Abstract
OBJECTIVE: To develop and validate a short health literacy assessment tool for Portuguese-speaking adults. METHODS: The Short Assessment of Health Literacy for Portuguese-speaking Adults is an assessment tool which consists of 50 items that assess an individual's ability to correctly pronounce and understand common medical terms. We evaluated the instrument's psychometric properties in a convenience sample of 226 Brazilian older adults. Construct validity was assessed by correlating the tool scores with years of schooling, self-reported literacy, and global cognitive functioning. Discrimination validity was assessed by testing the tool's accuracy in detecting inadequate health literacy, defined as failure to fully understand standard medical prescriptions. RESULTS: Moderate to high correlations were found in the assessment of construct validity (Spearman's coefficients ranging from 0.63 to 0.76). The instrument showed adequate internal consistency (Cronbach's alpha=0.93) and adequate test-retest reliability (intraclass correlation coefficient=0.95). The area under the receiver operating characteristic curve for detection of inadequate health literacy was 0.82. A version consisting of 18 items was tested and showed similar psychometric properties. CONCLUSIONS: The instrument developed showed good validity and reliability in a sample of Brazilian older adults. It can be used in research and clinical settings for screening inadequate health literacy.
Highlights
The instrument developed showed good validity and reliability in a sample of Brazilian older adults. It can be used in research and clinical settings for screening inadequate health literacy
Health literacy is defined as the ability to perform basic reading and numerical tasks required to function in the health care environment.[1]
There is increasing evidence that health literacy skills are related to important health outcomes, even after adjustments for confounding factors such as education, age, and gender
Summary
Health literacy is defined as the ability to perform basic reading and numerical tasks required to function in the health care environment.[1]. Inadequate health literacy has been independently associated with lower utilization of preventive services, poor self-management of chronic conditions, low medication adherence, increased hospitalization, and higher death rates.[4]. Inadequate health literacy may disproportionately affect the health of older people, as a result of generation gap in education, and because the elderly have more medical conditions, use more health care services, and are more likely to require complex therapeutic regimens.[12]. Because years of formal schooling alone are not a reliable indicator of health literacy and individuals with lower health literacy skills may try to hide it, it is difficult to recognize those patients with inadequate health literacy during routine clinical care.[15] Developing valid and reliable health literacy instruments is critically important as they help health care providers to identify patients who may require special communication needs and benefit from targeted interventions in clinical settings
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