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Validation of Screening Questions for Limited Health Literacy in a Large VA Outpatient Population
Objectives Previous studies have shown that a single question may identify individuals with inadequate health literacy. We evaluated and compared the performance of 3 health literacy screening questions for detecting patients with inadequate or marginal health literacy in a large VA population. Meth...
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| Published in: | Journal of general internal medicine : JGIM 2008-05, Vol.23 (5), p.561-566 |
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| container_issue | 5 |
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| container_title | Journal of general internal medicine : JGIM |
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| creator | Chew, Lisa D. Griffin, Joan M. Partin, Melissa R. Noorbaloochi, Siamak Grill, Joseph P. Snyder, Annamay Bradley, Katharine A. Nugent, Sean M. Baines, Alisha D. VanRyn, Michelle |
| description | Objectives
Previous studies have shown that a single question may identify individuals with inadequate health literacy. We evaluated and compared the performance of 3 health literacy screening questions for detecting patients with inadequate or marginal health literacy in a large VA population.
Methods
We conducted in-person interviews among a random sample of patients from 4 VA medical centers that included 3 health literacy screening questions and 2 validated health literacy measures. Patients were classified as having inadequate, marginal, or adequate health literacy based on the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Rapid Estimate of Adult Literacy in Medicine (REALM). We evaluated the ability of each of 3 questions to detect: 1) inadequate and the combination of “inadequate or marginal” health literacy based on the S-TOFHLA and 2) inadequate and the combination of “inadequate or marginal” health literacy based on the REALM.
Measurements and Main Results
Of 4,384 patients, 1,796 (41%) completed interviews. The prevalences of inadequate health literacy were 6.8% and 4.2%, based on the S-TOHFLA and REALM, respectively. Comparable prevalences for marginal health literacy were 7.4% and 17%, respectively. For detecting inadequate health literacy, “How confident are you filling out medical forms by yourself?” had the largest area under the Receiver Operating Characteristic Curve (AUROC) of 0.74 (95% CI: 0.69–0.79) and 0.84 (95% CI: 0.79–0.89) based on the S-TOFHLA and REALM, respectively. AUROCs were lower for detecting “inadequate or marginal” health literacy than for detecting inadequate health literacy for each of the 3 questions.
Conclusion
A single question may be useful for detecting patients with inadequate health literacy in a VA population. |
| doi_str_mv | 10.1007/s11606-008-0520-5 |
| format | article |
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Previous studies have shown that a single question may identify individuals with inadequate health literacy. We evaluated and compared the performance of 3 health literacy screening questions for detecting patients with inadequate or marginal health literacy in a large VA population.
Methods
We conducted in-person interviews among a random sample of patients from 4 VA medical centers that included 3 health literacy screening questions and 2 validated health literacy measures. Patients were classified as having inadequate, marginal, or adequate health literacy based on the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Rapid Estimate of Adult Literacy in Medicine (REALM). We evaluated the ability of each of 3 questions to detect: 1) inadequate and the combination of “inadequate or marginal” health literacy based on the S-TOFHLA and 2) inadequate and the combination of “inadequate or marginal” health literacy based on the REALM.
Measurements and Main Results
Of 4,384 patients, 1,796 (41%) completed interviews. The prevalences of inadequate health literacy were 6.8% and 4.2%, based on the S-TOHFLA and REALM, respectively. Comparable prevalences for marginal health literacy were 7.4% and 17%, respectively. For detecting inadequate health literacy, “How confident are you filling out medical forms by yourself?” had the largest area under the Receiver Operating Characteristic Curve (AUROC) of 0.74 (95% CI: 0.69–0.79) and 0.84 (95% CI: 0.79–0.89) based on the S-TOFHLA and REALM, respectively. AUROCs were lower for detecting “inadequate or marginal” health literacy than for detecting inadequate health literacy for each of the 3 questions.
