title: Measuring health literacy in caregivers of children: a comparison of the newest vital sign and S-TOFHLA.
abstract: OBJECTIVE
  We examined the performance of the Newest Vital Sign (NVS) and the Short Test of Functional Health Literacy in Adults (S-TOFHLA) in caregivers of children.
  
  
  METHODS
  Caregivers of children ≤12 years old seeking care for their child in a pediatric emergency department (ED) were tested using the NVS and the S-TOFHLA to measure health literacy. The results were compared with ED use outcomes.
  
  
  RESULTS
  The S-TOFHLA was found to have a ceiling effect as compared to the NVS; few caregivers scored in low literacy categories (P < .0001). This finding was demonstrated in both lower (P = .01) and higher (P < .001) educational attainment groups. The NVS was predictive of ED use outcomes (P = .02 and P < .01) whereas the S-TOFHLA was not (P = .21 and P = .11).
  
  
  CONCLUSIONS
  The measures do not seem to function similarly nor predict health outcomes equally. The NVS demonstrates sensitivity in identifying limited health literacy in younger adult populations.
authors.affiliation: Medical College of Wisconsin, Milwaukee, WI, USA akmorris@mcw.edu.
authors.forename: Andrea K
authors.initials: AK
authors.lastname: Morrison
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Marilyn M
authors.initials: MM
authors.lastname: Schapira
authors.affiliation: Children's Hospital of Wisconsin/Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Raymond G
authors.initials: RG
authors.lastname: Hoffmann
authors.affiliation: Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Brousseau
mesh_terms: D000328:Adult; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004521:Educational Measurement; D005260:Female; D057220:Health Literacy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D014481:United States
keywords: Newest Vital Sign; Test of Functional Health Literacy in Adults; child; health literacy; infant; preschool