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1.
Patel PJ Joel S Rovena G Pedireddy S Saad S Rachmale R Shukla M Deol BB Cardozo L 《Patient education and counseling》2011,85(3):505-507
Objective
To evaluate utility of the newest vital sign (NVS) which can be completed in 3 min compared to the short version test of functional literacy in adults (S-TOFHLA) that takes 7 min for health literacy in the older African American patients.Methods
We enrolled 62 older (age > 65 years) African American patients and administered the NVS and the S-TOFHLA. A score of less than 4 for the NVS and less than 16 for the S-TOFHLA was indicative of limited health literacy.Results
Mean age of our patients was 73.2 + 7.9 years with an average education level of twelfth grade. Using S-TOFHLA 51% of the subjects were deemed to be sufficiently literate, with a score of 23.0 + 8.6 compared to 56% on the NVS with a score of 3.0 + 1.9. The average time for completing the NVS was 11 min in our patient population.Conclusion
Based on our data, while health literacy level can be assessed with the NVS its practicality as a quick screening tool in the elderly population appears limited.Practice implications
Knowing the level of patient's health literacy may help physicians deliver health information in the format that patients can understand. 相似文献2.
Roopa Chari Joel Warsh Tara Ketterer Jobayer Hossain Iman Sharif 《Patient education and counseling》2014
Objective
We tested the association between child and parental health literacy (HL) and odds of child and adolescent obesity.Methods
We conducted an anonymous cross-sectional survey of a convenience sample of English-speaking child-parent dyads. Newest Vital Sign (NVS) measured HL. We used multivariable logistic regression to test adjusted association between child and parental NVS and obesity. Analyses were stratified for school-aged children (aged 7–11) vs. adolescents (aged 12–19).Results
We surveyed 239 child-parent dyads. Median child age was 11 [inter-quartile range 9–13]; 123 (51%) were male; 84% Medicaid recipients; 27% obese. For children, the odds of obesity [adjusted odds ratio (95% confidence interval)] decreased with higher parent NVS [0.75 (0.56,1.00)] and increased with parent obesity [2.53 (1.08,5.94)]. For adolescents, odds of obesity were higher for adolescents with the lowest category of NVS [5.00 (1.26, 19.8)] and older parental age [1.07 (1.01,1.14)] and lower for Medicaid recipients [0.21 (0.06,0.78)] and higher parental education [0.38 (0.22,0.63)].Conclusion
Obesity in school-aged children is associated with parental factors (obesity, parental HL); obesity in adolescents is strongly associated with the adolescent's HL.Practice implications
Strategies to prevent and treat obesity should consider limited HL of parents for child obesity and of adolescents for adolescent obesity. 相似文献3.
Kim MT Song HJ Han HR Song Y Nam S Nguyen TH Lee HC Kim KB 《Patient education and counseling》2012,87(2):165-170
Objective
While the role of health literacy in chronic disease management is well documented, few intervention studies have been reported. A major barrier to designing and implementing such interventions is the lack of valid health literacy tools. This study developed and tested a novel health literacy scale for individuals with high blood pressure (HBP).Methods
A two-step design process was used: In the construction phase, focus group studies and a literature review were conducted to generate a pool of items. The testing phase involved a psychometric evaluation and pilot-testing of the scale on hypertensive Korean Americans (n = 386). The end product was a HBP-health literacy scale (HBP-HLS) with two essential domains, print literacy and functional health literacy.Results
Psychometric testing indicated that the scale was reliable (Kuder–Richardson-20 coefficient = 0.98), valid (content validity index ≥0.8), and significantly correlated with theoretically selected variables (education, r = 0.67, p < 0.01; HBP knowledge, r = 0.33, p < 0.01).Conclusion
The HBP-HLS demonstrated its utility for evaluating HBP management interventions in the community setting.Practice implications
Utilizing the HBP-HLS should be considered as a potential tool for improving health literacy and evaluating intervention studies in the context of HBP management. 相似文献4.
