title: Validity of Single-Item Screening for Limited Health Literacy in English and Spanish Speakers.
abstract: OBJECTIVE
  To evaluate 3 single-item screening measures for limited health literacy in a community-based population of English and Spanish speakers.
  
  
  METHODS
  We recruited 324 English and 314 Spanish speakers from a community research registry in Dallas, Texas, enrolled between 2009 and 2012. We used 3 screening measures: (1) How would you rate your ability to read?; (2) How confident are you filling out medical forms by yourself?; and (3) How often do you have someone help you read hospital materials? In analyses stratified by language, we used area under the receiver operating characteristic (AUROC) curves to compare each item with the validated 40-item Short Test of Functional Health Literacy in Adults.
  
  
  RESULTS
  For English speakers, no difference was seen among the items. For Spanish speakers, "ability to read" identified inadequate literacy better than "help reading hospital materials" (AUROC curve = 0.76 vs 0.65; P = .019).
  
  
  CONCLUSIONS
  The "ability to read" item performed the best, supporting use as a screening tool in safety-net systems caring for diverse populations. Future studies should investigate how to implement brief measures in safety-net settings and whether highlighting health literacy level influences providers' communication practices and patient outcomes.
authors.affiliation: Wendy Pechero Bishop, Simon J. Craddock Lee, Celette Sugg Skinner, and Jasmin A. Tiro are with Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, and Harold C. Simmons Comprehensive Cancer Center, Dallas. Tiffany M. Jones is with the School of Public Health, University of Texas Health Science Center at Houston. Katharine McCallister is with Department of Clinical Sciences, UT Southwestern Medical Center.
authors.forename: Wendy Pechero
authors.initials: WP
authors.lastname: Bishop
authors.affiliation: Wendy Pechero Bishop, Simon J. Craddock Lee, Celette Sugg Skinner, and Jasmin A. Tiro are with Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, and Harold C. Simmons Comprehensive Cancer Center, Dallas. Tiffany M. Jones is with the School of Public Health, University of Texas Health Science Center at Houston. Katharine McCallister is with Department of Clinical Sciences, UT Southwestern Medical Center.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Craddock Lee
authors.affiliation: Wendy Pechero Bishop, Simon J. Craddock Lee, Celette Sugg Skinner, and Jasmin A. Tiro are with Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, and Harold C. Simmons Comprehensive Cancer Center, Dallas. Tiffany M. Jones is with the School of Public Health, University of Texas Health Science Center at Houston. Katharine McCallister is with Department of Clinical Sciences, UT Southwestern Medical Center.
authors.forename: Celette Sugg
authors.initials: CS
authors.lastname: Skinner
authors.affiliation: Wendy Pechero Bishop, Simon J. Craddock Lee, Celette Sugg Skinner, and Jasmin A. Tiro are with Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, and Harold C. Simmons Comprehensive Cancer Center, Dallas. Tiffany M. Jones is with the School of Public Health, University of Texas Health Science Center at Houston. Katharine McCallister is with Department of Clinical Sciences, UT Southwestern Medical Center.
authors.forename: Tiffany M
authors.initials: TM
authors.lastname: Jones
authors.affiliation: Wendy Pechero Bishop, Simon J. Craddock Lee, Celette Sugg Skinner, and Jasmin A. Tiro are with Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, and Harold C. Simmons Comprehensive Cancer Center, Dallas. Tiffany M. Jones is with the School of Public Health, University of Texas Health Science Center at Houston. Katharine McCallister is with Department of Clinical Sciences, UT Southwestern Medical Center.
authors.forename: Katharine
authors.initials: K
authors.lastname: McCallister
authors.affiliation: Wendy Pechero Bishop, Simon J. Craddock Lee, Celette Sugg Skinner, and Jasmin A. Tiro are with Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, and Harold C. Simmons Comprehensive Cancer Center, Dallas. Tiffany M. Jones is with the School of Public Health, University of Texas Health Science Center at Houston. Katharine McCallister is with Department of Clinical Sciences, UT Southwestern Medical Center.
authors.forename: Jasmin A
authors.initials: JA
authors.lastname: Tiro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D057220:Health Literacy / Q000706:statistics & numerical data*; D006630:Hispanic or Latino; D006801:Humans; D007802:Language; D000067010:Literacy; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D013781:Texas; D055815:Young Adult