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Toward a Framework for Understanding Embodied Health Literacy

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Cognitive Informatics in Health and Biomedicine

Part of the book series: Health Informatics ((HI))

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Abstract

This chapter addresses issues regarding the conceptualization of health literacy and its measurement from an embodied cognitive perspective. We also present a critical analysis of some aspects of health literacy research, while calling for a realist approach to the design of cognitive assessments that addresses the various abilities underlying health literacy and numeracy, which may better represent the actual processes involved in the comprehension of health information. While health information is ubiquitous in modern society, it is often not easily comprehensible given the literacy abilities of the general population. Health information and health literacy have been researched in isolation of each other, when in actuality, they are two faces of the same coin. It is important to investigate them together, but current assessments treat them separately using tools that do not take into account the complexity of the process of health information understanding. Furthermore, these two components are studied by means of abstract, variable-based models that often obscure the embodied nature of health information and its understanding. Although most researchers in these fields are aware of the limitations of the models and current tools to investigate health information and literacy, an embodied approach to health literacy is still needed to complement the traditional variable-based approach. The process of comprehension of health information is complex, requiring investigation at the microlevel to uncover its component processes. An embodied approach, however, would benefit from a realist philosophy that may serve to provide an epistemological framework for guiding research.

The first principle is that you must not fool yourself, and you are the easiest person to fool

—Richard P. Feynman, Cargo Cult Science, 1974

Much of the fascination of statistics lies embedded in our gut feeling—and never trust a gut feeling—that abstract measures summarizing large tables of data must express something more real and fundamental than the data themselves

—Stephen Jay Gould, The Mismeasure of Man, 1981

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References

  • ABC Canada Literacy Foundation. International Adult Literacy and Skills Survey (IALSS): report summary. Toronto, ON: ABC Canada; 2005.

    Google Scholar 

  • Acree M. Theories of statistical inference in psychological research: a historico-critical study [dissertation]. Worcerster, MA: Clark University; 1978.

    Google Scholar 

  • Altin SV, Finke I, Kautz-Freimuth S, Stock S. The evolution of health literacy assessment tools: a systematic review. BMC Public Health. 2014;14:1207.

    Article  PubMed  PubMed Central  Google Scholar 

  • Arocha JF, Patel VL. Novice diagnostic reasoning in medicine: accounting for evidence. J Learn Sci. 1995;4:355–84.

    Article  Google Scholar 

  • Arocha JF, Wang D, Patel VL. Identifying reasoning strategies in medical decision making: a methodological guide. J Biomed Inform. 2005;38:154–71.

    Article  PubMed  Google Scholar 

  • Baker D. The meaning and the measure of health literacy. J Gen Intern Med. 2006;21:878–83.

    Article  PubMed  PubMed Central  Google Scholar 

  • Baker D, Williams M, Parker R, Gazmararian J, Nurss J. Development of a brief test to measure functional health literacy. Patient Educ Couns. 1999;38:33–42.

    Article  CAS  PubMed  Google Scholar 

  • Berger JO, Sellke T. Testing a point null hypothesis: the irreconcilability of p values and evidence. J Am Stat Assoc. 1987;82:112–22.

    Google Scholar 

  • Berka K. Measurement: its concepts, theories, and problems. Dordrecht: D. Reidel; 1983.

    Google Scholar 

  • Berland GK, Elliott MN, Morales LS, et al. Health information on the internet: accessibility, quality, and readability in English and Spanish. JAMA. 2001;285:2612–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Borsboom D. Measuring the mind: conceptual issues in contemporary psychometrics. Cambridge, NY: Cambridge University Press; 2005. p. viii, 185.

    Book  Google Scholar 

  • Botash AS, Galloway AE, Booth T, Ploutz-snyder R, Hoffman-Rosenfeld J, Cahill L. Continuing medical education in child sexual abuse: cognitive gains but not expertise. Arch Pediatr Adolesc Med. 2005;159:561–6.

