Literacy Measures Research Articles

Relationship Between Health Literacy and Addiction Susceptibility in High School Adolescents

Background: Adolescence is a high-risk period. Teenagers experience risky behaviors in this period, including using abusive drugs and addiction. Meanwhile, sufficient awareness helps a person to interpret and analyze health-threatening factors. This study aimed to determine the relationship between health literacy and susceptibility to addiction in adolescents living in the western part of Tehran City, Iran. Methods: This descriptive-correlational study was performed on 265 senior high school students in the western part of Tehran in 2021. The subjects were recruited by cluster random sampling. The study data were collected online using the addiction susceptibility questionnaire and health literacy measure for adolescents. The obtained data were sorted by frequency distribution, Mean±SD and analyzed utilizing the Pearson correlation coefficient, independent t-test, and analysis of variance in SPSS software, version 16. The significance level was set at 0.05. Results: Most study subjects (56.4%) were female. Their Mean±SD score of health literacy was 65.31±21.15. Among the subscales of health literacy, “calculation”, with a Mean±SD score of 68.96±35.89, and “utilization”, with 61.29±25.05, had the highest and lowest mean scores, respectively. The Mean±SD score of addiction susceptibility was 25.3±30.05, and among its subscales, “showing off” with a mean score of 33.09±32.64 and “family dissatisfaction” with 19.75±35.47 had the highest and lowest mean scores, respectively. Health literacy and its dimensions had a negative correlation with addiction susceptibility (P<0.001). Conclusion: According to the findings, it is recommended to use appropriate strategies to increase adolescent health literacy by health service providers, school officials, school health nurses, and teachers. The results of this study can be used as a source for further research on addiction and health literacy in adolescents.

A Review of Health Literacy Measurement Tools from the Health Literacy Tool Shed Database

A Review of Health Literacy Measurement Tools from the Health Literacy Tool Shed Database

Financial Literacy and Saving Behaviors of Households

This paper studies the relationship between financial/numeric literacy and household saving and investment behaviors using the New York Feds Survey of Consumer Expectations. Using a panel dataset and a regression analysis, the study finds that although overall propensities to save, measured by saving rate and savings-to-wealth ratio, does not show a significant correlation with literacy measures, individuals portfolio choices between risk-free and risky assets are indeed affected by both literacy measures. The research indicates that individuals who report higher self-rated financial literacy and attain higher numeracy scores tend to allocate a more substantial portion of their savings into stocks. By contrast, they are inclined to hold a smaller portion of their wealth in risk-free liquid assets, such as checking accounts. More particularly, individuals with higher numeracy scores tend to allocate approximately 5.384% greater portion of their investments into stocks while simultaneously reducing their investments in checking accounts by 4.251%. Similarly, those with higher financial literacy tend to demonstrate an average increase of 10.085% in stock investments, coupled with a decrease of 12.506% in checking account investments. Notably, these effects are separate from influences of other factors like education, gender, and income.

Future research recommendations for transforming higher education with generative AI

Higher education is crucial for producing ethical citizens and professionals globally. The introduction of generative AI (GenAI), such as ChatGPT, has posed opportunities and challenges to the traditional model of education. However, the current conversations primarily focus on policy development and assessment, with limited research on the future of higher education. GenAI's impact on learning outcomes, pedagogy, and assessment is crucial for reforming and advancing the workforce. This qualitative study aims to investigate student perspectives on GenAI's impact on higher education. The study uses an initial conceptual framework driven by a systematic literature review to investigate the opportunities and challenges of AI in education. This framework serves as an initial data collection and analysis framework. A sample of 51 students from three research-intensive universities was selected for this study. Thematic analysis identified three themes and 10 subthemes. The findings suggest that future higher education should be transformed to train students to be future-ready for employment in a society powered by GenAI. They suggest new learning outcomes—skills in learning and teaching with GenAI, AI literacy—and emphasize the significance of interdisciplinarity and maker learning, with assessment focusing on in-class and hands-on activities. They recommend six future research directions – competence for future workforce and its self-assessment measures, AI literacy or competency measures, new literacies and their relationships, interdisciplinary teaching, Innovative pedagogies and their evaluation, new assessment and its acceptance.

