8.2 How is Health Literacy Measured

Question 1

National Assessment of Adult Literacy (NAAL)

Answer 1

• Used to assess health literacy

- Involves Prose, Document, and Quantitative Scales

Question 2

Prose Tasks

Answer 2

• Knowledge/Skills to preform prose tasks

- Ability to use information from text such as news, stories, brochures, and instructional material

Question 3

Document Tasks

Answer 3

• Job applications, payroll forms, transportation schedules, maps, tablets.

Question 4

Quantitative Scales

Answer 4

• Ability to identify and preform computations

- Balancing a checkbook, maintaining a budget

Question 5

TASKS OF HEALTH LITERACY MEASUREMENT

Answer 5

Clinical domain - Filling out a patient form or reading a prescription bottle
Prevention domain - Ability to understand written material of health risks of obesity
Navigation domain - Ability to navigate healthcare and understanding of what insurance will pay for.

Question 6

4 Levels of Prose Literacy

Question 7

Below Basic

Answer 7

• Find 1 piece of information

- Example is the date on a medical appointment slip that is shorter and simpler than the text

Question 8

Basic

Answer 8

• Ability to provide 2 reasons why a person with no symptoms to a disease should be tested for that disease by using information in a pamphlet

Question 9

Intermediate

Answer 9

• Interpret and apply information presented in complex graphs, tablets, or other health related texts or documents

Question 10

Proficient

Answer 10

• Drawing abstract inferences, comparing multiple pieces of information within complex texts or documents
• Applying abstract or complicated information

Question 11

What the Levels Mean

Answer 11

• Basic/Below - Less likely to get information from written sources and more likely to get information from radio and television than higher literacy levels.

Question 12

Limitations of NAAL Assessment

Answer 12

• Does not capture full range of skills needed for health literacy
  CANNOT DIFFERENTIATE
• Reading ability
• Lack of health-related background knowledge
• Lack of familiarity with language and materials
• Cultural differences in approaches to health

Question 13

TOFHLA

Answer 13

• Test of Functional Health Literacy

- Gold Standard

Question 14

Other health literacy assessments-

Answer 14

• Rapid Estimate of Adult Literacy in Medicine (REALM)
• Short Assessment of Health Literacy for Spanish Speaking Adults (SAHLSA)
• Spoken Knowledge of Low Literacy Patients with Diabetes (SKILLD)
• Literacy Assessment for Diabetes (LAD)

Question 15

REALM

Answer 15

• Medical word recognition and pronunciation test
• Begins with simple words and ends with more difficult words
• Scored on the amount of words pronounced correctly

0-18 words correct - 3rd grade
19-44 words correct - 4th-6th grade
45-60 words correct - 7th-8th grade
61-66 words correct - 9th grade

Question 16

How to evaluate patients understanding

Answer 16

• Ask the individual how they prefer their information (verbal, computer-based, videos, written)
• Teach-back technique
• Translate written information into primary language
• Interactive education techniques
• Assess/document literacy needs of a patient