Conclusion
A single question may be useful for detecting patients with inadequate health literacy in a VA population.</description><identifier>ISSN: 0884-8734</identifier><identifier>EISSN: 1525-1497</identifier><identifier>DOI: 10.1007/s11606-008-0520-5</identifier><identifier>PMID: 18335281</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Aged ; Biological and medical sciences ; Chemical Sciences ; Educational Status ; Female ; General aspects ; Health Knowledge, Attitudes, Practice ; Hospitals, Veterans ; Humans ; Internal Medicine ; Interviews as Topic ; Male ; Medical sciences ; Medical screening ; Medicine ; Medicine & Public Health ; Middle Aged ; Miscellaneous ; Organic chemistry ; Original ; Original Article ; Outpatient care facilities ; Prevention and actions ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Questionnaires ; ROC Curve ; Surveys and Questionnaires ; United States ; Veterans</subject><ispartof>Journal of general internal medicine : JGIM, 2008-05, Vol.23 (5), p.561-566</ispartof><rights>Society of General Internal Medicine 2008</rights><rights>2008 INIST-CNRS</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c597t-2b127778bce0b668197f7987c9a3adbf206d45960b936742905f976a9842afb3</citedby><cites>FETCH-LOGICAL-c597t-2b127778bce0b668197f7987c9a3adbf206d45960b936742905f976a9842afb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2324160/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2324160/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20448065$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18335281$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-00815952$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Chew, Lisa D.</creatorcontrib><creatorcontrib>Griffin, Joan M.</creatorcontrib><creatorcontrib>Partin, Melissa R.</creatorcontrib><creatorcontrib>Noorbaloochi, Siamak</creatorcontrib><creatorcontrib>Grill, Joseph P.</creatorcontrib><creatorcontrib>Snyder, Annamay</creatorcontrib><creatorcontrib>Bradley, Katharine A.</creatorcontrib><creatorcontrib>Nugent, Sean M.</creatorcontrib><creatorcontrib>Baines, Alisha D.</creatorcontrib><creatorcontrib>VanRyn, Michelle</creatorcontrib><title>Validation of Screening Questions for Limited Health Literacy in a Large VA Outpatient Population</title><title>Journal of general internal medicine : JGIM</title><addtitle>J GEN INTERN MED</addtitle><addtitle>J Gen Intern Med</addtitle><description>Objectives
Previous studies have shown that a single question may identify individuals with inadequate health literacy. We evaluated and compared the performance of 3 health literacy screening questions for detecting patients with inadequate or marginal health literacy in a large VA population.
Methods
We conducted in-person interviews among a random sample of patients from 4 VA medical centers that included 3 health literacy screening questions and 2 validated health literacy measures. Patients were classified as having inadequate, marginal, or adequate health literacy based on the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Rapid Estimate of Adult Literacy in Medicine (REALM). We evaluated the ability of each of 3 questions to detect: 1) inadequate and the combination of “inadequate or marginal” health literacy based on the S-TOFHLA and 2) inadequate and the combination of “inadequate or marginal” health literacy based on the REALM.
Measurements and Main Results
Of 4,384 patients, 1,796 (41%) completed interviews. The prevalences of inadequate health literacy were 6.8% and 4.2%, based on the S-TOHFLA and REALM, respectively. Comparable prevalences for marginal health literacy were 7.4% and 17%, respectively. For detecting inadequate health literacy, “How confident are you filling out medical forms by yourself?” had the largest area under the Receiver Operating Characteristic Curve (AUROC) of 0.74 (95% CI: 0.69–0.79) and 0.84 (95% CI: 0.79–0.89) based on the S-TOFHLA and REALM, respectively. AUROCs were lower for detecting “inadequate or marginal” health literacy than for detecting inadequate health literacy for each of the 3 questions.
Conclusion
A single question may be useful for detecting patients with inadequate health literacy in a VA population.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Chemical Sciences</subject><subject>Educational Status</subject><subject>Female</subject><subject>General aspects</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Hospitals, Veterans</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Interviews as Topic</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medical screening</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Organic chemistry</subject><subject>Original</subject><subject>Original Article</subject><subject>Outpatient care facilities</subject><subject>Prevention and actions</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Questionnaires</subject><subject>ROC Curve</subject><subject>Surveys and Questionnaires</subject><subject>United States</subject><subject>Veterans</subject><issn>0884-8734</issn><issn>1525-1497</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><recordid>eNp1kV9rFDEUxYModlv9AL5IEBR8GE0y-ftSWIp1hYEqlr6GTCazmzKbrMlMod_ejLO0WvApJPd3z705B4A3GH3CCInPGWOOeIWQrBAjqGLPwAozwipMlXgOVkhKWklR0xNwmvMtQrgmRL4EJ1jWNSMSr4C5MYPvzOhjgLGHP21yLviwhT8ml-fXDPuYYOP3fnQd3DgzjLtyHV0y9h76AA1sTNo6eLOGV9N4KFIujPB7PEzDH9lX4EVvhuxeH88zcH355fpiUzVXX79drJvKMiXGirSYCCFkax1qOZdYiV4oKawytenaniDeUaY4alXNBSUKsV4JbpSkxPRtfQbOF9nD1O5dZ8sSyQz6kPzepHsdjdf_VoLf6W2806QmtNhYBD4uArsnbZt1o-e3YjNmipE7XNgPx2Ep_pqN0nufrRsGE1ycsuYKE4XxLPruCXgbpxSKD1oKxiWTihYIL5BNMefk-ofxGOk5aL0EPW-g56A1Kz1v__7uY8cx2QK8PwImWzP0yQTr8wNHEKUS8VmILFwupbB16XHD_0__DeVwvzk</recordid><startdate>20080501</startdate><enddate>20080501</enddate><creator>Chew, Lisa D.