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A shortened instrument for literacy screening

Abstract

The Rapid Estimate of Adult Literacy in Medicine (REALM-R), a new 8-item instrument designed to rapidly screen patients for potential health literacy problems, was administered to 157 patients. The REALM-R was correlated with Wide Range Achievement Test-Revised (WRAT-R) (.64) and demonstrated a Cronbach’s α of 0.91. The REALM-R identified 26 of 30 persons scoring more than 1 standard deviation below the mean on the WRAT-R, corresponding to a sixth grade reading level. The REALM-R identified a substantial number of people who scored poorly on the WRAT-R, and depending on further studies of validity and reliability, may offer a practical approach to identify patients at risk for health literacy problems in a clinical setting.

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References

  1. Kirsh I, Jungenlut A, Jenjins L. Adult Literacy in America: A First Look at the Findings of the National Adult Literacy Survey. Washington, DC: National Center for Education Statistics, US Department of Education; 1993.

    Google Scholar 

  2. Williams MV, Baker DW, Parker RM, Nurss JR. Relationship of functional health literacy to patients’ knowledge of their chronic disease: a study of patients with hypertension and diabetes. Arch Intern Med. 1998;158:166–72.

    PubMed  Article  CAS  Google Scholar 

  3. Williams MV, Baker DW, Honig EG, Lee TM, Nowlan A. Inadequate literacy is a barrier to asthma knowledge and self care. Chest. 1998;114:1008–15.

    PubMed  CAS  Google Scholar 

  4. Baker DW, Parker RM, Clark WS, Nurss JR. The relationship of patient reading ability to self-reported health and use of health services. Am J Public Health. 1997;87:1027–30.

    PubMed  CAS  Article  Google Scholar 

  5. Grosse RN, Auffrey C. Literacy and health status in developing countries. Annu Rev Public Health. 1989;10:281–97.

    PubMed  Article  CAS  Google Scholar 

  6. Weiss BD, Hart G, McGee DL, D’Estelle S. Health status of illiterate adults: relation between literacy and health status among persons with low literacy skills. J Am Board Fam Pract. 1992;5:257–64.

    PubMed  CAS  Google Scholar 

  7. Davis TC, Crouch MA, Long SW, et al. Rapid assessment literacy levels in adult primary care patients. Fam Med. 1991;23:433–5.

    PubMed  CAS  Google Scholar 

  8. Davis TC, Crouch MA, Wills G, Abdehou D. The gap between patient reading comprehension and the readability of patient education materials. J Fam Pract. 1990;31:533–8.

    PubMed  CAS  Google Scholar 

  9. Jackson RH, Davis TC, Bairnsfather LE, George RB, Crouch MA. Patient reading ability: an overlooked problem in health care. South Med J. 1991;84:1172–5.

    PubMed  Article  CAS  Google Scholar 

  10. Murphy PW, Davis TC, Decker B, Arnold C, Jackson RH. Rapid estimate of adult literacy in medicine: using a novel reading recognition test. J Reading. 1993;37:124–30.

    Google Scholar 

  11. Slosson R. Slosson Oral Reading Tests-Revised. East Aurora, NY: Slosson Educational Publishers; 1990.

    Google Scholar 

  12. Davis TC, Long SW, Jackson RH, et al. Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med. 1993;25:391–5.

    PubMed  CAS  Google Scholar 

  13. Jastak S, Wilkinson GS. Wide Range Achievement Test—Revised 3. Wilmington, DE: Jastak Associates; 1993.

    Google Scholar 

  14. Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults (TOFHLA): a new instrument for measuring patients’ literacy skills. J Gen Intern Med. 1995;10:537–45.

    PubMed  CAS  Google Scholar 

  15. Anastasi A. Psychological testing. In: Anastasi A, ed. New York: Macmillan; 1988.

    Google Scholar 

  16. Doak C, Doak L, Root J. Teaching Patients with Low Literacy Skills. Philadelphia: Lippincott; 1985.

    Google Scholar 

  17. Davis TC, Michielutte R, Askov EN, Williams MV, Weiss BD. Practical assessment of adult literacy in health care. Health Educ Behav. 1998;25:613–24.

    PubMed  Article  CAS  Google Scholar 

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Correspondence to Pat F. Bass III MD, MS.

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Bass, P.F., Wilson, J.F. & Griffith, C.H. A shortened instrument for literacy screening. J GEN INTERN MED 18, 1036–1038 (2003). https://doi.org/10.1111/j.1525-1497.2003.10651.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2003.10651.x

Key words

  • health literacy
  • screening
  • reading level