K = 0.75, P < 0.001) and 8th grade levels (development: 94% agreement, K = 0.78, P < 0.001; validation: 84% agreement, K = 0.67, P < 0.001). REALM-SF and Wide Range Achievement Test scores were highly correlated (r = 0.83, P < 0.001) in field testing validation. CONCLUSIONS: The REALM-SF provides researchers a brief, validated instrument for assessing patient literacy in diverse research settings.
BACKGROUND: Although prior studies used the 66-item Rapid Estimate of Adult Literacy in Medicine (REALM instrument) for literacy assessment, researchers may require a shorter, validated instrument when designing interventions for clinical contexts. OBJECTIVE: To develop and validate a very brief literacy assessment tool, the REALM-Short Form (REALM-SF). PATIENTS: The model development, validation, and field testing validation samples included 1336, 164, and 50 patients, respectively. SETTING: General medicine and subspecialty clinics and medicine inpatient wards. DESIGN: For development and validation samples, indicator variables for REALM instrument items were evaluated as potential predictors of REALM instrument score by stepwise multiple regression analysis with subsequent bootstrap and confirmatory factor analysis of selected items. Pearson correlations compared REALM-SF and REALM instrument scores and kappa analyses compared grade level assignments. For the field testing validation sample, Pearson correlations compared Wide Range Achievement Test and REALM-SF scores. RESULTS: The REALM-SF included 7 items with stable model coefficients and 1 underlying linear factor. REALM-SF and REALM instrument scores were highly correlated in development (r = 0.95, P < 0.001) and validation (r = 0.94, P < 0.001) samples. There was excellent agreement between REALM-SF and REALM instrument grade-level assignments when dichotomized at the 6th grade (development: 97% agreement, K = 0.88, P < 0.001; validation: 88% agreement, K = 0.75, P < 0.001) and 8th grade levels (development: 94% agreement, K = 0.78, P < 0.001; validation: 84% agreement, K = 0.67, P < 0.001). REALM-SF and Wide Range Achievement Test scores were highly correlated (r = 0.83, P < 0.001) in field testing validation. CONCLUSIONS: The REALM-SF provides researchers a brief, validated instrument for assessing patient literacy in diverse research settings.
Authors: Richa Gawande; My Ngoc To; Elizabeth Pine; Todd Griswold; Timothy B Creedon; Alexandra Brunel; Angela Lozada; Eric B Loucks; Zev Schuman-Olivier Journal: J Gen Intern Med Date: 2018-12-03 Impact factor: 5.128
Authors: Candice A Myers; Robbie A Beyl; Corby K Martin; Stephanie T Broyles; Peter T Katzmarzyk Journal: Public Health Nutr Date: 2020-06-29 Impact factor: 4.022
Authors: Stephanie W Edmonds; Samantha L Solimeo; Vu-Thuy Nguyen; Nicole C Wright; Douglas W Roblin; Kenneth G Saag; Peter Cram Journal: Perm J Date: 2016-11-18
Authors: Tam H Nguyen; Hyunjeong Park; Hae-Ra Han; Kitty S Chan; Michael K Paasche-Orlow; Jolie Haun; Miyong T Kim Journal: Patient Educ Couns Date: 2015-07-29
Authors: William B Brinkman; Jessica Hartl; Lauren M Rawe; Heidi Sucharew; Maria T Britto; Jeffery N Epstein Journal: Arch Pediatr Adolesc Med Date: 2011-11
Authors: Jeffrey A Sparks; Maura D Iversen; Rachel Miller Kroouze; Taysir G Mahmoud; Nellie A Triedman; Sarah S Kalia; Michael L Atkinson; Bing Lu; Kevin D Deane; Karen H Costenbader; Robert C Green; Elizabeth W Karlson Journal: Contemp Clin Trials Date: 2014-08-20 Impact factor: 2.226
Authors: Pearman D Parker; Sue P Heiney; Swann Arp Adams; Daniela B Friedman; Robin M Dawson Journal: Appl Nurs Res Date: 2020-07-23 Impact factor: 2.257
Authors: Mary F Wyman; Daniel Liebzeit; Corrine I Voils; Barbara J Bowers; Elizabeth N Chapman; Andrea Gilmore-Bykovskyi; Korey A Kennelty; Amy J H Kind; Julia Loosen; Nicole Rogus-Pulia; Melissa Dattalo Journal: Patient Educ Couns Date: 2020-02-15