title: Optimal health literacy measurement for the clinical setting: A systematic review.
abstract: OBJECTIVE
  To identify the optimal measurement instrument for assessing health literacy in a clinical setting.
  
  
  METHODS
  Seven databases were searched for studies evaluating health literacy instruments used with patients. Standardised systematic review methods were used by two reviewers independently assessing eligibility, extracting data and evaluating study quality. A narrative summary was produced.
  
  
  RESULTS
  The searches identified 626 articles of which 64 were eligible. Forty-three different health literacy instruments were identified. The quality of these instruments, based on their psychometric properties, varied considerably. The majority of health literacy instruments were found to only assess communicative health literacy of which the numeracy element was often not represented. The NVS instrument was found to be the most practical health literacy instrument to use.
  
  
  CONCLUSIONS
  There is an urgent need to develop and psychometrically test a more encompassing health literacy instrument applicable in clinical settings as well as health promotion in general.
  
  
  CONCLUSIONS
  In the absence of a more comprehensive health literacy instrument, the NVS is a practical instrument to quickly assess for health literacy in a clinical setting.
authors.affiliation: University of East Anglia, School of Pharmacy, Norwich Research Park, Norwich, UK. Electronic address: p.duell@uea.ac.uk.
authors.forename: Paul
authors.initials: P
authors.lastname: Duell
authors.affiliation: University of East Anglia, School of Pharmacy, Norwich Research Park, Norwich, UK.
authors.forename: David
authors.initials: D
authors.lastname: Wright
authors.affiliation: School of Social Sciences and Psychology, University of Western Sydney, Sydney, Australia.
authors.forename: Andre M N
authors.initials: AM
authors.lastname: Renzaho
authors.affiliation: University of East Anglia, School of Pharmacy, Norwich Research Park, Norwich, UK.
authors.forename: Debi
authors.initials: D
authors.lastname: Bhattacharya
mesh_terms: D016208:Databases, Factual; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D005791:Patient Care; D011594:Psychometrics
keywords: Health literacy