Construct Validity and Measurement Invariance of the eHEALS in a Diverse US High School Sample

Abstract: Although the eHealth Literacy Scale (eHEALS) is a widely used measure of eHealth literacy (eHL), it has not been validated in a diverse sample of US adolescents. This study assessed the construct validity and item and measurement invariance of the eHEALS using both Rasch analyses and classical test theory (CTT). Data were collected from adolescents at a US Northeastern high school ( N = 355, 64.9% were 16–18-years old, 54.8% male, 76.4% from a racially minoritized group, and 50.5% Latinx). Adolescents completed a survey that included demographic variables (i.e., age in years, gender, and ethnicity) and the eHEALS. Using Rasch and CTT methodologies, the dimensionality of the eHEALS and item and measurement invariance across gender, age, and ethnicity were assessed. The unidimensional structure of the eHEALS as well as item and measurement invariance across gender, age, and ethnicity were supported. Rasch analyses also suggested that responses to eHEALS items can be summed to determine eHL abilities, although there was a ceiling effect. The eHEALS is a unidimensional measure of eHL that may provide information in health education settings about adolescents’ eHL skills. It performs similarly across male and female as well as older and younger adolescents. However, given the ceiling effect and changes in adolescents’ Internet use since its development, future studies should revise the eHEALS to better capture adolescents’ eHL abilities. Future studies should also examine item and measurement invariance by age (in years), race, family income, and longitudinally to determine the usefulness of the measure across groups and time.

The Scientific Literacy Test Instrument on Particle Dynamics for High School Students

The measurement of scientific literacy is very focused, this is shown by the urgency of preparing scientific literacy test instruments. This research develops a proper scientific literacy test instrument on particle dynamics material. This research is a development research adapted from the Borg and Gall model. The test subjects of this study were 202 students. Design validation, instrument validity, instrument reliability, instrument difficulty level and instrument differentiability are data analysis techniques. The product produced is a material science literacy test instrument for particle dynamics totaling 10 questions in the form of reasoned multiple choice questions. The results showed that (1) the questions were in the valid category, (2) had reliability with very good criteria of 0.83 (3) the difficulty level of the questions obtained 1 item in the difficult category and 11 questions with moderate criteria, (4) the results of the discriminating power of the questions show that there are 2 questions with sufficient discriminating power so that the items can still be used and there are 2 items with bias so that 2 items are discarded. It can be concluded that the developed scientific literacy test instrument can be used to measure students' scientific literacy competence.

The mediating role of health literacy between the presence of chronic disease and psychological distress among older persons in Xi’an city of China

BackgroundThe increased number of older persons in China, and the prevalence of most chronic diseases raised with age significantly increased the total disease burden. When a person ages, psychological distress happens when they are faced with stressors that they cannot cope with. Psychological distress refers to non-specific symptoms of depression, anxiety, and stress. Health literacy influences several health outcomes, such as emotional functioning among the population. The primary purpose of this study is to examine the mediator role of health literacy between the presence of chronic disease and psychological distress among older persons living in Xi’an city. Thus, this study used the Cognitive Behavior Theory (CBT) as a combination of the basic behavioral and cognitive psychology principles to explain the cognitive processes associated with psychological distress.MethodsThis study employs a quantitative research design using a cross-sectional survey of 300 older persons over 60 years living in the six urban districts of Xi’an city. Data were collected using the Health Literacy Questionnaire (HLQ) and the Depression Anxiety Stress Scale (DASS-21). This study employed descriptive statistics and inferential methods to analyze the data. The inferential methods applied structural equation modeling (SEM) to test the hypothesis of the mediator role of health literacy between the presence of chronic disease and psychological distress.ResultsIn this study, chronic disease had an effect on health literacy among older persons living in Xi’an city (β=-0.047, p < 0.01); chronic disease impact on psychological distress among older persons living in Xi’an city (β = 0.047, p < 0.01); health literacy was identified effect on psychological distress among older persons in Xi’an city (β=-0.738, p < 0.001); health literacy as a partial mediator between chronic disease and psychological distress (β = 0.07, p < 0.01).ConclusionPsychological distress among older persons is affected by chronic disease and health literacy. Health literacy had a partial mediating effect on the presence of chronic disease and psychological distress. Improved health literacy measures should be considered when treating older persons with psychological distress.

Assessing the relative need and demand for financial education programs

We measure the relative need and demand for financial education programs among graduate stu- dents at a large university system. We find that self-assessed and measured financial literacy is sig- nificantly related to interest and demand for financial education. Individuals who self-report a high level of financial literacy but have low measured financial literacy are significantly less likely to be interested in financial education, while the opposite is true for financially literate individuals self- reporting a low level of financial literacy. Our study adds to research showing the importance of both believed and actual financial literacy measures and has implications for financial education programs.

