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A shortened instrument for literacy screening

Journal of General Internal Medicine volume 18, pages 1036–1038 (2003)Cite this article

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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Author information

Authors and Affiliations

  1. the Department of Internal Medicine, University of Kentucky, Louisville, Ky

    John F. Wilson PhD

  2. Department of Behavioral Science, University of Kentucky, Louisville, Ky

    Charles H. Griffith MD

  3. Department of Internal Medicine, LSUHSC—Shreveport, 1501 King’s Highway, PO Box 33932, 71130-3932, Shreveport, LA

    Pat F. Bass III MD, MS

Authors
  1. Pat F. Bass III MD, MS
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  2. John F. Wilson PhD
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  3. Charles H. Griffith MD
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Corresponding author

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