Dagmara Paiva Susana Silva Milton Severo Pedro Ferreira Osvaldo Santos Nuno Lunet Ana Azevedo 《Patient education and counseling》2014
Objective
We aimed to culturally adapt and validate METER in the Portuguese population, and to define cut-off values for adequate health literacy.Methods
We used the standard procedure for the adaptation of the words and surveyed health professionals to select the non-words. The instrument was administered to a total sample of 249 participants and retested in a sub-sample of 45 after three months. Cut-offs were defined using the modified Angoff procedure. Construct validity was assessed through association with educational attainment and health-related occupation.Results
Exploratory factor analysis revealed two dimensions of the instrument, one for words and another for non-words. METER showed a high degree of internal consistency, and acceptable test–retest reliability. Adequate health literacy was defined as scoring at least 35/40 in words and 18/30 in non-words. Physicians scored higher than any other group, followed by health researchers, researchers from other areas and by people with progressively lower levels of education (p < 0.001).Conclusion
We culturally adapted a brief and simple instrument for health literacy assessment, and showed it was valid and reliable.Practice implications
The Portuguese version of METER can be used to assess health literacy in Portuguese adults and to explore associations with health outcomes. 相似文献5.
Rosalie van der Vaart Constance H.C. Drossaert Erik Taal Peter M. ten Klooster Rianne T.E. Hilderink-Koertshuis Joost M. Klaase Mart A.F.J. van de Laar 《Patient education and counseling》2012
Objective
While most existing health literacy (HL) measures focus primarily on reading comprehension, the functional, communicative and critical HL scales from Ishikawa et al. [19] aim to measure a broader HL spectrum. The objective of this study was to evaluate the validity of the Dutch translation of this instrument.Methods
Two survey studies (n = 79 and n = 209) and one cognitive interview study (n = 18) were performed among samples of breast cancer patients and patients with rheumatic diseases.Results
Analyses showed the scales measured three distinct factors and convergent validity was satisfactory for communicative and critical HL. Nevertheless, the comprehension of the items and the suitability of the response options raised some problems.Conclusion
The HL scales seem promising to measure a broad definition of HL. By revising some of the items and response options as proposed in this article, the scale will become more understandable for people with low HL skills, which might increase the content validity and the distributional properties of the scale.Practice implications
The scale should be revised and revalidated. An improved version should be used in practice to gain insight into HL levels of patients. This will help to develop suitable education programs for people with low HL skills. 相似文献6.
《Patient education and counseling》2020,103(5):888-897
ObjectiveHealth literacy measurement can identify healthcare consumers’ needs and help inform healthcare service delivery. The objective of this review is to identify and evaluate tools to measure health literacy among Chinese speakers.MethodsA systematic literature search was undertaken in nine databases, both English and Chinese, on articles published from the databases’ inception to May 2018, addressing health literacy among Chinese speakers.ResultsTen health literacy instruments in the Chinese language were reported in 17 studies, of which ten were published in English and seven in Chinese. Of the 17 studies, six reported on a new instrument, while the remainder reported on derivative instruments. All, except for one, are self-administered. These studies applied various implicit or explicit conceptual or operational health literacy definitions. The psychometric strength varied across the instruments.ConclusionsA number of instruments are available for assessing health literacy among Chinese speakers. Careful selection is recommended, given the variation in components and psychometric properties assessed.Practice implicationsThis review can be used by healthcare providers and researchers to select effective health literacy tools to examine patients’ ability to understand and apply health information so that services can be more appropriately tailored to Chinese speaking patients. 相似文献
7.
《Patient education and counseling》2020,103(6):1245-1251
ObjectiveExisting instruments for assessing health literacy skills in parents have limited scope to inform the design and evaluation of health literacy interventions. In this study we aimed to develop and validate a new performance-based measure of health literacy for Australian parents, the Parenting Plus Skills Index (PPSI). The instrument aimed to assess functional, communicative and critical health literacy skills.MethodsThe PPSI was developed in three phases: 1) Modified Delphi Expert Panel to provide feedback on 34 initial items; 2) Evaluation of psychometric properties of each item using a multidimensional item response theory model in a sample of Australian adults of parenting age (20−44 years) (N = 500); 3) Assessment of subset of items in an independent sample (N = 500).ResultsFollowing the three phases, 13 items were included in the final instrument. Participants scored on average 8.9/13 (69 %). The instrument demonstrated acceptable reliability (r = 0.70) and was significantly correlated with other performance-based health literacy instruments.ConclusionsThe PPSI is a validated 13-item performance-based instrument that assesses health literacy skills for parents in an Australian setting.Practice implicationsThe PPSI fills an important gap in available health literacy instruments that may be useful for facilitating development and evaluation of health literacy interventions. 相似文献
8.
