Weiss Barry D, Mays Mary Z, Martz William, Castro Kelley Merriam, DeWalt Darren A, Pignone Michael P, Mockbee Joy, Hale Frank A
University of Arizona College of Medicine, Department of Family and Community Medicine, Tucson 85719, USA.
Ann Fam Med. 2005 Nov-Dec;3(6):514-22. doi: 10.1370/afm.405.
Current health literacy screening instruments for health care settings are either too long for routine use or available only in English. Our objective was to develop a quick and accurate screening test for limited literacy available in English and Spanish.
We administered candidate items for the new instrument and also the Test of Functional Health Literacy in Adults (TOFHLA) to English-speaking and Spanish-speaking primary care patients. We measured internal consistency with Cronbach's alpha and assessed criterion validity by measuring correlations with TOFHLA scores. Using TOFLHA scores <75 to define limited literacy, we plotted receiver-operating characteristics (ROC) curves and calculated likelihood ratios for cutoff scores on the new instrument.
The final instrument, the Newest Vital Sign (NVS), is a nutrition label that is accompanied by 6 questions and requires 3 minutes for administration. It is reliable (Cronbach alpha >0.76 in English and 0.69 in Spanish) and correlates with the TOFHLA. Area under the ROC curve is 0.88 for English and 0.72 for Spanish versions. Patients with more than 4 correct responses are unlikely to have low literacy, whereas fewer than 4 correct answers indicate the possibility of limited literacy.
NVS is suitable for use as a quick screening test for limited literacy in primary health care settings.
当前用于医疗保健机构的健康素养筛查工具要么太长不适用于常规使用，要么仅提供英文版本。我们的目标是开发一种快速且准确的筛查测试，用于评估英文和西班牙文读写能力有限的人群。
我们向讲英语和讲西班牙语的初级保健患者发放了新工具的候选项目以及成人功能性健康素养测试（TOFHLA）。我们用克朗巴哈系数（Cronbach's alpha）测量内部一致性，并通过测量与TOFHLA分数的相关性来评估标准效度。使用TOFLHA分数<75来定义有限素养，我们绘制了受试者操作特征（ROC）曲线，并计算了新工具截止分数的似然比。
最终工具“最新生命体征”（NVS）是一个营养标签，附带6个问题，完成测试需要3分钟。它具有可靠性（英文版本的克朗巴哈系数>0.76，西班牙文版本为0.69），并且与TOFHLA相关。英文版本的ROC曲线下面积为0.88，西班牙文版本为0.72。正确回答超过4个问题的患者不太可能具备低素养，而正确答案少于4个则表明可能存在有限素养。
NVS适合用作初级卫生保健机构中有限素养的快速筛查测试。