    Article  PubMed  Google Scholar 

  • Bransford JD, Johnson MK. Contextual prerequisites for understanding: some investigations of comprehension and recall. J Verbal Learn Verbal Behav. 1972;11:717–26.

    Article  Google Scholar 

  • Brigo F, Otte WM, Igwe SC, Tezzon F, Nardone R. Clearly written, easily comprehended? The readability of websites providing information on epilepsy. Epilepsy Behav. 2015;44:35–9.

    Article  PubMed  Google Scholar 

  • Bunge M. On confusing ‘measure’ with ‘measurement’ in the methodology of behavioral science. In: Bunge M, editor. The methodological unity of science. Dordretch: D. Reidel; 1973. p. 105–22.

    Google Scholar 

  • Bunge M. Semantics: sense and reference. Dordrecht: Reidel; 1974. p. xii, 185.

    Google Scholar 

  • Bunge M. Quality, quantity, pseudoquantity and measurement in social science. J Quant Linguist. 1995;2:1–10.

    Article  Google Scholar 

  • Bunge M. Finding philosophy in social science. New Haven: Yale University Press; 1996. p. xii, 432.

    Google Scholar 

  • Bunge M. Chasing reality: strife over realism. Toronto: University of Toronto Press; 2014. p. xiv, 342.

    Google Scholar 

  • Carreiras M, Monahan PJ, Lizarazu M, Duñabeitia JA, Molinaro N. Numbers are not like words: different pathways for literacy and numeracy. Neuroimage. 2015;118:79–89.

    Article  PubMed  Google Scholar 

  • Cherla DV, Sanghvi S, Choudhry OJ, Liu JK, Eloy JA. Readability assessment of internet-based patient education materials related to endoscopic sinus surgery. Laryngoscope. 2012;122:1649–54.

    Article  PubMed  Google Scholar 

  • Chi MTH, Feltovich PJ, Glaser R. Categorization and representation of physics problems by experts and novices. Cognit Sci. 1981;5:121–52.

    Article  Google Scholar 

  • Coughlin LD, Patel VL. Processing of critical information by physicians and medical students. J Med Educ. 1987;62:818–28.

    CAS  PubMed  Google Scholar 

  • Davis TC, Wolf MS, Bass PF, et al. Low literacy impairs comprehension of prescription drug warning labels. J Gen Intern Med. 2006;21:847–51.

    Article  PubMed  PubMed Central  Google Scholar 

  • Delazer M, Kemmler G, Benke T. Health numeracy and cognitive decline in advanced age. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2013;20:639–59.

    Article  PubMed  Google Scholar 

  • Dolan JG, Cherkasky OA, Li Q, Chin N, Veazie PJ. Should health numeracy be assessed objectively or subjectively. Med Decis Making. 2016;36(7):868–75.

    Article  PubMed  Google Scholar 

  • Donelle L, Arocha JF, Hoffman-goetz L. Health literacy and numeracy: key factors in cancer risk comprehension. Chronic Dis Can. 2008;29:1–8.

    CAS  PubMed  Google Scholar 

  • Donelle L, Hoffman-Goetz L, Gatobu S, Arocha JF. Comprehension of Internet-based numeric cancer information by older adults. Inform Health Soc Care. 2009;34:209–24.

    Article  PubMed  Google Scholar 

  • Downs JS, de Bruin WB, Fischhoff B. Parents’ vaccination comprehension and decisions. Vaccine. 2008;26:1595–607.

    Article  PubMed  Google Scholar 

  • Fagerlin A, Zikmund-Fisher BJ, Ubel PA, Jankovic A, Derry HA, Smith DM. Measuring numeracy without a math test: development of the subjective numeracy scale. Med Decis Making. 2007;27:672–80.

    Article  PubMed  Google Scholar 

  • Flaherty D, Hoffman-Goetz L, Arocha JF. What is consumer health informatics? A systematic review of published definitions. Inform Health Soc Care. 2015;40:91–112.

