OBJECTIVES: This paper compares estimates of poor health literacy using two widely used assessment tools and assesses the effect of non-response on these estimates. STUDY DESIGN AND SETTING: A total of 4,868 veterans receiving care at four VA medical facilities between 2004 and 2005 were stratified by age and facility and randomly selected for recruitment. Interviewers collected demographic information and conducted assessments of health literacy (both REALM and S-TOFHLA) from 1,796 participants. Prevalence estimates for each assessment were computed. Non-respondents received a brief proxy questionnaire with demographic and self-report literacy questions to assess non-response bias. Available administrative data for non-participants were also used to assess non-response bias. RESULTS: Among the 1,796 patients assessed using the S-TOFHLA, 8% had inadequate and 7% had marginal skills. For the REALM, 4% were categorized with 6th grade skills and 17% with 7-8th grade skills. Adjusting for non-response bias increased the S-TOFHLA prevalence estimates for inadequate and marginal skills to 9.3% and 11.8%, respectively, and the REALM estimates for < or = 6th and 7-8th grade skills to 5.4% and 33.8%, respectively. CONCLUSIONS: Estimates of poor health literacy varied by the assessment used, especially after adjusting for non-response bias. Researchers and clinicians should consider the possible limitations of each assessment when considering the most suitable tool for their purposes.
RCT Entities:
OBJECTIVES: This paper compares estimates of poor health literacy using two widely used assessment tools and assesses the effect of non-response on these estimates. STUDY DESIGN AND SETTING: A total of 4,868 veterans receiving care at four VA medical facilities between 2004 and 2005 were stratified by age and facility and randomly selected for recruitment. Interviewers collected demographic information and conducted assessments of health literacy (both REALM and S-TOFHLA) from 1,796 participants. Prevalence estimates for each assessment were computed. Non-respondents received a brief proxy questionnaire with demographic and self-report literacy questions to assess non-response bias. Available administrative data for non-participants were also used to assess non-response bias. RESULTS: Among the 1,796 patients assessed using the S-TOFHLA, 8% had inadequate and 7% had marginal skills. For the REALM, 4% were categorized with 6th grade skills and 17% with 7-8th grade skills. Adjusting for non-response bias increased the S-TOFHLA prevalence estimates for inadequate and marginal skills to 9.3% and 11.8%, respectively, and the REALM estimates for < or = 6th and 7-8th grade skills to 5.4% and 33.8%, respectively. CONCLUSIONS: Estimates of poor health literacy varied by the assessment used, especially after adjusting for non-response bias. Researchers and clinicians should consider the possible limitations of each assessment when considering the most suitable tool for their purposes.
Authors: David W Baker; Julie A Gazmararian; Mark V Williams; Tracy Scott; Ruth M Parker; Diane Green; Junling Ren; Jennifer Peel Journal: Am J Public Health Date: 2002-08 Impact factor: 9.308
Authors: Lisa D Chew; Joan M Griffin; Melissa R Partin; Siamak Noorbaloochi; Joseph P Grill; Annamay Snyder; Katharine A Bradley; Sean M Nugent; Alisha D Baines; Michelle Vanryn Journal: J Gen Intern Med Date: 2008-03-12 Impact factor: 5.128
Authors: Nancy C Dolan; M Rosario Ferreira; Terry C Davis; Marian L Fitzgibbon; Alfred Rademaker; Dachao Liu; Brian P Schmitt; Nicolle Gorby; Michael Wolf; Charles L Bennett Journal: J Clin Oncol Date: 2004-07-01 Impact factor: 44.544
Authors: Jamie A Green; Maria K Mor; Anne Marie Shields; Mary Ann Sevick; Paul M Palevsky; Michael J Fine; Robert M Arnold; Steven D Weisbord Journal: Clin J Am Soc Nephrol Date: 2011-05-05 Impact factor: 8.237
Authors: Fatima Al Sayah; Sumit R Majumdar; Beverly Williams; Sandy Robertson; Jeffrey A Johnson Journal: J Gen Intern Med Date: 2012-10-13 Impact factor: 5.128
Authors: Tyler A Kuhn; Emily C Gathright; Mary A Dolansky; John Gunstad; Richard Josephson; Joel W Hughes Journal: J Cardiovasc Nurs Date: 2022 Jan-Feb 01 Impact factor: 2.083
Authors: Joan M Griffin; Alisha Baines Simon; Erin Hulbert; John Stevenson; Joseph P Grill; Siamak Noorbaloochi; Melissa R Partin Journal: BMC Med Res Methodol Date: 2011-05-26 Impact factor: 4.615
Authors: Rosalie van der Vaart; Alexander Jam van Deursen; Constance Hc Drossaert; Erik Taal; Jan Amg van Dijk; Mart Afj van de Laar Journal: J Med Internet Res Date: 2011-11-09 Impact factor: 5.428
Authors: Vanessa Rodríguez; Allen D Andrade; Rocio García-Retamero; Ramanakumar Anam; Remberto Rodríguez; Miriam Lisigurski; Joseph Sharit; Jorge G Ruiz Journal: J Health Commun Date: 2013