PMID- 22092896
OWN - NLM
STAT- MEDLINE
DCOM- 20120329
LR  - 20220318
IS  - 1553-2712 (Electronic)
IS  - 1069-6563 (Print)
IS  - 1069-6563 (Linking)
VI  - 18
IP  - 11
DP  - 2011 Nov
TI  - Short, subjective measures of numeracy and general health literacy in an adult 
      emergency department.
PG  - 1148-55
LID - 10.1111/j.1553-2712.2011.01210.x [doi]
AB  - OBJECTIVES: The objective was to evaluate the reliability and validity of brief 
      subjective measures of numeracy and general health literacy in the adult 
      emergency department (ED) setting. METHODS: A convenience sample of adult ED 
      patients completed subjective measures of general health literacy (Short Literacy 
      Survey [SLS]) and numeracy (Subjective Numeracy Scale [SNS]). These patients also 
      completed two objective tests of literacy (the Short Test of Functional Health 
      Literacy in Adults [S-TOFHLA] and the Rapid Estimate of Adult Literacy in 
      Medicine [REALM]) and an objective test of numeracy (Wide Range Achievement 
      Test-4 [WRAT4]). Internal reliability of the subjective measures was assessed 
      using Cronbach's alpha. Construct validity of the subjective measures was 
      assessed by correlating them against the S-TOFHLA, REALM, and WRAT4, using 
      Spearman's rank correlation coefficients, receiver operating characteristics 
      (ROC) curves, and hierarchical, multiple linear regression with adjustment for 
      patient age, sex, race, and education. RESULTS: The median age of the 207 
      patients surveyed was 46 years (interquartile range [IQR] = 32 to 59 years); 27% 
      were African American. Sixty-one percent of patients reported that their highest 
      level of education was high school or below. As measured by the S-TOFHLA and 
      REALM, most patients had adequate literacy levels (89% and 80%, respectively), 
      while 44% of patients had below average numeracy skills on the WRAT4. The median 
      SLS score was 14 (IQR = 12 to 15) on a scale of 3 to 15; the median SNS score was 
      36 (IQR = 30 to 42) on a scale of 6 to 48. The SLS and SNS had good internal 
      reliability, with Cronbach's alphas of 0.74 and 0.82, respectively. The SLS 
      Spearman's rank order correlation coefficient was 0.33 (95% confidence interval 
      [CI] = 0.20 to 0.45) for the S-TOFHLA, with a standardized beta coefficient of 
      0.36 (p < 0.05) after adjustment for patient demographics. The SLS correlation 
      coefficient was 0.26 (95% CI = 0.13 to 0.38) for the REALM, with a standardized 
      beta coefficient of 0.38 (p < 0.05) after adjustment for patient demographics. 
      The area under the ROC curve (AUC) for the SLS was 0.74 (95% CI = 0.68 to 0.80) 
      when compared to the S-TOFHLA and 0.72 (95% CI = 0.65 to 0.78) when compared to 
      the REALM. The SNS predicted numeracy well, with a correlation coefficient of 
      0.57 (95% CI = 0.47 to 0.65) for the WRAT4, a standardized beta coefficient of 
      0.30 (p < 0.05) after adjustment for patient demographics, and an AUC of 0.77 
      (95% CI = 0.70 to 0.82). CONCLUSIONS: The SNS and SLS are reliable, valid tests 
      that can be used to rapidly estimate general health literacy and numeracy skill 
      levels in adult ED patients. Continuing work is needed to establish their ability 
      to predict clinical outcomes.
CI  - (c) 2011 by the Society for Academic Emergency Medicine.
FAU - McNaughton, Candace
AU  - McNaughton C
AD  - Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. 
      candace.mcnaughton@vanderbilt.edu
FAU - Wallston, Kenneth A
AU  - Wallston KA
FAU - Rothman, Russell L
AU  - Rothman RL
FAU - Marcovitz, David E
AU  - Marcovitz DE
FAU - Storrow, Alan B
AU  - Storrow AB
LA  - eng
GR  - K12 HL109019/HL/NHLBI NIH HHS/United States
GR  - UL1 RR024975/RR/NCRR NIH HHS/United States
GR  - 1 UL1 RR024975/RR/NCRR NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - United States
TA  - Acad Emerg Med
JT  - Academic emergency medicine : official journal of the Society for Academic 
      Emergency Medicine
JID - 9418450
SB  - IM
MH  - Adult
MH  - Area Under Curve
MH  - Emergency Service, Hospital
MH  - Female
MH  - *Health Literacy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - ROC Curve
MH  - Reproducibility of Results
PMC - PMC3886121
MID - NIHMS531086
EDAT- 2011/11/19 06:00
MHDA- 2012/03/30 06:00
PMCR- 2014/01/09
CRDT- 2011/11/19 06:00
PHST- 2011/11/19 06:00 [entrez]
PHST- 2011/11/19 06:00 [pubmed]
PHST- 2012/03/30 06:00 [medline]
PHST- 2014/01/09 00:00 [pmc-release]
AID - 10.1111/j.1553-2712.2011.01210.x [doi]
PST - ppublish
SO  - Acad Emerg Med. 2011 Nov;18(11):1148-55. doi: 10.1111/j.1553-2712.2011.01210.x.