State of the science of health literacy measures: Validity implications for minority populations.
OBJECTIVE
To review the evidence supporting the validity of health literacy (HL) measures for ethnic minority populations.


METHODS
PubMed, CINAHL, and PsycINFO databases were searched for HL measures between 1965 and 2013.


RESULTS
A total of 109HL measures were identified; 37 were non-English HL measures and 72 were English language measures. Of the 72 English language measures, 17 did not specify the racial/ethnic characteristic of their sample. Of the remaining 55 measures, 10 (18%) did not include blacks, 30 (55%) did not include Hispanics, and 35 (64%) did not include Asians in their validation sample. When Hispanic and Asian Americans were included, they accounted for small percentages in the overall sample. Between 2005-2013, a growing number of REALM and TOFHLA translations were identified, and new HL measures for specific cultural/linguistic groups within and outside the United States were developed.


CONCLUSIONS
While there are a growing number of new and translated HL measures for minority populations, many existing HL measures have not been properly validated for minority groups.


CONCLUSIONS
HL measures that have not been properly validated for a given population should be piloted before wider use. In addition, improving HL instrument development/validation methods are imperative to increase the validity of these measures for minority populations.
School of Nursing, Boston College, Chestnut Hill, USA. Electronic address: tam.nguyen@bc.edu.
Tam H
TH
Nguyen
Department of Nursing, Towson University, Towson, USA.
Hyunjeong
H
Park
School of Nursing, Johns Hopkins University, Baltimore, USA.
Hae-Ra
HR
Han
School of Public Health, Johns Hopkins University, Baltimore, USA.
Kitty S
KS
Chan
Boston University School of Medicine, Boston Medical Center, Boston, USA.
Michael K
MK
Paasche-Orlow
Center of Innovation on Disability and Rehabilitation Research, James A. Haley VA Hospital, Tampa, USA; Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, USA.
Jolie
J
Haun
School of Nursing, University of Texas at Austin, Austin, USA.
Miyong T
MT
Kim
Health Literacy; Minority Health; Psychometric; Review