Dataset Information

Validation of self-reported health literacy questions among diverse English and Spanish-speaking populations.

ABSTRACT:

Background

Limited 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.

Objective

To 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.

Design

This was a validation study nested within a trial of diabetes self-management support in the San Francisco Department of Public Health.

Participants

English and Spanish-speaking adults with type 2 diabetes receiving primary care.

Methods

Using 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 results

Of 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.

Conclusions

A 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.

SUBMITTER: Sarkar U

PROVIDER: S-EPMC3043178 | biostudies-literature | 2011 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Validation of self-reported health literacy questions among diverse English and Spanish-speaking populations.

Sarkar Urmimala U Schillinger Dean D López Andrea A Sudore Rebecca R

Journal of general internal medicine 20101106 3

<h4>Background</h4>Limited 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.<h4>Objective</h4>To 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 infor ...[more]

PMID: 21057882

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Dataset Information

Validation of self-reported health literacy questions among diverse English and Spanish-speaking populations.

Background

Objective

Design

Participants

Methods

Key results

Conclusions

Publications

Validation of self-reported health literacy questions among diverse English and Spanish-speaking populations.

Similar Datasets

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