Table 2.
Instrumentation of Health Literacy
| Instrument Used to Measure Health Literacy | Studies (n) | Study Citations |
|---|---|---|
| TOFHLA | 8 | |
| TOFHLA-Short Version | 7 | Garcia et al., 2013; Lee et al., 2006; Lee et al., 2009; Mayberry et al., 2014; Rubin et al., 2011; Stewart et al., 2014; Waldrop-Valverde et al., 2014 |
| TOFHLA (adapted to include HIV/AIDS related information) | 1 | Kalichman et al., 1999 |
| REALM | 5 | |
| REALM | 3 | Arozullah et al., 2006; Johnson et al., 2010; Ussher et al., 2010 |
| REALM-Teen | 1 | Chisolm et al., 2015 |
| REALM-Revised | 1 | Osborn et al., 2010 |
| Chew items | 6 | |
| Three Chew items | 3 | Levin et al., 2014; Maneze et al., 2015; Geboers et al., 2016 |
| One self-reported item (difficulty understanding written items) | 2 | Rosland et al., 2010; Rosland et al., 2011a |
| Unnamed self-reported measure of functional health literacyb | 1 | Aikens et al., 2015 |
| Other | 11 | |
| One self-reported item (“confidence filling out medical forms by yourself”) | 1 | Sentell et al., 2014 |
| Health LiTT | 1 | Hahn et al., 2015 |
| A validated instrument of health literacyc | 1 | Yang et al., 2013 |
| Korean Adult Health Literacy Scale | 1 | Kim et al., 2015 |
| Scales developed in Japan to assess functional, communicative, and critical health literacy | 1 | Inoue et al., 2013 |
| Four reading comprehension questions from fictitious medicine label-reading taskd | 1 | Kobayashi et al., 2015 |
| National Assessment of Adult Literacy data | 1 | Cimasi et al., 2013 |
| Chinese version of Health Literacy Scale for Patients with Chronic Disease | 1 | Zou et al., 2016 |
| Measure of Interactive Health Literacy | 1 | Rubin et al., 2011 |
| Assumed from study context: students taking ESL courses | 1 | Santos et al., 2014 |
| Health Literacy Management Scale | 1 | Lambert et al., 2015 |
Note:.ESL = English as a Second Language, LiTT = Health Literacy Assessment Using Talking Touchscreen Technology; REALM = Rapid Estimate of Adult Literacy in Medicine; TOFHLA = Test of Functional Health Literacy in Adults.
Authors deliberately exclude the other two Chew questions to avoid confounding.
Authors cite Chew et al. (2004, 2008) but do not indicate which questions were used or how scores were calculated.
From the information available in the article, the items in this instrument appear to be knowledge-based not skill/capacity-based, such as information about ideal body weight, fitness, and vaccines. This is a distinct way in which to define health literacy.
Developed by the Organisation for Economic Co-operation and Development and Statistics Canada for the Adult Literacy & Life Skills Survey.