title: Administration of the Rapid Estimate of Adult Literacy in Medicine Via Telephone.
abstract: OBJECTIVE
  Over a third of adults in the United States have limited health literacy, which has been associated with numerous negative health outcomes and high health care costs. Most commonly used, objective measures of patients' literacy skills have traditionally been administered in person. This study assessed the feasibility of administering the Rapid Estimate of Adult Literacy in Medicine (REALM) via telephone.
  
  
  METHODS
  A total of 119 participants were recruited after participating in a separate study where the REALM was administered in person. After approximately 1 week, patients were sent copies of the REALM prompt via mail and, when provided, email. A research assistant called participants approximately 1 week later to determine if the REALM had been received and could be accessed for use during the call. Multiple attempts to reach participants were made; 84 participants were able to successfully complete the study, yielding a response rate of 70.6%. The REALM was then administered over the phone, and results were compared with the scores from the in-person administration.
  
  
  RESULTS
  There was a high correlation between both assessments (Spearman=0.85). The agreement between literacy categories (low, marginal, and adequate) between the in-person and telephone-based assessments was also high at 84.5% (kappa=0.72). Participants who completed the study were older than participants who did not complete the study, more likely to be white, and less likely to be currently working.
  
  
  CONCLUSIONS
  The findings from this study indicate the REALM can be administered over the phone, providing alternative methodologies for literacy assessments in future studies.
authors.affiliation: Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Vitko
authors.forename: Autumn
authors.initials: A
authors.lastname: Locklear
authors.forename: Izabela E
authors.initials: IE
authors.lastname: Annis
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Reuland
authors.forename: Betsy L
authors.initials: BL
authors.lastname: Sleath
authors.forename: Michael S
authors.initials: MS
authors.lastname: Wolf
authors.forename: Stacy Cooper
authors.initials: SC
authors.lastname: Bailey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D057220:Health Literacy; D006801:Humans; D007407:Interviews as Topic / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D014481:United States