Lisa K. Sharp Peter J. Ureste Leianne A. Torres Lauren Bailey Howard S. Gordon Ben S. Gerber 《Patient education and counseling》2013
Objective
To evaluate the relationship between amount of time taken to sign one's name and health literacy.Methods
A prospective, one time assessment was conducted on a convenience sample of 98 patients recruited in an inner-city outpatient internal medicine clinic. The amount of time required to sign (i.e. initiation to completion of writing) was measured by stopwatch. Health literacy was measured with the REALM.Results
The sample averaged 54.1 (SD 16.2) years of age. Twenty-seven percent had less than high school education and 33% had a terminal general equivalency diploma or high school degree. The time required to sign ranged from 0.91 to 21.3 s. Sixty-two percent of the sample had health literacy challenges. Signature time was longest for those with inadequate health literacy (mean 10.0 s), compared with marginal (7.3 s) and adequate (4.7 s, p ≤ 0.001). Signature time remained significant in a logistic regression model after controlling for education and age (AOR = 0.785, CI = 0.661–0.932).Conclusion
Individuals with signatures completed in six seconds or less were highly likely to display adequate health literacy.Practice implications
Signature time may offer a practical and quick approach to health literacy screening in the health care setting. 相似文献9.
Andrea M. Russell Deesha A. Patel Laura M. Curtis Kwang-Youn A. Kim Michael S. Wolf Megan E. Rowland Danielle M. McCarthy 《Patient education and counseling》2019,102(4):749-752
Objective
To determine the reliability of the Newest Vital Sign (NVS) administered via telephone by examining test-retest properties of the measure.Methods
Data were obtained from a randomized controlled trial promoting opioid safe use. Participants were 18 or older and English-speaking. NVS assessment occurred in-person at baseline and in-person or via telephone at follow-up. Intraclass correlation coefficients (ICCs) were used to assess the test-retest reliability using raw NVS scores by mode of administration of the second NVS assessment. Kappa statistics were used to examine test-retest agreement based on categorized NVS score. Internal consistency was measured with Cronbach’s alpha.Results
Data from 216 patients (70 completing follow-up in-person and 146 via telephone) were included. Reliability was high (ICCs: in-person?=?0.81, phone?=?0.70). Agreement was lower for three category NVS score (Kappas: in-person?=?0.58, 95% CI [0.39-0.77]; phone?=?0.52, 95% CI [0.39-0.65]) compared to two category NVS (Kappas: in-person?=?0.65, 95% CI [0.46-0.85]; phone?=?0.64, 95% CI [0.51-0.78]). Correlations decreased as time between administrations increased. Internal consistency was moderately high (baseline NVS in-person (α?=?0.76), follow-up NVS in-person (α?=?0.76), and phone follow-up (α?=?0.78).Conclusion
The test-retest properties of the NVS are similar by mode of administration.Practice implications
This data suggests the NVS measure is reliably administered by telephone. 相似文献10.
《Patient education and counseling》2022,105(4):926-932
ObjectivesThe aim of this study was to investigate whether a self-report measurement instrument (the Brief Health Literacy Screen, BHLS) correctly identifies healthcare consumers with inadequate health literacy. The yardstick for assessing the tool was the Newest Vital Sign (NVS).MethodsThe study used baseline data from the Västerbotten Intervention Programme - VIsualiZation of Asymptomatic Atherosclerotic disease for Optimum Cardiovascular Prevention (VIPVIZA), a randomized controlled trial that is nested within the Västerbotten Intervention Program (VIP) in Sweden. Our analyses were computed on a subsample of 460 persons who underwent the measure of both health literacy scales. ROC analysis was used for the crucial computations.ResultsThe potential of the BHLS to identify healthcare consumers with inadequate health literacy remained unsatisfying for the complete sample, but reached an acceptable level for women and persons with only basic education.ConclusionsThe relationship is somewhat weaker than in comparable research in various other European countries. The differences might partly have been caused by the use of self-perception questions. Self-delusions, invariably a part of self-perception, may have affected the respective measure.Practice implicationsCaution is advised when patients’ health literacy is assessed by only a few questions for self-report. 相似文献
11.
