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Short Assessment of Health Literacy-Spanish and English: a comparable test of health literacy for Spanish and English speakers.

ABSTRACT: The intent of the study was to develop and validate a comparable health literacy test for Spanish-speaking and English-speaking populations.The design of the instrument, named the Short Assessment of Health Literacy-Spanish and English (SAHL-S&E), combined a word recognition test, as appearing in the Rapid Estimate of Adult Literacy in Medicine (REALM), and a comprehension test using multiple-choice questions designed by an expert panel. We used the item response theory (IRT) in developing and validating the instrument.Validation of SAHL-S&E involved testing and comparing the instrument with other health literacy instruments in a sample of 201 Spanish-speaking and 202 English-speaking subjects recruited from the Ambulatory Care Center at the University of North Carolina Healthcare System.Based on IRT analysis, 18 items were retained in the comparable test. The Spanish version of the test, SAHL-S, was highly correlated with other Spanish health literacy instruments, Short Assessment of Health Literacy for Spanish-Speaking Adults (r=0.88, p<.05) and the Spanish Test of Functional Health Literacy in Adults (TOFHLA) (r=0.62, p<.05). The English version, SAHL-E, had high correlations with REALM (r=0.94, p<.05) and the English TOFHLA (r=0.68, p<.05). Significant correlations were found between SAHL-S&E and years of schooling in both Spanish- and English-speaking samples (r=0.15 and 0.39, respectively). SAHL-S&E displayed satisfactory reliability of 0.80 and 0.89 in the Spanish- and English-speaking samples, respectively. IRT analysis indicated that the SAHL-S&E score was highly reliable for individuals with a low level of health literacy.The new instrument, SAHL-S&E, has good reliability and validity. It is particularly useful for identifying individuals with low health literacy and could be used to screen for low health literacy among Spanish and English speakers.

SUBMITTER: Lee SY

PROVIDER: S-EPMC2910571 | biostudies-literature | 2010 Aug

REPOSITORIES: biostudies-literature

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Short Assessment of Health Literacy-Spanish and English: a comparable test of health literacy for Spanish and English speakers.

Lee Shoou-Yih Daniel SY Stucky Brian D BD Lee Jessica Y JY Rozier R Gary RG Bender Deborah E DE

Health services research 20100524 4

<h4>Objective</h4>The intent of the study was to develop and validate a comparable health literacy test for Spanish-speaking and English-speaking populations.<h4>Study design</h4>The design of the instrument, named the Short Assessment of Health Literacy-Spanish and English (SAHL-S&E), combined a word recognition test, as appearing in the Rapid Estimate of Adult Literacy in Medicine (REALM), and a comprehension test using multiple-choice questions designed by an expert panel. We used the item re ...[more]

PMID: 20500222

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Project description:BackgroundLimited health literacy (HL) contributes to poor health outcomes and disparities, and direct measurement is often time-intensive. Self-reported HL questions have not been validated among Spanish-speaking and diverse English-speaking populations.ObjectiveTo evaluate three self-reported questions: 1 "How confident are you filling out medical forms?"; 2 "How often do you have problems learning about your medical condition because of difficulty understanding written information?"; and 3 "How often do you have someone help you read hospital materials?" Answers were based on a 5-point Likert scale.DesignThis was a validation study nested within a trial of diabetes self-management support in the San Francisco Department of Public Health.ParticipantsEnglish and Spanish-speaking adults with type 2 diabetes receiving primary care.MethodsUsing the Test of Functional Health Literacy in Adults (s-TOFHLA) in English and Spanish as the reference, we classified HL as inadequate, marginal, or adequate. We calculated the C-index and test characteristics of the three questions and summative scale compared to the s-TOFHLA and assessed variations in performance by language, race/ethnicity, age, and education.Key resultsOf 296 participants, 48% were Spanish-speaking; 9% were White, non-Hispanic; 47% had inadequate HL and 12% had marginal HL. Overall, 57% reported being confident with forms "somewhat" or less. The "confident with forms" question performed best for detecting inadequate (C-index = 0.82, (0.77-0.87)) and inadequate plus marginal HL (C index = 0.81, (0.76-0.86); p<0.01 for differences from other questions), and performed comparably to the summative scale. The "confident with forms" question and scale also performed best across language, race/ethnicity, educational attainment, and age.ConclusionsA single self-reported HL question about confidence with forms and a summative scale of three questions discriminated between Spanish and English speakers with adequate HL and those with inadequate and/or inadequate plus marginal HL. The "confident with forms" question or the summative scale may be useful for estimating HL in clinical research involving Spanish-speaking and English-speaking, chronically-ill, diverse populations.

Project description:ObjectivesTo develop and validate a Weight Literacy Scale in English and Spanish for adults.MethodsThe two-phase study utilized quantitative and qualitative methods. Phase 1 of the study consisted of developing an initial survey (English and Spanish versions) assessing weight literacy based on a review of the literature; conducting semi-structured interviews with content experts (N = 9) to refine survey items; and conducting in-person cognitive interviews with 20 study participants (N = 10 English-speaking and N = 10 Spanish-speaking adults) for survey pre-testing. Survey items were modified based on Phase 1 findings. Phase 2 consisted of a psychometric study of the Weight Literacy Scale developed in Phase 1. Procedures included administering the Weight Literacy Scale to 200 study participants (N = 100 English-speaking and N = 100 Spanish-speaking adults), a quantitative survey assessing dietary and physical activity behaviors and sociodemographics, measuring participants' height and weight, and assessing the scale's validity and internal reliability. A subset of Phase 2 participants (N = 71) completed the weight literacy scale at two-weeks follow-up to assess test-retest reliability. Participant recruitment and study procedures took place in community settings in central Massachusetts for both study phases. Weight literacy scale scores were calculated as the sum of total correct items. Three rounds of factor analysis were performed to identify items for elimination. The Kuder Richardson's Coefficient of reliability was calculated. Correlations between the Weight Literacy Scale scores and related measures (body mass index and weight status, dietary behaviors, physical activity behaviors, and confidence in filling out medical forms) were examined.ResultsThe final scale included 31 items and demonstrated strong internal consistency (Kuder Richardson Coefficient = 0.90), reasonable construct validity, and acceptable test-retest reliability (ρ = 0.72).ConclusionThe Weight Literacy Scale is a reliable and valid research instrument to assess weight literacy among English- and Spanish-speaking adults.

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Short Assessment of Health Literacy-Spanish and English: a comparable test of health literacy for Spanish and English speakers.

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Short Assessment of Health Literacy-Spanish and English: a comparable test of health literacy for Spanish and English speakers.

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