</creator><creator>Griffin, Joan M.</creator><creator>Partin, Melissa R.</creator><creator>Noorbaloochi, Siamak</creator><creator>Grill, Joseph P.</creator><creator>Snyder, Annamay</creator><creator>Bradley, Katharine A.</creator><creator>Nugent, Sean M.</creator><creator>Baines, Alisha D.</creator><creator>VanRyn, Michelle</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><general>Springer Verlag</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>RC3</scope><scope>7X8</scope><scope>1XC</scope><scope>5PM</scope></search><sort><creationdate>20080501</creationdate><title>Validation of Screening Questions for Limited Health Literacy in a Large VA Outpatient Population</title><author>Chew, Lisa D. ; Griffin, Joan M. ; Partin, Melissa R. ; Noorbaloochi, Siamak ; Grill, Joseph P. ; Snyder, Annamay ; Bradley, Katharine A. ; Nugent, Sean M. ; Baines, Alisha D. ; VanRyn, Michelle</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c597t-2b127778bce0b668197f7987c9a3adbf206d45960b936742905f976a9842afb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Chemical Sciences</topic><topic>Educational Status</topic><topic>Female</topic><topic>General aspects</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Hospitals, Veterans</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Interviews as Topic</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medical screening</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Organic chemistry</topic><topic>Original</topic><topic>Original Article</topic><topic>Outpatient care facilities</topic><topic>Prevention and actions</topic><topic>Public health. 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Previous studies have shown that a single question may identify individuals with inadequate health literacy. We evaluated and compared the performance of 3 health literacy screening questions for detecting patients with inadequate or marginal health literacy in a large VA population.
Methods
We conducted in-person interviews among a random sample of patients from 4 VA medical centers that included 3 health literacy screening questions and 2 validated health literacy measures. Patients were classified as having inadequate, marginal, or adequate health literacy based on the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Rapid Estimate of Adult Literacy in Medicine (REALM). We evaluated the ability of each of 3 questions to detect: 1) inadequate and the combination of “inadequate or marginal” health literacy based on the S-TOFHLA and 2) inadequate and the combination of “inadequate or marginal” health literacy based on the REALM.
Measurements and Main Results
Of 4,384 patients, 1,796 (41%) completed interviews. The prevalences of inadequate health literacy were 6.8% and 4.2%, based on the S-TOHFLA and REALM, respectively. Comparable prevalences for marginal health literacy were 7.4% and 17%, respectively. For detecting inadequate health literacy, “How confident are you filling out medical forms by yourself?” had the largest area under the Receiver Operating Characteristic Curve (AUROC) of 0.74 (95% CI: 0.69–0.79) and 0.84 (95% CI: 0.79–0.89) based on the S-TOFHLA and REALM, respectively. AUROCs were lower for detecting “inadequate or marginal” health literacy than for detecting inadequate health literacy for each of the 3 questions.
Conclusion
A single question may be useful for detecting patients with inadequate health literacy in a VA population.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>18335281</pmid><doi>10.1007/s11606-008-0520-5</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0884-8734 |
| ispartof | Journal of general internal medicine : JGIM, 2008-05, Vol.23 (5), p.561-566 |
| issn | 0884-8734 1525-1497 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2324160 |
| source | PubMed Central（OA）; Springer Nature |
| subjects | Aged Biological and medical sciences Chemical Sciences Educational Status Female General aspects Health Knowledge, Attitudes, Practice Hospitals, Veterans Humans Internal Medicine Interviews as Topic Male Medical sciences Medical screening Medicine Medicine & Public Health Middle Aged Miscellaneous Organic chemistry Original Original Article Outpatient care facilities Prevention and actions Public health. Hygiene Public health. Hygiene-occupational medicine Questionnaires ROC Curve Surveys and Questionnaires United States Veterans |
| title | Validation of Screening Questions for Limited Health Literacy in a Large VA Outpatient Population |
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