Development of a patient-reported outcome measure of digital health literacy for chronic patients: results of a French international online Delphi study

BackgroundA psychometrically robust patient-reported outcome measure (PROM) to assess digital health literacy for chronic patients is needed in the context of digital health. We defined measurement constructs for a new PROM in previous studies using a systematic review, a qualitative description of constructs from patients, health professionals and an item pool identification process. This study aimed to evaluate the content validity of a digital health literacy PROM for chronic patients using an e-Delphi technique.MethodsAn international three-round online Delphi (e-Delphi) study was conducted among a francophone expert panel gathering academics, clinicians and patient partners. These experts rated the relevance, improvability, and self-ratability of each construct (n = 5) and items (n = 14) of the preliminary version of the PROM on a 5-point Likert scale. Consensus attainment was defined as strong if ≥ 70% panelists agree or strongly agree. A qualitative analysis of comments was carried out to describe personal coping strategies in healthcare expressed by the panel. Qualitative results were presented using a conceptually clustered matrix.ResultsThirty-four experts completed the study (with 10% attrition at the second round and 5% at the third round). The panel included mostly nurses working in clinical practice and academics from nursing science, medicine, public health background and patient partners. Five items were excluded, and one question was added during the consensus attainment process. Qualitative comments describing the panel view of coping strategies in healthcare were analysed. Results showed two important themes that underpin most of personal coping strategies related to using information and communications technologies: 1) questionable patient capacity to assess digital health literacy, 2) digital devices as a factor influencing patient and care.ConclusionConsensus was reached on the relevance, improvability, and self-ratability of 5 constructs and 11 items for a digital health literacy PROM. Evaluation of e-health programs requires validated measurement of digital health literacy including the empowerment construct. This new PROM appears as a relevant tool, but requires further validation.

Structural Validation and Measurement Invariance Testing of the Chinese Version of the eHealth Literacy Scale Among Undergraduates: Cross-Sectional Study.

The eHealth Literacy Scale (eHEALS) was introduced in China in 2013 as one of the most important electronic health literacy measurement instruments. After a decade of development in China, it has received widespread attention, although its theoretical underpinnings have been challenged, thus demanding more robust research evidence of factorial validity and multigroup measurement properties. This study aimed to evaluate the Chinese version of the eHEALS in terms of its measurement properties. A cross-sectional survey was conducted in a university setting in China. Item statistics were checked for response distributions and floor and ceiling effects. Internal consistency reliability was confirmed with Cronbach α, split-half reliability, Cronbach α if an item was deleted, and item-total correlation. A total of 5 representative eHEALS factor structures were examined and contrasted using confirmatory factor analysis. The study used the item-level content validity index (I-CVI) and the average of the I-CVI scores of all items on the scale to assess the content validity of the dominance model. Furthermore, the validated dominance model was subsequently used to evaluate the relevance and representation of elements in the instrument and to assess measurement invariance across genders. A total of 972 respondents were identified, with a Cronbach α of .92, split-half reliability of 0.88, and item-total score correlation coefficients ranging from 0.715 to 0.781. Cronbach α if an item was deleted showed that all items should be retained. Acceptable content validity was supported by I-CVIs ≥0.80. The confirmatory factor analysis confirmed that the 3-factor model was acceptable. The measurement model met all relevant fit indices: average variance extracted from 0.663 to 0.680, composite reliability from 0.810 to 0.857, chi-square divided by the df of 4.768, root mean square error of approximation of 0.062, standardized root mean squared residual of 0.020, comparative fit index (CFI) of 0.987, and Tucker-Lewis index of 0.979. In addition, the scale demonstrated error variance invariance (Δnormed fit index=-0.016, Δincremental fit index=-0.012, ΔTucker-Lewis index=0.005, Δcomparative fit index=-0.012, Δrelative fit index=0.005, and Δroot mean square error of approximation=0.005). A 3-factor model of the Chinese version of the eHEALS fits best, and our findings provide evidence for the strict measurement invariance of the instrument regarding gender.

