Patients' perceptions of screening for health literacy: reactions to the newest vital sign.

Difficulties in caring for patients with limited health literacy have prompted interest in health literacy screening. Several prior studies, however, have suggested that health literacy testing can lead to feelings of shame and stigmatization. In this study, we examine patient reaction to the Newest Vital Sign (NVS), a screening instrument developed specifically for use in primary care. Data were collected in 2008 in the Morehouse School of Medicine, Department of Family Medicine Primary Care Clinics, where health literacy screening was implemented as part of routine intake procedures. Following the visit, patients completed a series of questions assessing their screening experiences. A total of 179 patients completed both the NVS and the reaction survey. Nearly all (> 99%) patients reported that the screening did not cause them to feel shameful. There were also no differences in the reported prevalence of shame (p <or= .33) by literacy level. Finally, when asked if they would recommend clinical screening, 97% of patients answered in the affirmative. These results suggest that screening for limited health literacy in primary care may not automatically elicit feelings of shame. Even patients with the lowest levels of literacy were both comfortable with and strongly supportive of clinical screening.