    Article  PubMed  Google Scholar 

  • Flesch R. A new readability yardstick. J Appl Psychol. 1948;32:221.

    Article  CAS  PubMed  Google Scholar 

  • Foltz PW, Kintsch W, Landauer TK. The measurement of textual coherence with latent semantic analysis. Discourse Processes. 1998;25:285–307.

    Article  Google Scholar 

  • Frederiksen CH. Representing logical and semantic structure of knowledge acquired from discourse. Cogn Psychol. 1975;7:371–458.

    Article  Google Scholar 

  • Friedman DB, Hoffman-Goetz L. An exploratory study of older adults’ comprehension of printed cancer information: is readability a key factor. J Health Commun. 2007;12:423–37.

    Article  PubMed  Google Scholar 

  • Friedman D, Hoffman-Goetz L, Arocha J. Readability of cancer information on the internet. J Cancer Educ. 2004;19:117–22.

    Article  PubMed  Google Scholar 

  • Friedman DB, Hoffman-Goetz L, Arocha JF. Health literacy and the World Wide Web: comparing the readability of leading incident cancers on the Internet. Med Inform Internet Med. 2006;31:67–87.

    Article  CAS  PubMed  Google Scholar 

  • Gatobu SK, Arocha JF, Hoffman-Goetz L. Numeracy, health numeracy, and older immigrants’ primary language: an observation-oriented exploration. Basic Appl Soc Psychol. 2016;38:185.

    Article  Google Scholar 

  • Ghane A, Sweeny K. Embodied health: a guiding perspective for research in health psychology. Health Psychol Rev. 2013;7:S159–84.

    Article  Google Scholar 

  • Gigerenzer G. Mindless statistics. J Socio-Econ. 2004;33:587–606.

    Article  Google Scholar 

  • Gigerenzer G, Krauss S, Vitouch O. The null ritual: what you always wanted to know about significance testing but were afraid to ask. In: Kaplan D, editor. The Sage handbook of methodology for the social sciences. Thousand Oaks: Sage; 2004. p. 391–408.

    Google Scholar 

  • Gliner JA, Leech NL, Morgan GA. Problems with null hypothesis significance testing (NHST): what do the textbooks say? J Exp Educ. 2002;71:83–92.

    Article  Google Scholar 

  • Golbeck A, Ahlersschmidt C, Paschal A, Dismuke S. A definition and operational framework for health numeracy. Am J Prev Med. 2005;29:375–6.

    Article  PubMed  Google Scholar 

  • Golbeck A, Paschal A, Jones A, Hsiao T. Correlating reading comprehension and health numeracy among adults with low literacy. Patient Educ Couns. 2011;84:132–4.

    Article  PubMed  Google Scholar 

  • Grice JW. Observation oriented modeling: analysis of cause in the behavioral sciences, vol. 242. London: Academic; 2011.

    Google Scholar 

  • Grice JW, Barrett PT, Schlimgen LA, Abramson CI. Toward a brighter future for psychology as an observation oriented science. Behav Sci. 2012;2:1–22.

    Article  PubMed  PubMed Central  Google Scholar 

  • Haller H, Krauss S. Misinterpretations of significance: a problem students share with their teachers. Methods Psychol Res Online. 2002;7:1–20.

    Google Scholar 

  • Hannon B, Daneman M. Age-related changes in reading comprehension: an individual-differences perspective. Exp Aging Res. 2009;35:432–56.

    Article  PubMed  Google Scholar 

  • Hoffman-Goetz L, Donelle L, Ahmed R. Health literacy in Canada: a primer for students. Toronto, ON: Canadian Scholars Press; 2014. p. 264.

    Google Scholar 

  • Hoppe IC, Ahuja NK, Ingargiola MJ, Granick MS. A survey of patient comprehension of readily accessible online educational material regarding plastic surgery procedures. Aesthet Surg J. 2013;33:436–42.

    Article  PubMed  Google Scholar 

  • Hubbard R, Lindsay RM. Why p values are not a useful measure of evidence in statistical significance testing. Theory Psychol. 2008;18:69–88.