Reading between the lines: the association between education, literacy, and dementia in a cohort of older South African adults

AbstractBackgroundThe relationship between education and cognitive function in later life has been widely studied, yet it remains uncertain whether the association is due to a true protective effect of education or to test‐taking skills developed through formal education. Literacy, as an objective measure of learning, may clarify this relationship, particularly in low‐ and middle‐income countries (LMIC) where the effect of education may be influenced by school attendance and quality. This study aimed to investigate: 1) the concordance between subjective and objective literacy measures and educational attainment, and 2) the ability of literacy to predict cognitive outcomes.MethodThis study utilized data from Wave 2 of the Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), a population‐based study in Agincourt, South Africa, and its dementia sub‐study (n = 559), collected in 2019‐2020 and 2018‐2019, respectively. Three measures of literacy (self‐report, short sentence reading, reading grade level test) were compared using Cohen’s kappa statistic. Multivariable seemingly unrelated regression (SUR) models were used to examine the association of literacy with cognitive test scores, adjusting for age, sex, and educational attainment. Additionally, multivariable logistic regression models were conducted to assess the independent effect of literacy on dementia risk, controlling for educational attainment.ResultThe Cohen’s kappa score between the three literacy measures was 0.615, indicating substantial agreement. The Cohen’s kappa score between the literacy measures and educational attainment was 0.608. SUR models revealed a statistically significant relationship (p‐value&lt;0.05) between literacy and z‐standardized cognitive test scores in most tests. Literacy was associated with reduced risk of dementia beyond education, with a relative risk ratio of 0.13 (p‐value&lt;0.001) for the literate vs. illiterate groups without education.ConclusionThis study highlights the importance of utilizing objective reading tests to measure literacy in populations, rather than relying solely on self‐reported literacy status. Results indicate that literacy is significantly associated with cognitive function, independent of educational attainment. This suggests that literacy skills acquired outside of formal education may reflect underlying protective factors, such as motivation and resilience, against dementia.

Variability in conceptualizations and measurement of genetic literacy.

To examine definitions and measures for genetic literacy in the published literature, and the associations between commonly utilized measures. We completed a systematic review searching eight databases for empirical articles containing quantitative measures of genetic literacy. Articles were assessed for study properties, definitions, and measure characteristics. An online survey was then completed by 531 U.S. adults to examine correlations between frequently used genetic literacy measures. 92 articles met inclusion criteria for the systematic review. Articles rarely defined genetic literacy, and existing definitions showed inconsistencies in the knowledge and cognitive domains that comprise genetic literacy. Definitions frequently included objective conceptual knowledge, comprehension, and applied knowledge, however most measures only assessed objective or subjective knowledge. Genetic literacy measures were infrequently assessed for psychometric properties and the content domains assessed by measures varied considerably. Correlation analyses showed weak to moderate relationships between genetic literacy measures. A comprehensive and consistent definition of genetic literacy and its cognitive and conceptual domains should be implemented to inform the development of concordant measurement tools and improve research and clinical care in genetics. We examine and compare definitions and measures of genetic literacy, suggest a more comprehensive definition, and recommendations for research development.

P55: Reaching Caregivers living with a loved one with Dementia/Alzheimer's Disease

Objectives:Caregiving can be a daunting and isolating experience, especially when supporting a loved one with Dementia The objective of this intervention was to provide a series of educational sessions available to caregivers to help educate them on strategies to enhance their well-being and interactions with a loved one living with dementia.Methods:The Caregiver Literacy Series is a compilation o 18 webinar sessions with therapeutic workbooks designed to help caregivers understand the nature of specific dementia-related issues, and designed to help the caregiver build some personal strategy to help better manage their caregiving role. Based upon a Framework that uses the Perceived Self-Efficacy Theory, each webinar provides educational materials, and resources and is designed to help build an action plan for the caregiver. Topics include “What is Caregiving?”, “Caregiving and Compassion Fatigue and Self-Care” and topics address coping and communication strategies. The webinar sessions were administered monthly and semi-monthly to consumers through a local Alzheimer’s Association network in the rural Midwest of the United States.Results:Feedback from consumers who have used the materials suggest that the materials have provided some measure of information and helpful educational materials. The workbooks have also been an effective tool to help guide and empower the caregiver.Conclusion:The Caregiver Literacy Series provides some effective and needed materials to help equip caregivers living with a loved one that has Dementia or Alzheimer’s disease with some measure of health literacy and empowers them to feel some sense of empowerment and comfort in the process.

Health Literacy in Ethiopia: Evidence Synthesis and Implications.

