Document Type

Article

Publication Date

2023

Journal Title

Patient Education and Counseling

Volume Number

109

First Page

1

Last Page

8

DOI

https://doi.org/10.1016/j.pec.2023.107628

Version

Publisher PDF: the final published version of the article, with professional formatting and typesetting

Disciplines

Nursing

Abstract

Objective

Prior studies comparing subjective and objective health literacy measures have yielded inconsistent results. Our aim was to examine the concordance between Newest Vital Sign (NVS) and Brief Health Literacy Screen (BHLS) scores in a large cohort of English- and Spanish-speaking urban Hispanic adults.

Methods

Item means, standard deviations, corrected-item total correlations, Cronbach’s alpha, and Spearman correlations and area under receiver operating characteristic (AUROC) curve analysis were used to compare NVS and BHLS items and total scores.

Results

N = 2988 (n = 1259 English; n = 1729 Spanish). Scores on both measures demonstrated good internal consistency (NVS: α = .843 English, .846 Spanish; BHLS: α = .797 English, .846 Spanish) but NVS items had high difficulty; more than half of respondents scored 0. Measures were only weakly correlated (rs = .21, p < .001, English; rs = .19, p< .001, Spanish). The AUROC curves were .606 (English) and .605 (Spanish) for discriminating the lowest NVS scoring category.

Conclusion

Subjective health literacy scores were poor predictors of objective scores. Objective scores demonstrated floor effects, precluding discrimination at low levels of the trait continuum.

Practice implications

Subjective health literacy scores may fail to identify individuals with limited health literacy.

Included in

Nursing Commons

Share

COinS