    Article  Google Scholar 

  • Jordan JE, Osborne RH, Buchbinder R. Critical appraisal of health literacy indices revealed variable underlying constructs, narrow content and psychometric weaknesses. J Clin Epidemiol. 2011;64:366–79.

    Article  PubMed  Google Scholar 

  • Kauchack D, Leroy G. Moving beyond readability metrics for health-related text simplification. IT Professional. 2016;May/June:45–51.

    Article  Google Scholar 

  • Kazemek FE. A brief discussion of readability formulas. High Sch J. 1984;67:248–51.

    Google Scholar 

  • Kennaway R. Population statistics cannot be used for reliable individual prediction. Unpublished manuscript; 1998. 25 p.

    Google Scholar 

  • Kennaway R. When causation does not imply correlation: robust violations of the faithfulness axiom. School of Computing Sciences, University of East Anglia. (June 17, 2013); Unpublished manuscript: 27.

    Google Scholar 

  • Kiechle ES, Bailey SC, Hedlund LA, Viera AJ, Sheridan SL. Different measures, different outcomes? A systematic review of performance-based versus self-reported measures of health literacy and numeracy. J Gen Intern Med. 2015;30:1538–46.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kintsch W. Comprehension: a paradigm for cognition. Cambridge, MA: Cambridge University Press; 1998.

    Google Scholar 

  • Kintsch W. An overview of top-down and bottom-up effects in comprehension: the ci perspective. Discourse Process. 2005;39:125–8.

    Article  Google Scholar 

  • Kintsch W, Keenan J. Reading rate and retention as a function of the number of propositions in the base structure of sentences. Cogn Psychol. 1973;5:257–74.

    Article  Google Scholar 

  • Kirk JK, Grzywacz JG, Arcury TA, et al. Performance of health literacy tests among older adults with diabetes. J Gen Intern Med. 2012;27:534–40.

    Article  PubMed  Google Scholar 

  • Kobayashi LC, Wardle J, Wolf MS, von Wagner C. Aging and functional health literacy: a systematic review and meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2016;71:445–57.

    Article  PubMed  Google Scholar 

  • Lambdin C. Significance tests as sorcery: science is empirical—significance tests are not. Theory Psychol. 2012;22:67–90.

    Article  Google Scholar 

  • Landauer TK, DS MN, Dennis S, Kintsch W. Handbook of latent semantic analysis. New York: Routledge; 2013.

    Google Scholar 

  • Lecoutre M-P, Poitevineau J, Lecoutre B. Even statisticians are not immune to misinterpretations of null hypothesis significance tests. Int J Psychol. 2003;38:37–45.

    Article  Google Scholar 

  • Leroy G, Kauchak D. The effect of word familiarity on actual and perceived text difficulty. J Am Med Inform Assoc. 2014;21:e169–72.

    Article  PubMed  Google Scholar 

  • Leroy G, Helmreich S, Cowie JR, Miller T, Zheng W. Evaluating online health information: beyond readability formulas. In: AMIA annual symposium proceedings/AMIA symposium; 2008. p. 394–8.

    Google Scholar 

  • Leroy G, Helmreich S, Cowie JR. The influence of text characteristics on perceived and actual difficulty of health information. Int J Med Inform. 2010;79:438–49.

    Article  PubMed  Google Scholar 

  • Leroy G, Kauchak D, Mouradi O. A user-study measuring the effects of lexical simplification and coherence enhancement on perceived and actual text difficulty. Int J Med Inform. 2013;82:717–30.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lipkus IM, Samsa G, Rimer BK. General performance on a numeracy scale among highly educated samples. Med Decis Making. 2001;21:37.

    Article  CAS  PubMed  Google Scholar 

  • Manganello JA. Health literacy and adolescents: a framework and agenda for future research. Health Educ Res. 2008;23:840–7.