Health literacy plays a pivotal role in healthcare utilization and health-related lifestyle choices. This makes health literacy a pressing concern, particularly in low-income countries like Ethiopia, where there are intricate health challenges. Despite its significance, there is a dearth of studies on the issue in Ethiopia. This study aimed to provide a comprehensive synthesis of the available evidence on health literacy in Ethiopia, and to discuss the implications for healthcare practice, health promotion, and research endeavors. A systematic scoping review was conducted to achieve the purpose of this study. A comprehensive search of databases such as PubMed, CINAHL, AJOL, and PLOS Global Public Health was conducted for eligible evidence. Searches were conducted from May 12 to September 9, 2022. The PRISMA flow diagram guideline was utilized to ensure transparent reporting of the reviews process. The data extraction tool used was based on the JBI methodology guidance for reviews. The search in total yielded 543 records. However, only 16 studies met the eligibility criteria after a thorough screening process. All eligible studies were conducted in health facilities and schools with limited scopes. The main findings of the eligible studies focused on health literacy levels, health information sources, and health literacy determinants among the studies participants. Many of the studies reported low health literacy levels and multiple predicting factors ranging from personal to socioeconomic conditions among the respondents. This review has provided critical insights into the state of health literacy in Ethiopia. There is a need for comprehensive research and the development of context-appropriate health literacy measurements tailored to the Ethiopian context, as well as evidence-based health literacy interventions. Prioritizing health literacy as a key research and intervention area is essential for improving the health of individuals and populations and achieving health-related Sustainable Development Goals in Ethiopia.

An Important Strategy to Improve Adolescent Health Literacy: COVID-19 Modules in High School in Indonesia.

During the second coronavirus disease 2019 (COVID-19) surge, cases increased sharply due to low awareness and compliance with measures to limit disease spread. Health literacy (HL) is an important component of public health initiatives, and schools are potential sources of health education to increase HL via the presentation of COVID-19 educational modules. This cross-sectional study involved an online questionnaire administered to students from 5 high schools in Surabaya and Sidoarjo, Indonesia, 6-7 weeks after the start of government-issued directives restricting public gatherings. We collected data on each respondent's age, gender, parental education, and socioeconomic variables. HL was determined by the Health Literacy Measure for Adolescents. We additionally measured their attitudes and behaviors related to preventing the spread of COVID-19. The students were asked if they watched the COVID-19 module at school, their feelings about vaccination, and preferred online sources of COVID-19-related information. Most of the 432 respondents had viewed COVID-19 modules at school. Module exposure was associated with significantly higher total and domain-specific HL and more positive attitudes toward government-issued COVID-19 restrictions on travel and public gatherings (p<0.05). However, behaviors to prevent COVID-19 spread and vaccine acceptance were not associated with module exposure. Most students chose social media as their source of COVID-19-related information. Schools can provide information to increase adolescents' HL and the public's support for health initiatives to prevent or limit the spread of COVID-19.

Development and psychometric evaluation of the Chinese mental health support scale

ABSTRACT Objective To culturally adapt a self-report measure of mental health first aid behaviours, the Mental Health Support Scale (MHSS), into Chinese. Method The MHSS has two versions that measure either Intended support, or Provided support, and is applicable to a range of mental health problems. The MHSS was adapted for consistency with Chinese mental health first aid guidelines, forward- and back-translated, and pre-tested with 19 adult residents of mainland China to check the scale was understandable, acceptable and clear. The psychometric properties of the final translation were evaluated with a convenience sample of 406 Chinese adults. Participants completed both versions of the Chinese MHSS: the Chinese MHSS Intended, which measures help a respondent intended to provide if a person close to them developed a mental health problem or crisis, and the Chinese MHSS Provided if they had supported a person with a mental health problem, as well as measures of stigma and mental health literacy. Results The Chinese MHSS Intended comprised two factors: Recommended Actions with 17 items and Not Recommended Actions with 5 items. The Chinese MHSS Provided comprised 10 items in a single factor. Scales demonstrated excellent internal consistency and there was evidence in support of validity, particularly for the Chinese MHSS Intended. Discussion These preliminary results suggest the Chinese MHSS has acceptable psychometric properties. Future research should examine the responsiveness of the scales to MHFA training.

Digital Technology Characteristics and Literacy Among Families With Children With Asthma: Cross-Sectional Study.