Raymond L. Ownby Amarilis Acevedo Drenna Waldrop-Valverde Robin J. Jacobs Joshua Caballero 《Patient education and counseling》2014
Objective
Health literacy has been recognized as an important factor in patients’ health status and outcomes, but the relative contribution of demographic variables, cognitive abilities, academic skills, and health knowledge to performance on tests of health literacy has not been as extensively explored. The purpose of this paper is to propose a model of health literacy as a composite of cognitive abilities, academic skills, and health knowledge (ASK model) and test its relation to measures of health literacy in a model that first takes demographic variables into account.Methods
A battery of cognitive, academic achievement, health knowledge and health literacy measures was administered to 359 Spanish- and English-speaking community-dwelling volunteers. The relations of health literacy tests to the model were evaluated using regression models.Results
Each health literacy test was related to elements of the model but variability existed across measures.Conclusion
Analyses partially support the ASK model defining health literacy as a composite of abilities, skills, and knowledge, although the relations of commonly used health literacy measures to each element of the model varied widely.Practice implications
Results suggest that clinicians and researchers should be aware of the abilities and skills assessed by health literacy measures when choosing a measure. 相似文献12.
《Patient education and counseling》2021,104(10):2406-2411
Research in health literacy is fundamentally impacted by our ability to adequately assess the construct. Although various measures of health literacy have been developed, there are few reflective discussions of the challenges and learnings from the instrument development process. This is somewhat surprising given that health literacy is a multi-dimensional and contested concept (with inherent measurement challenges), and that there are important practical considerations owing to the fact that people completing health literacy assessments may have lower general literacy (i.e. ability to read and write) and English-language skills. This paper discusses our learnings from developing a performance-based measure of parenting health literacy skills (the Parenting Plus Skills Index). The performance-based instrument is characterised by its grounding in health literacy as asset, with items spanning Nutbeam’s functional, communicative and critical health literacy skills, and was designed chiefly to capture improvements resulting from health literacy skills training. This paper elucidates critical junctures in the development process, particularly regarding the conceptualisation and operationalisation of the construct. We also outline our approach to addressing practical measurement issues (e.g. administration time; item difficulty). In summarising these, we offer a 13-item checklist to inform the development of health literacy instruments for other health contexts or health conditions. 相似文献
13.
Fatima Al Sayah Sumit R. Majumdar Leonard E. Egede Jeffrey A. Johnson 《Patient education and counseling》2014
Objective
To examine the measurement properties of the 16 screening questions (16-SQ) of inadequate health literacy (HL) and their briefer version (3-SQ), and identify the best screen for inadequate HL in non-white populations.Methods
Sample included 378 individuals with type-2 diabetes. We computed sensitivity, specificity, positive and negative likelihood ratios, and C-indices, using the s-TOFHLA as a reference measure. We also conducted exploratory factor analysis, and used structural equation modeling (SEM) for confirmatory purposes.Results
Mean age was 56.1 years, 69% were female, and 83% were African–American. 10% had limited HL (s-TOHFLA scores <23). Six questions (6-SQ) were identified and included in the final item-reduced factor analysis, which showed good fit in confirmatory SEM (chi-square = 9.5; P = 0.305; RMSEA = 0.023). Weighted summative score of the 6-SQ and the item “difficulty understanding written information” performed better than the 3-SQ in identifying patients with inadequate HL (C-indices 0.67 versus 0.75).Conclusion
The weighted summative score of the 6-SQ and the item “difficulty understanding written information” performed better than the other items or combinations of these items in identifying individuals with inadequate HL.Practice implications
The proposed weighting of scores could be applied in studies using these screening questions for better classification of inadequate HL. 相似文献14.
