title: Clinical utility of a brief screen for health literacy and numeracy among adults with diabetes mellitus.
abstract: OBJECTIVE
  Our objectives were to (1) compare Newest Vital Sign (NVS) scores and administration characteristics with the short (S) version of the Test of Functional Health Literacy in Adults (S-TOFHLA) and Spoken Knowledge in Low-Literacy Diabetes (SKILLD) tool and (2) gather information from research assistants (RAs) regarding their perceptions of patient understanding of NVS items.
  
  
  METHODS
  Adults, age ? 18 years, with diabetes mellitus visiting a primary care clinic were recruited to participate. An RA orally administered a sociodemographic questionnaire. Patients completed, in random order, the NVS, S-TOFHLA, and SKILLD. Completion time for each tool was electronically recorded, while patients assessed tool difficulty using a 5-point Likert-type scale. RAs' comments regarding patients' understanding of individual NVS items were tallied.
  
  
  RESULTS
  A total of 226 patients (mean age=53.8 years, 31% male, 45.1% African American, 28.8% high school graduate) participated. African Americans were significantly less likely to score ?4 on the NVS (adjusted OR=0.23, 95% CI=0.13, 0.42) as compared to Caucasians. NVS scores were highly correlated with S-TOFHLA scores, rho=0.62, and moderately correlated with SKILLD scores, rho=0.39. NVS scores were inversely correlated with completion time, rho=-0.25 and difficulty rating, rho=-0.37.
  
  
  CONCLUSIONS
  Related to the care of patients with diabetes, the most important feature of the NVS is that it can quickly provide a clinician with valuable insight regarding their patients' ability to complete a practical skill (ie, interpreting a food label) needed to achieve tight blood glucose control.
authors.affiliation: Department of Family Medicine, Ohio State University, Columbus, OH 43201, USA. miser.6@osu.edu
authors.forename: William F
authors.initials: WF
authors.lastname: Miser
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Jeppesen
authors.forename: Lorraine S
authors.initials: LS
authors.lastname: Wallace
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D001294:Attitude to Health / Q000208:ethnology*; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000628:therapy; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011795:Surveys and Questionnaires / Q000592:standards*; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult