Department of Health Services Research, Division of Cancer Prevention & Population Sciences, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd.Unit 1444, Houston, TX, 77030, USA.
Department of Health Disparities Research, Division of Cancer Prevention & Population Sciences, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd.Unit 1440, Houston, TX, 77030, USA.
BMC Public Health. 2018 Mar 27;18(1):405. doi: 10.1186/s12889-018-5333-9.
Although the Short Test of Functional Health Literacy in Adults (S-TOFHLA) is widely used, misidentification of individuals with low health literacy (HL) in specific HL dimensions, like numeracy, is a concern. We examined the degree to which individuals scored as "adequate" HL on the S-TOFHLA would be considered as having low HL by two additional numerical measures.
English-speaking adults aged 45-75 years were recruited from a large, urban academic medical center and a community foodbank in the United States. Participants completed the S-TOFHLA, the Subjective Numeracy Scale (SNS), and the Graphical Literacy Measure (GL), an objective measure of a person's ability to interpret numeric information presented graphically. Established cut-points or a median split classified participants and having high and low numeracy.
Participants (n = 187), on average were: aged 58 years; 63% female; 70% Black/African American; and 45% had a high school degree or less. Of those who scored "adequate" on the S-TOFHLA, 50% scored low on the SNS and 40% scored low on GL. Correlation between the S-TOFHLA and the SNS Total was moderate (r = 0.22, n = 186, p = 0.01), while correlation between the S-TOFHLA and the GL Total was large (r = 0.53, n = 187, p ≤ 0.01).
Findings suggest that the S-TOFHLA may not capture an individuals' HL in the dimension of numeracy. Efforts are needed to develop more encompassing and practical strategies for identifying those with low HL for use in research and clinical practice.
NCT02151032 (retrospectively registered: May 30, 2014).
尽管成年人简易功能性健康素养测试（S-TOFHLA）应用广泛，但在特定的健康素养维度（如计算能力）中，错误识别低健康素养（HL）个体是一个令人关注的问题。我们研究了在 S-TOFHLA 中被评为“足够” HL 的个体，通过另外两种数值测量方法，会被认为具有低 HL。
在美国的一家大型城市学术医疗中心和社区食品银行，招募了年龄在 45-75 岁之间的讲英语的成年人。参与者完成了 S-TOFHLA、主观计算能力量表（SNS）和图形阅读能力测量（GL），这是一种评估个人解读图形呈现的数值信息能力的客观方法。既定的切点或中位数将参与者分为计算能力高和低的两类。
参与者（n=187），平均年龄为 58 岁；63%为女性；70%为黑人和非裔美国人；45%的人拥有高中或以下学历。在 S-TOFHLA 中得分“足够”的人中，有 50%在 SNS 上得分低，有 40%在 GL 上得分低。S-TOFHLA 与 SNS 总分的相关性为中等（r=0.22，n=186，p=0.01），而 S-TOFHLA 与 GL 总分的相关性为强（r=0.53，n=187，p≤0.01）。
研究结果表明，S-TOFHLA 可能无法捕捉个体在计算能力维度上的 HL。需要努力开发更全面和实用的策略，以确定那些在研究和临床实践中具有低 HL 的人。
NCT02151032（回顾性注册：2014 年 5 月 30 日）。