Chandra Y. Osborn Kenneth A. Wallston Adam Shpigel Kerri Cavanaugh Sunil Kripalani Russell L. Rothman 《Patient education and counseling》2013
Objective
Because existing numeracy measures may not optimally assess ‘health numeracy’, we developed and validated the General Health Numeracy Test (GHNT).Methods
An iterative pilot testing process produced 21 GHNT items that were administered to 205 patients along with validated measures of health literacy, objective numeracy, subjective numeracy, and medication understanding and medication adherence. We assessed the GHNT's internal consistency reliability, construct validity, and explored its predictive validity.Results
On average, participants were 55.0 ± 13.8 years old, 64.9% female, 29.8% non-White, and 51.7% had incomes ≤$39 K with 14.4 ± 2.9 years of education. Psychometric testing produced a 6-item version (GHNT-6). The GHNT-21 and GHNT-6 had acceptable-good internal consistency reliability (KR-20 = 0.87 vs. 0.77, respectively). Both versions were positively associated with income, education, health literacy, objective numeracy, and subjective numeracy (all p < .001). Furthermore, both versions were associated with participants’ understanding of their medications and medication adherence in unadjusted analyses, but only the GHNT-21 was associated with medication understanding in adjusted analyses.Conclusions
The GHNT-21 and GHNT-6 are reliable and valid tools for assessing health numeracy.Practice implications
Brief, reliable, and valid assessments of health numeracy can assess a patient's numeracy status, and may ultimately help providers and educators tailor education to patients. 相似文献15.
Objective
Patient empowerment and health literacy have both been studied empirically, but they have hardly ever been explicitly linked.Methods
Pertinent literature from the development of both concepts was studied, drawing not only on health care literature, but also on management research.Results
This article argues that it is important to recognize that the concepts are distinct, both conceptually and empirically. At the same time, the impacts of health literacy and patient empowerment are deeply intertwined. High literacy does not necessarily entail empowerment and vice versa, and mismatches of the two can have deleterious consequences. High levels of health literacy without a corresponding high degree of patient empowerment creates an unnecessary dependence of patients on health professionals, while a high degree of empowerment without a corresponding degree of health literacy poses the risk of dangerous health choices.Conclusion
We discuss the importance of carefully conceptualizing both approaches, the implications for their measurement and the design of health interventions.Practice implications
Communication programs must include the empowerment that motivates consumers to engage and the literacy that enables them to make informed and reasoned choices. 相似文献16.
Objective
This study aimed to translate and validate German, Italian, and French versions of the Short-Test of Functional Health Literacy (S-TOFHLA), to be used in Switzerland and its neighboring countries.Methods
The original English version of the S-TOFHLA was translated by applying standardized translation methods and cultural adaptations. 659 interviews were conducted with Swiss residents in their preferred language (249 German, 273 Italian, and 137 French). To assess the validity of the measures, known predictors for health literacy (age, education, and presence of a chronic condition) were tested.Results
For all three language versions, results show that younger participants, participants with a higher education and participants with chronic medical conditions had significantly higher levels of health literacy. Furthermore, the three health literacy scales categorized participants into three health literacy levels with most people possessing either inadequate or adequate levels. The highest levels of health literacy were found in the Swiss-German sample (93%), followed by the Swiss-French (83%) and Swiss-Italian (67%) samples.Conclusion
The German, Italian, and French versions of the S-TOFHLA provide valid measures of functional health literacy.Practice implications
The translated versions can be used in the three different language regions of Switzerland as well as in neighboring countries following ‘country specific’ adjustments and validations. 相似文献17.
《Patient education and counseling》2020,103(11):2347-2352
ObjectiveThe purpose of this study is to assess the validity and reliability of the English version of the FCCHL tool in urban and rural, socioeconomically vulnerable or unstable, chronic comorbid adults in the United States.MethodsA cross-sectional study measuring both validity and reliability.ResultsA total of 276 participants were recruited. Internal consistency was measured using Cronbach’s alpha of α = 0.87. External reliability was measured by test-retest methodology. Construct validity was measured using Confirmatory Factor Analysis that showed good fit. Criterion validity was measured by comparing the mean scores of the FCCHL tool sub-scales. Concurrent validity was measured by comparison of means of the FCCHL tool and education level compared to the NVS and s-TOFHLA.ConclusionThe results demonstrated that the FCCHL tools is measuring three different concepts. Overall, the FCCHL tool was seen to have good validity and reliability in the identified population.Practice ImplicationsThe FCCHL tool is a 14-item, self-report health literacy tool measuring more than functional health literacy. The tool can be used in practice to improve not only functional health literacy, but also communicative and critical which is highly applicable. 相似文献
18.