    Article  PubMed  Google Scholar 

  • McClure E, Ng J, Vitzthum K, Rudd R. A mismatch between patient education materials about sickle cell disease and the literacy level of their intended audience. Prev Chronic Dis. 2016;13

    Google Scholar 

  • McConnell C. Readability: blind faith in numbers? J Econ Educ. 1983;14:65–71.

    Article  Google Scholar 

  • McLaughlin GH. Smog grading—a new readability formula. J Read. 1969;22:639–46.

    Google Scholar 

  • McNaughton CD, Cavanaugh KL, Kripalani S, Rothman RL, Wallston KA. Validation of a short, 3-item version of the subjective numeracy scale. Med Decis Making. 2015;35:932–6.

    Article  PubMed  PubMed Central  Google Scholar 

  • Meade CD, Smyth CF. Readability formulas: cautions and criteria. Patient Educ Couns. 1991;17:153–8.

    Article  Google Scholar 

  • Meehl PE. Theoretical risks and tabular asterisks: Sir Karl, Sir Ronald, and the slow progress of soft psychology. J Consult Clin Psychol. 1978;46:806–34.

    Article  Google Scholar 

  • Michell J. Quantitative science and the definition of measurement in psychology. Br J Psychol. 1997;88:355–83.

    Article  Google Scholar 

  • Michell J. Measurement in psychology: a critical history of a methodological concept. Cambridge: Cambridge University Press; 1999.

    Book  Google Scholar 

  • Michell J. The quantitative imperative. Theory Psychol. 2003;13:5–31.

    Article  Google Scholar 

  • Moeller K, Fischer U, Link T, et al. Learning and development of embodied numerosity. Cogn Process. 2012;13(Suppl 1):S271–4.

    Article  PubMed  Google Scholar 

  • Morrison AK, Schapira MM, Hoffmann RG, Brousseau DC. Measuring health literacy in caregivers of children: a comparison of the newest vital sign and S-TOFHLA. Clin Pediatr (Phila). 2014;53:1264–70.

    Article  Google Scholar 

  • Muñoz R, Okan Y, Garcia-Retamero R. Habilidades numéricas y salud: Una revisión crítica. Rev Latinoam Psicol. 2015;47:111–23.

    Article  Google Scholar 

  • Murphy PW, Davis TC, Long SW, Jackson RH, Decker BC. Rapid estimate of adult literacy in medicine (REALM): a quick reading test for patients. J Read. 1993;37:124–30.

    Google Scholar 

  • Nielsen-Bohlman L, Panzer AM, Kindig DA, editors. Health literacy: a prescription to end confusion. Washington, DC: National Academies Press; 2004.

    Google Scholar 

  • Nutbeam D. Defining and measuring health literacy: what can we learn from literacy studies [editorial]. Int J Public Health. 2009;54(5):303.

    Article  PubMed  Google Scholar 

  • O’Connor M, Casey L, Clough B. Measuring mental health literacy—a review of scale-based measures. J Ment Health. 2014;23:197–204.

    Article  PubMed  Google Scholar 

  • Osborn CY, Wallston KA, Shpigel A, Cavanaugh K, Kripalani S, Rothman RL. Development and validation of the General Health Numeracy Test (GHNT). Patient Educ Couns. 2013;91:350–6.

    Article  PubMed  PubMed Central  Google Scholar 

  • Paasche-Orlow MK, Wolf MS. The causal pathways linking health literacy to health outcomes. Am J Health Behav. 2007;31(Suppl 1):S19–26.

    Article  PubMed  Google Scholar 

  • Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults: a new instrument for measuring patients’ literacy skills. J Gen Intern Med. 1995;10:537–41.

    Article  CAS  PubMed  Google Scholar 

  • Patel VL, Arocha JF, Kaufman DR. Diagnostic reasoning and medical expertise. Psychol Learn Motiv. 1994;31:137–252.

    Google Scholar 

  • Patel VL, Arocha JF, Kaufman DR. A primer on aspects of cognition for medical informatics. J Am Med Inform Assoc. 2001;8:324–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Peters P, Smith A, Funk Y, Boyages J. Language, terminology and the readability of online cancer information. Med Humanit. 2016;42:36–41.

