title: Tools to measure health literacy among Spanish speakers: An integrative review of the literature.
abstract: OBJECTIVE
  Health literacy measurement can help inform healthcare service delivery. The objective of this study is to identify validated tools to measure health literacy among Spanish speakers and to summarize characteristics that are relevant when selecting tools for use in clinical or research settings.
  
  
  METHODS
  An English and Spanish search of 9 databases was conducted between October 2014 and May 2015. Inclusion criteria were peer-reviewed articles presenting initial validation and psychometric properties of a tool to measure health literacy among Spanish speaking patients. Characteristics relevant to tool selection were reviewed and presented.
  
  
  RESULTS
  Twenty articles validating 19 instruments met inclusion criteria. Instruments were designed for use with Spanish speakers in numerous contexts and measured different health literacy skills such as reading comprehension or numeracy. Methods used to validate tools were inconsistent across instruments.
  
  
  CONCLUSIONS
  Although tools have inconsistencies and inefficiencies, many can be used for assessment of health literacy among Spanish speakers.
  
  
  CONCLUSIONS
  Healthcare providers, organizations, and researchers can use this review to select effective health literacy tools to indicate patient's ability to understand and use health information so that services and materials can be more appropriately tailored to Spanish speaking patients.
authors.affiliation: Columbia University School of Nursing, New York, NY, USA. Electronic address: Slb2201@Cumc.Columbia.edu.
authors.forename: Samantha
authors.initials: S
authors.lastname: Stonbraker
authors.affiliation: Columbia University School of Nursing, New York, NY, USA. Electronic address: Rb897@Cumc.Columbia.edu.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Schnall
authors.affiliation: Columbia University School of Nursing, New York, NY, USA; Mailman School of Public Health, Department of Epidemiology, New York, NY, USA. Electronic address: Ell23@Cumc.Columbia.edu.
authors.forename: Elaine
authors.initials: E
authors.lastname: Larson
keywords: Assessment; Health literacy; Instrument; Integrative review; Measurement; Spanish; Tool