title: Development of a brief test to measure functional health literacy.
abstract: We describe the development of an abbreviated version of the Test of Functional Health Literacy in Adults (TOFHLA) to measure patients' ability to read and understand health-related materials. The TOFHLA was reduced from 17 Numeracy items and 3 prose passages to 4 Numeracy items and 2 prose passages (S-TOFHLA). The maximum time for administration was reduced from 22 minutes to 12. In a group of 211 patients given the S-TOFHLA, Cronbach's alpha was 0.68 for the 4 Numeracy items and 0.97 for the 36 items in the 2 prose passages. The correlation (Spearman) between the S-TOFHLA and the Rapid Estimate of Adult Literacy in Medicine (REALM) was 0.80, although there were important disagreements between the two tests. The S-TOFHLA is a practical measure of functional health literacy with good reliability and validity that can be used by health educators to identify individuals who require special assistance to achieve learning goals.
authors.affiliation: Department of Medicine, Department of Epidemiology and Biostatistics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109-1998, USA. dwb@po.cwru.edu
authors.forename: D W
authors.initials: DW
authors.lastname: Baker
authors.forename: M V
authors.initials: MV
authors.lastname: Williams
authors.forename: R M
authors.initials: RM
authors.lastname: Parker
authors.forename: J A
authors.initials: JA
authors.lastname: Gazmararian
authors.forename: J
authors.initials: J
authors.lastname: Nurss
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000193:education; D000367:Age Factors; D004358:Drug Therapy; D004521:Educational Measurement / Q000379:methods*; D004522:Educational Status; D005260:Female; D006266:Health Education; D006801:Humans; D016014:Linear Models; D008297:Male; D008433:Mathematics; D008489:Medical Indigency / Q000523:psychology; D008875:Middle Aged; D020380:Needs Assessment; D011932:Reading; D012646:Self Administration; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires / Q000592:standards*; D013664:Teaching Materials