The use of digital technology in pediatric asthma management has emerged as a potential tool for improving asthma management. However, the use of digital tools has the potential to contribute to the inequitable delivery of asthma care because of existing social factors associated with asthma disparities. Our study focused on parents' chosen language and sociodemographic factors that might shape the use of digital technology in asthma self-management. This study aims to estimate and compare patient, family, and technology-related characteristics by parents' chosen language (English or Spanish) and compare a digital literacy measure by sociodemographic factors. Survey data were collected from July to December 2021 from parents of children with asthma who were seen by a Chicago pediatric health system pulmonary provider. Questions assessed patient and family characteristics, digital technology use, and digital literacy, measured using the validated eHealth Literacy Scale (eHEALS). Chi-square tests and multivariable logistic regression were used for comparisons, and Kruskal-Wallis tests were used for comparing median eHEALS scores by social characteristics. Of the 197 parents surveyed, 24.4% (n=49) of parents identified as a race categorized as other, 37.1% (n=67) as White, and 38.6% (n=75) as Black; 47.2% (n=93) identified as Hispanic/Latino/Latina. Additionally, 79.7% (n=157) of parents preferred English, and 20.3% (n=40) preferred Spanish. English-speaking parents were more likely to report having a data plan for their smartphone (117/157, 74.5%) or high-speed internet (138/157, 87.9%) compared to Spanish-speaking parents (smartphone: 23/40, 58%; P=.03; internet: 27/40, 68%; P=.002). Compared with Spanish-speaking parents, English-speaking parents were less likely to report having a lot or some concern about paying for internet (28/40, 70% vs 83/157, 52.9%; P=.046) or about data privacy (35/40, 88% vs 105/157, 67.5%; P=.01). Digital literacy scores differed significantly by race, income, education level, and language. In a multivariable model, language was not a significant factor for having high-speed internet service (P=.12) or concern about paying for internet at home (P=.60), but it was a significant factor for concerns about data privacy (P=.04). The significant differences in technology-related characteristics suggest that digital connectivity, affordability, and data privacy may also be important factors in considering digital technology use in asthma care.

High General Health Literacy Does Not Ensure Hearing Loss Health Literacy in Mothers of Children Who Are Deaf and Hard of Hearing.

The purpose of this study was to characterize general health literacy and hearing loss health literacy for mothers of children who are deaf and hard of hearing (DHH). Participants included 25 mothers of 2-year-old and 3-year-old children who had a diagnosis of permanent, bilateral hearing loss for at least 1 year. Measures of general health literacy and hearing loss health literacy were collected. Results indicated that mothers had high general health literacy but had lower hearing loss health literacy skills than expected. Although mothers had high education and experience of at least 1 year of having a child with hearing loss, performance on hearing loss health literacy measures was low. Caregiver understanding of hearing loss terminology and concepts is essential for decision making regarding their child's hearing loss health care.

Consent for Research Involving Spanish- and English-Speaking Latinx Adults With Schizophrenia.

Latinxs are vastly underrepresented in mental health research; one of many contributing factors may be complexities in the research consent process, including language preferences. We examined determinants of comprehension of research consent procedures and tested the effects of a preconsent research schema condition among 180 adults with schizophrenia (60 Latinx-English and 60 Latinx-Spanish preference, and 60 non-Latinx White). Participants were randomly assigned (equal allocation) to an educational session regarding clinical research concepts and processes (schema condition) or to an attention control. Following a subsequent simulated consent procedure for a hypothetical drug trail, comprehension of consent disclosures was measured with 2 standard measures. One-way ANOVAs showed significant medium effect size differences between ethnicity/language groups on both measures of comprehension (η2s = 0.066-0.070). The Latinx-Spanish group showed lower comprehension than non-Latinx White participants; differences between the 2 Latinx groups did not reach statistical significance. Group differences were not statistically significant after adjusting for differences in education, or on scores from structured measures of acculturation, health literacy, or research literacy. Two-way ANOVAs showed no significant main effects for consent procedure on either comprehension measure (Ps > .369; partial η2s < 0.006) and no significant group-by-consent interactions (Ps > .554; partial η2s < 0.008). Although the preconsent procedure was not effective, the results suggest health and research literacy may be targets for reducing disparities in consent comprehension. The onus is on researchers to improve communication of consent information as an important step to addressing health care disparities.

Spanish Heritage Language Learners' Reading Accuracy and Spelling Difficulties

Spelling has been recognized as a challenging aspect of literacy for Spanish Heritage Language Learners (SHLLs). This study examines the relationship between reading and spelling accuracy, with a specific focus on the vowel e, in monophthongs and diphthongs. A total of forty-five participants completed the Bilingual Language Profile and a reading task involving the contrast between monophthongs and diphthongs in real words and pseudowords. The results of the study indicate that participants encountered greater difficulties in accurately reading the vowel e when it appeared in a diphthong (ie) than when it appeared in a monophthong. Moreover, participants’ reading abilities were subject to a lexicality effect and hindered by limited phonological awareness and decoding skills. The paper further explores the connections between individual language dominance factors and literacy measures.