    Article  PubMed  Google Scholar 

  • Pires C, Vigário M, Cavaco A. Readability of medicinal package leaflets: a systematic review. Rev Saúde Pública. 2015;49:1–13.

    Article  Google Scholar 

  • Pleasant A, McKinney J, Rikard RV. Health literacy measurement: a proposed research agenda. J Health Commun. 2011;16(Suppl 3):11–21.

    Article  PubMed  Google Scholar 

  • Poitevineau J, Lecoutre B. Interpretation of significance levels by psychological researchers: The .05 Cliff effect may be overstated. Psychon Bull Rev. 2001;8:847–50.

    Article  CAS  PubMed  Google Scholar 

  • Powers WT. Quantitative analysis of purposive systems: some spadework at the foundations of scientific psychology. Psychol Rev. 1978;85:417.

    Article  Google Scholar 

  • Powers WT. Control theory and statistical generalizations. Am Behav Sci. 1990;34(1):24–31.

    Article  Google Scholar 

  • Powers WT. Making sense of behavior: the meaning of control. New Canaan: Benchmark Publications; 1998. p. x, 180.

    Google Scholar 

  • Powers WT. Living control systems III: the fact of control. Bloomfield: Benchmark Publications; 2008. p. xiii, 204.

    Google Scholar 

  • Ramirez-Zohfeld V, Rademaker AW, Dolan NC, et al. Comparing the performance of the S-TOFHLA and NVS among and between English and Spanish speakers. J Health Commun. 2015;20:1458–64.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ratzan SC, Parker RM. Health literacy—identification and response. J Health Commun. 2006;11:713–5.

    Article  PubMed  Google Scholar 

  • Reyna VF, Nelson WL, Han PK, Dieckmann NF. How numeracy influences risk comprehension and medical decision making. Psychol Bull. 2009;135:943–73.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rozeboom WW. The fallacy of the null-hypothesis significance test. Psychol Bull. 1960;57:416–28.

    Article  CAS  PubMed  Google Scholar 

  • Schapira MM, Fletcher KE, Gilligan MA, et al. A framework for health numeracy: how patients use quantitative skills in health care. J Health Commun. 2008;13:501–17.

    Article  PubMed  PubMed Central  Google Scholar 

  • Schapira MM, Walker CM, Cappaert KJ, et al. The numeracy understanding in medicine instrument: a measure of health numeracy developed using item response theory. Med Decis Making. 2012;32:851–65.

    Article  PubMed  PubMed Central  Google Scholar 

  • Serper M, Patzer RE, Curtis LM, et al. Health literacy, cognitive ability, and functional health status among older adults. Health Serv Res. 2014;49:1249–67.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sivaramakrishnan M, Arocha JF, Patel VL. Cognitive assessment and health education in children from two different cultures. Soc Sci Med. 1998;47:697–712.

    Article  CAS  PubMed  Google Scholar 

  • Smith TW. Measurement in health psychology research. In: Friedman HS, Silver RC, editors. Foundations of health psychology. New York: Oxford University Press; 2007. p. 19–51.

    Google Scholar 

  • Smith KH. Aging and health literacy. J Consum Health Internet. 2014;18:94–100.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sokal AD. Transgressing the boundaries: towards a transformative hermeneutics of quantum gravity. Social Text. 1996;46/47:217–52.

    Article  Google Scholar 

  • Sokal AD. The Sokal hoax: the sham that shook the academy. Lincoln: University of Nebraska Press; 2000. p. ix, 271.

    Google Scholar 

  • Sokal AD, Bricmont J. Fashionable nonsense: postmodern intellectuals’ abuse of science. New York: Picador; 1998. p. xiv, 300.

    Google Scholar 

  • Sørensen K, Van den Broucke S, Fullam J, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:80.

