Table 2.

Health literacy measures used in studies included in this review

Health Literacy MeasureNo. of Studies Using Measure (%)FormApproximate Time Taken (min)Health Literacy Categorization
STOFHLA9 (45) Three studies used both English and Spanish versions36 Reading comprehension items selected from four choices to replace missing words in text (modified Cloze procedure)120–22: Limited, 23–36: adequate
REALM6 (30)125 Health-related words (66 in more commonly used form) tested for pronunciation accuracy30–44: Inadequate; 45–60: marginal; 61–66: adequate (limited = inadequate + marginal)
REALM-T1 (5)69 Kidney transplant–related terms tested for pronunciation accuracy3Not clearly defined
BHLS4 (20)Three questions. How confident are you filling out forms by yourself? How often do you have someone help you read hospital materials? How often do you have problems learning about your medical condition because of difficulty reading hospital materials? All graded 1–5; scores range from 3 to 15 (or 0–12 in one study [Cavanaugh et al., unpublished data], Supplemental Table 1)<13–8 (or 0–5): Lower; 9–14 (or 6–12): moderate/higher (<10/15 or <6/12 indicates limited health literacy)
NVS1 (5)Six-item assessment of reading comprehension from an ice cream nutrition label, 6 maximum (average 2.9) (56)0–1: High likelihood marginal/inadequate; 2–3: possible marginal/inadequate; 4–6: adequate (score <4 indicates limited health literacy [39])
SILS2 (10) (one used English and Spanish versions)“How often do you need to have someone help you when you read instructions, pamphlets or other written material from your doctor or pharmacy” answered on a 5-point Likert scale from 1 (never) to 5 (always)<1<3: Adequate; ≥3: limited
TILS1 (5) (English or Spanish)Two questions. What was the last (educational) grade you completed? Can you estimate your reading ability with one of the following: “I frequently read complete books,” “I read the newspaper,” ”I occasionally need help with the newspaper,” or “I frequently need help with the newspaper”; scored from −4 to +5<1Sensitivity/specificity of different cutoff points was tested; use of TILS>1 to indicate limited health literacy is suggested
  • STOFHLA, Short Test of Functional Health Literacy in Adults; REALM, Rapid Evaluation of Adult Literacy in Medicine; REALM-T, transplant-specific version of the Rapid Estimate of Adult Literacy in Medicine; BHLS, Brief Health Literacy Screener; NVS, Newest Vital Sign; SILS, Single-Item Literacy Screener; TILS, Two-Item Literacy Screener