青少年医学素养快速评估工具（REALM-Teen）的开发与验证：一种在医疗环境中筛查青少年阅读水平低于年级标准情况的工具。

Development and validation of the Rapid Estimate of Adolescent Literacy in Medicine (REALM-Teen): a tool to screen adolescents for below-grade reading in health care settings.

作者信息

Davis Terry C, Wolf Michael S, Arnold Connie L, Byrd Robert S, Long Sandra W, Springer Thomas, Kennen Estela, Bocchini Joseph A

机构信息

Department of Pediatrics and Medicine, Louisiana State University Health Sciences Center, Shreveport, Shreveport, LA 71130, USA.

出版信息

Pediatrics. 2006 Dec;118(6):e1707-14. doi: 10.1542/peds.2006-1139.

DOI:10.1542/peds.2006-1139

PMID:17142495

Abstract

OBJECTIVE

The magnitude and consequences of low literacy in adolescent health and health care are unknown. The purpose of this study was to validate the Rapid Estimate of Adolescent Literacy in Medicine (REALM-Teen), a word-recognition test in English that can be used as a brief literacy-screening tool in health care settings.

PATIENTS AND METHODS

A total of 1533 adolescents aged 10 to 19 years attending 1 of 5 middle schools, 3 high schools, 1 pediatric clinic, or 2 summer programs in Louisiana and North Carolina participated in face-to-face interviews. Demographic information was solicited, and participants were administered a battery of reading tests, including the REALM-Teen, Wide Range Achievement Test-Revised (WRAT-3), and Slosson Oral Reading Test-Revised (SORT-R). Internal consistency for the REALM-Teen was determined using Cronbach's alpha, and criterion validity was established through correlations with both the WRAT-R and SORT-R. Using reading below grade level (according to SORT-R scores) as an outcome, instrument accuracy and corresponding cutoff scores were calculated by plotting receiver operating characteristic curves and stratum-specific likelihood ratios.

RESULTS

Participants were 50% black and 53% female; 34% were enrolled in middle school and 66% in high school. The average time required to administer the REALM-Teen was 3 minutes. Internal consistency was excellent, as was test-retest reliability. The REALM-Teen is strongly correlated with both the WRAT-R and SORT-R. Five reading level categories were identified: 3rd grade and below, 4th to 5th grade, 6th to 7th grade, 8th to 9th grade, and 10th grade and above. Forty-six percent of participants were reading below grade level according to the SORT-R and 28% had repeated at least 1 grade.

CONCLUSION

The REALM-Teen is a brief, reliable instrument for assessing adolescent literacy skills and reading below grade level.

摘要

目的

青少年健康及医疗保健领域中文盲的严重程度和后果尚不清楚。本研究的目的是验证医学青少年识字率快速评估法（REALM-Teen），这是一项英文单词识别测试，可作为医疗保健环境中简短的识字筛查工具。

患者与方法

来自路易斯安那州和北卡罗来纳州的5所初中、3所高中、1家儿科诊所或2个暑期项目中的1533名10至19岁青少年参加了面对面访谈。收集了人口统计学信息，并让参与者进行了一系列阅读测试，包括REALM-Teen、修订版广泛成就测验（WRAT-3）和修订版斯洛森口语阅读测验（SORT-R）。使用克朗巴赫α系数确定REALM-Teen的内部一致性，并通过与WRAT-R和SORT-R的相关性建立效标效度。以低于年级阅读水平（根据SORT-R分数）为结果，通过绘制受试者工作特征曲线和特定分层似然比来计算工具准确性和相应的截断分数。

结果

参与者中50%为黑人，53%为女性；34%就读于初中，66%就读于高中。实施REALM-Teen平均所需时间为3分钟。内部一致性良好，重测信度也良好。REALM-Teen与WRAT-R和SORT-R均高度相关。确定了五个阅读水平类别：三年级及以下、四年级至五年级、六年级至七年级、八年级至九年级、十年级及以上。根据SORT-R，46%的参与者阅读水平低于年级，28%的参与者至少留级过一次。