title: Development and validation of a literacy assessment tool for persons with diabetes.
abstract: This research was conducted to develop a valid, reliable, quick, and nonstigmatizing tool for assessing literacy in the healthcare setting.
  
  
  
  The Literacy Assessment for Diabetes (LAD) instrument was developed as a word recognition test composed of 3 graded word lists in ascending difficulty. This literacy test, which was specific to diabetes, measured a patient's ability to pronounce terms that they would encounter during clinic visits and in reading menu and self-care instructions. The majority of the terms were on a 4th-grade reading level, with the remaining words ranging from the 6th-through 16th-grade levels. To assess reliability and validity, the LAD was compared with the Wide Range Achievement Test (WRAT3) and the Rapid Estimate of Adult Literacy in Medicine (REALM) by administering all 3 tests to 203 participants in a test-retest study design.
  
  
  
  All 3 tests (LAD, REALM, and WRAT3) reliably detected true intrasubject variation in word recognition from test to retest. In addition, LAD measured word recognition ability similar to the REALM and WRAT3.
  
  
  
  The LAD is a reliable and valid instrument for measuring literacy in adults with diabetes. It can be administered in 3 minutes or less, and the raw score is scaled to a reading grade level.
authors.affiliation: The Department of Family Medicine, West Virginia Uni­versity, Morgantown (Drs Nath and Yasek)
authors.forename: C R
authors.initials: CR
authors.lastname: Nath
authors.affiliation: The Department of Reading, California University of Penn­sylvania, California, Pennsylvania (Dr Sylvester)
authors.forename: S T
authors.initials: ST
authors.lastname: Sylvester
authors.affiliation: The Department of Family Medicine, West Virginia Uni­versity, Morgantown (Drs Nath and Yasek)
authors.forename: V
authors.initials: V
authors.lastname: Yasek
authors.affiliation: The Department of Statistics, West Virginia Uni­versity, Morgantown (Dr Gunel)
authors.forename: E
authors.initials: E
authors.lastname: Gunel
mesh_terms: D003920:Diabetes Mellitus / Q000534:rehabilitation*; D004522:Educational Status; D011932:Reading; D015203:Reproducibility of Results; D012959:Socioeconomic Factors