title: Quantifying word use to study health literacy in doctor-patient communication.
abstract: Most health literacy research to date has assessed health literacy using either general reading tests or text-based appraisals of reading and numeracy skills, yet the definition of health literacy includes domains beyond reading ability. Effective oral communication between doctor and patient is an important component of health literacy, but only recently have efforts been made to develop measures that tap into domains beyond those that can be assessed with text-based measures. Focusing on oral exchange, this article describes computer-assisted approaches to quantifying word use and the development of three word-use measures that can be used to study health literacy in transcripts of clinical encounters. The measures can be used to assess either the expressed literacy level of patients or the aural literacy demands made by doctors. Importantly, the computer-assisted quantitative measures described here make it possible for word use to be analyzed at a level of detail that human raters would be hard pressed to attain.
authors.affiliation: Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts 02111, USA. Skochw01@tufts.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Koch-Weser
authors.forename: Rima E
authors.initials: RE
authors.lastname: Rudd
authors.forename: William
authors.initials: W
authors.lastname: Dejong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D005260:Female; D057220:Health Literacy; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012219:Rheumatology; D055815:Young Adult
references.citation: JAMA. 1999 Jan 20;281(3):283-7
references.pmid: 9918487
references.citation: Patient Educ Couns. 1997 Sep-Oct;32(1-2):81-91
references.pmid: 9355575
references.citation: Fam Med. 1993 Jun;25(6):391-5
references.pmid: 8349060
references.citation: Soc Sci Med. 1991;32(2):193-6
references.pmid: 2014414
references.citation: BMJ. 2004 Feb 28;328(7438):501-2
references.pmid: 14988186
references.citation: Health Educ J. 1979;38(4):111-21
references.pmid: 10318516
references.citation: Patient Educ Couns. 2000 Jan;39(1):5-15
references.pmid: 11013543
references.citation: Am J Health Behav. 2007 Sep-Oct;31 Suppl 1:S85-95
references.pmid: 17931142
references.citation: BMJ. 2002 Sep 28;325(7366):682-3
references.pmid: 12351359
references.citation: Arthritis Rheum. 1992 Nov;35(11):1257-63
references.pmid: 1445439
references.citation: Soc Sci Med. 2007 Oct;65(7):1442-57
references.pmid: 17614177
references.citation: Nurs Res. 1984 May-Jun;33(3):178-81
references.pmid: 6563536
references.citation: J Appl Psychol. 2001 Dec;86(6):1232-43
references.pmid: 11768064
references.citation: Patient Educ Couns. 2004 Mar;52(3):315-23
references.pmid: 14998602
references.citation: Acad Med. 2002 Oct;77(10):1039-41
references.pmid: 12377684
references.citation: Br Med J. 1970 May 2;2(5704):286-9
references.pmid: 5420179
references.citation: Am J Health Behav. 2007 Sep-Oct;31 Suppl 1:S8-18
references.pmid: 17931141
references.citation: Baillieres Clin Rheumatol. 1993 Jun;7(2):221-39
references.pmid: 8334710
references.citation: Soc Sci Med. 1989;28(4):339-46
references.pmid: 2705006
references.citation: J Gen Intern Med. 1995 Oct;10(10):537-41
references.pmid: 8576769