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      Development of a brief test to measure functional health literacy.

      Patient Education and Counseling

      Adolescent, Adult, African Americans, education, Age Factors, Drug Therapy, Educational Measurement, methods, Educational Status, Female, Health Education, Humans, Linear Models, Male, Mathematics, Medical Indigency, psychology, Middle Aged, Needs Assessment, Questionnaires, standards, Reading, Self Administration, Statistics, Nonparametric, Teaching Materials

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          Abstract

          We describe the development of an abbreviated version of the Test of Functional Health Literacy in Adults (TOFHLA) to measure patients' ability to read and understand health-related materials. The TOFHLA was reduced from 17 Numeracy items and 3 prose passages to 4 Numeracy items and 2 prose passages (S-TOFHLA). The maximum time for administration was reduced from 22 minutes to 12. In a group of 211 patients given the S-TOFHLA, Cronbach's alpha was 0.68 for the 4 Numeracy items and 0.97 for the 36 items in the 2 prose passages. The correlation (Spearman) between the S-TOFHLA and the Rapid Estimate of Adult Literacy in Medicine (REALM) was 0.80, although there were important disagreements between the two tests. The S-TOFHLA is a practical measure of functional health literacy with good reliability and validity that can be used by health educators to identify individuals who require special assistance to achieve learning goals.

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