title: Time to sign: The relationship between health literacy and signature time.
abstract: OBJECTIVE
  To evaluate the relationship between amount of time taken to sign one's name and health literacy.
  
  
  METHODS
  A prospective, one time assessment was conducted on a convenience sample of 98 patients recruited in an inner-city outpatient internal medicine clinic. The amount of time required to sign (i.e. initiation to completion of writing) was measured by stopwatch. Health literacy was measured with the REALM.
  
  
  RESULTS
  The sample averaged 54.1 (SD 16.2) years of age. Twenty-seven percent had less than high school education and 33% had a terminal general equivalency diploma or high school degree. The time required to sign ranged from 0.91 to 21.3s. Sixty-two percent of the sample had health literacy challenges. Signature time was longest for those with inadequate health literacy (mean 10.0 s), compared with marginal (7.3s) and adequate (4.7s, p ≤ 0.001). Signature time remained significant in a logistic regression model after controlling for education and age (AOR = 0.785, CI = 0.661-0.932).
  
  
  CONCLUSIONS
  Individuals with signatures completed in six seconds or less were highly likely to display adequate health literacy.
  
  
  CONCLUSIONS
  Signature time may offer a practical and quick approach to health literacy screening in the health care setting.
authors.affiliation: Section of Health Promotion Research, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago 60608, USA. sharpl@uic.edu
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Sharp
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Ureste
authors.forename: Leianne A
authors.initials: LA
authors.lastname: Torres
authors.forename: Lauren
authors.initials: L
authors.lastname: Bailey
authors.forename: Howard S
authors.initials: HS
authors.lastname: Gordon
authors.forename: Ben S
authors.initials: BS
authors.lastname: Gerber
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002641:Chicago; D004522:Educational Status; D005260:Female; D057220:Health Literacy; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies; D012372:ROC Curve; D011795:Surveys and Questionnaires; D013997:Time Factors; D014505:Urban Population