Julia C.M. van Weert Monique C. Alblas Liset van Dijk Jesse Jansen 《Patient education and counseling》2021,104(1):109-117
ObjectiveTo investigate 1) younger (< 65) and older (> 65) adults’ preference for and understanding of graph formats presenting risk information, and 2) the contribution of age, health literacy, numeracy and graph literacy in understanding information.Materials and methodsTo assess preferences, participants (n = 219 < 65 and n = 227>65) were exposed to a storyboard presenting six types of graphs. Understanding (verbatim and gist knowledge) was assessed in an experiment using a 6 (graphs: clock, bar, sparkplug, table, pie vs pictograph) by 2 (age: younger [<65] vs older [>65]) between-subjects design.ResultsMost participants preferred clock, pie or bar chart. Pie was not well understood by both younger and older people, and clock not by older people. Bar was fairly well understood in both groups. Table yielded high knowledge scores, particularly in the older group. Lower age, higher numeracy and higher graph literacy contributed to higher verbatim knowledge scores. Higher health literacy and graph literacy were associated with higher gist knowledge.Discussion and conclusionAlthough not the preferred format, tables are best understood by older adults.Practice implicationsGraph literacy skills are essential for both verbatim and gist understanding, and are important to take into account when developing risk information. 相似文献
19.
Jessica Shum Iraj Poureslami Darrin Wiebe Mary M. Doyle-Waters Laura Nimmon J. Mark FitzGerald 《Patient education and counseling》2018,101(4):596-618
Objective
To identify and evaluate asthma/COPD measurement tools that assess any of the five health literacy (HL) domains: (1) access, (2) understand, (3) evaluate, (4) communicate, and (5) use, as well as numeracy.Methods
MEDLINE/Embase (via Ovid) databases from 1974 to 2016 were searched and complimented by grey literature. Study selection and data extraction were conducted by two reviewers independently.Results
We identified 65 tools including 40 asthma, 22 COPD, and 3 asthma/COPD focused tools. Thirty tools had been validated and two assessed all five domains. The ‘understand’ domain was captured in 49 tools, followed by ‘access’ in 29 tools, ‘use’ in 24 tools, ‘evaluate’ in 20 tools, and ‘communicate’ in 10 tools. Two tools assessed ‘numeracy’. Tool content comprised disease physiology, triggers, symptoms, inhaler technique, self-management practices, and rehab programs.Conclusions
This review highlights paucity of HL tools that have been validated and/or assess the ‘communicate’ domain and makes a valuable contribution to filling an existing research gap in the field of HL by determining the deficiencies of such tools.Practice implications
Our review uncovers which HL domains are under-measured, justifying the need to develop an airways HL measurement tool which applies the 5-domain model for asthma/COPD management. 相似文献20.
Rebecca Kowalski Muge Capan Peter Lodato Danielle Mosby Tamekia Thomas Ryan Arnold 《Journal of medical engineering & technology》2017,41(8):623-629
Wearable vital sign monitors are a promising step towards optimal patient surveillance, providing continuous data to allow for early detection and treatment of patient deterioration. However, as wearable monitors become more widely adopted in healthcare, there is a corresponding need to carefully design the implementation of these tools to promote their integration into clinical workflows and defend against potential misuse and patient harm. Prior to the roll-out of these monitors, our multidisciplinary team of clinicians, clinical engineers, information technologists and research investigators conducted a modified Healthcare Failure Mode and Effect Analysis (HFMEA), a proactive evaluation of potential problems which could be encountered in the use of a wireless vital signs monitoring system. This evaluation was accomplished by focussing on the identification of procedures and actions that would be required during the devices’ regular usage, as well as the implementation of the system as a comprehensive process. Using this method, the team identified challenges that would arise throughout the lifecycle of the device and developed recommendations to address them. This proactive risk assessment can guide the implementation of wearable patient monitors, optimising the use of innovative health information technology. 相似文献