title: Development and validation of the General Health Numeracy Test (GHNT).
abstract: OBJECTIVE
  Because existing numeracy measures may not optimally assess 'health numeracy', we developed and validated the General Health Numeracy Test (GHNT).
  
  
  METHODS
  An iterative pilot testing process produced 21 GHNT items that were administered to 205 patients along with validated measures of health literacy, objective numeracy, subjective numeracy, and medication understanding and medication adherence. We assessed the GHNT's internal consistency reliability, construct validity, and explored its predictive validity.
  
  
  RESULTS
  On average, participants were 55.0 ± 13.8 years old, 64.9% female, 29.8% non-White, and 51.7% had incomes ≤$39K with 14.4 ± 2.9 years of education. Psychometric testing produced a 6-item version (GHNT-6). The GHNT-21 and GHNT-6 had acceptable-good internal consistency reliability (KR-20=0.87 vs. 0.77, respectively). Both versions were positively associated with income, education, health literacy, objective numeracy, and subjective numeracy (all p<.001). Furthermore, both versions were associated with participants' understanding of their medications and medication adherence in unadjusted analyses, but only the GHNT-21 was associated with medication understanding in adjusted analyses.
  
  
  CONCLUSIONS
  The GHNT-21 and GHNT-6 are reliable and valid tools for assessing health numeracy.
  
  
  CONCLUSIONS
  Brief, reliable, and valid assessments of health numeracy can assess a patient's numeracy status, and may ultimately help providers and educators tailor education to patients.
authors: Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232-8300, USA. chandra.osborn@vanderbilt.edu
authors: Chandra Y
authors: CY
authors: Osborn
authors: Kenneth A
authors: KA
authors: Wallston
authors: Adam
authors: A
authors: Shpigel
authors: Kerri
authors: K
authors: Cavanaugh
authors: Sunil
authors: S
authors: Kripalani
authors: Russell L
authors: RL
authors: Rothman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004521:Educational Measurement; D005260:Female; D057220:Health Literacy / Q000145:classification*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010865:Pilot Projects; D011594:Psychometrics / Q000295:instrumentation / Q000592:standards*; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D013714:Tennessee; D055815:Young Adult; D016903:Drug Monitoring