    Article  PubMed  PubMed Central  Google Scholar 

  • Squiers L, Peinado S, Berkman N, Boudewyns V, McCormack L. The health literacy skills framework. J Health Commun. 2012;17(Suppl 3):30–54.

    Article  PubMed  Google Scholar 

  • Stevens SS. The operational basis of psychology. Am J Psychol. 1935;47:323–30.

    Article  Google Scholar 

  • Stevens SS. On the theory of scales of measurement. Science. 1946;103:677–80.

    Article  Google Scholar 

  • Stonbraker S, Schnall R, Larson E. Tools to measure health literacy among Spanish speakers: an integrative review of the literature. Patient Educ Couns. 2015;98(12):1513–23.

    Article  Google Scholar 

  • Ta-Min R, Arocha JF, Hoffman-Goetz L. Assessing readability and comprehensibility of web-based cancer information. J Inf Technol Healthcare. 2007;5:300–12.

    Google Scholar 

  • Thomson MD, Hoffman-Goetz L. Cancer information comprehension by English-as-a-second-language immigrant women. J Health Commun. 2011;16:17–33.

    Article  CAS  PubMed  Google Scholar 

  • Trafimow D, Marks M. Editorial. Basic Appl Soc Psychol. 2015;37:1–2.

    Article  Google Scholar 

  • Trendler G. Measurement theory, psychology and the revolution that cannot happen. Theory Psychol. 2009;19:579–99.

    Article  Google Scholar 

  • Tulsieram KL, Arocha JF, Lee J. Readability and coherence of Department/Ministry of health HPV information. J Cancer Educ. 2016. http://link.springer.com/10.1007/s13187-016

  • Vail MW, Earp JB, Antón AI. An empirical study of consumer perceptions and comprehension of web site privacy policies. IEEE Trans Eng Manag. 2008;55:442–54.

    Article  Google Scholar 

  • Vogel SE, Keller C, Koschutnig K, et al. The neural correlates of health risk perception in individuals with low and high numeracy. ZDM. 2016;48:337–50.

    Article  Google Scholar 

  • Waller NG. The fallacy of the null hypothesis in soft psychology. Appl Prev Psychol. 2004;11:83–6.

    Article  Google Scholar 

  • Weiss BD, Mays MZ, Martz W, et al. Quick assessment of literacy in primary care: the newest vital sign. Ann Fam Med. 2005;3:514–22.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wray D, Janan D. Readability revisited? The implications of text complexity. Curric J. 2013;24:553–62.

    Article  Google Scholar 

  • Zamanian M, Heydari P. Readability of texts: state of the art. Theory Pract Lang Stud. 2012;2(1):43–53.

    Google Scholar 

  • Zikmund-Fisher BJ, Fagerlin A, Ubel PA. Mortality versus survival graphs: improving temporal consistency in perceptions of treatment effectiveness. Patient Educ Couns. 2007a;66:100–7.

    Article  PubMed  Google Scholar 

  • Zikmund-Fisher B, Smith D, Ubel P, Fagerlin A. Validation of the subjective numeracy scale: effects of low numeracy on comprehension of risk communications and utility elicitations. Med Decis Making. 2007b;27:663–71.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada

    Jose F. Arocha & Laurie Hoffman-Goetz Ph.D.

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  1. Jose F. Arocha
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  2. Laurie Hoffman-Goetz Ph.D.
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Correspondence to Jose F. Arocha .

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Editors and Affiliations

  1. The New York Academy of Medicine, New York, NY, USA

    Vimla L. Patel

  2. University of Waterloo, Waterloo, ON, Canada

    Jose F. Arocha

  3. Weill Cornell Medical College, New York, NY, USA

    Jessica S. Ancker

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Arocha, J.F., Hoffman-Goetz, L. (2017). Toward a Framework for Understanding Embodied Health Literacy. In: Patel, V., Arocha, J., Ancker, J. (eds) Cognitive Informatics in Health and Biomedicine. Health Informatics. Springer, Cham. https://doi.org/10.1007/978-3-319-51732-2_4

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