TY - JOUR
T1 - Single-item or two-item literacy screener to predict the S-TOFHLA among adult hemodialysis patients
AU - Brice, Jane H.
AU - Foster, Mark B.
AU - Principe, Stephanie
AU - Moss, Chailee
AU - Shofer, Frances S.
AU - Falk, Ronald J.
AU - Ferris, Maria E.
AU - DeWalt, Darren A.
N1 - Funding Information:
Mr. Foster was supported by a Carolina Medical Student Research Program short-term grant. No other disclosures to report.
PY - 2014/1
Y1 - 2014/1
N2 - Objective: We compared single-item (SILS) and two-item (TILS) literacy screeners in predicting Short Test of Functional Health Literacy in Adults (S-TOFHLA) scores. Methods: Adult hemodialysis patients completed SILS, which determines need for assistance when reading written medical information; TILS (last grade completed and self-reported reading ability); and S-TOFHLA. Receiver operator characteristic curves (ROC) and stratum specific likelihoods were calculated. Results: Of 227 participants, median S-TOFHLA was 24 (IQR 15-34). 129 (55%) participants had adequate, 70 (30%) inadequate, and 37 (16%) marginal health literacy. SILS and TILS predicted S-TOFHLA scores equivalently. Test characteristics predicting inadequate health literacy were: SILS sensitivity for threshold >1, 54% (95%CI: 44, 64), for >2, 39% (29, 49) and specificity for >1, 73% (64, 80), for >2, 93% (87, 97), area under the ROC of 0.67 (0.60-0.74); TILS sensitivity for threshold >1, 72% (62, 80), for >2, 30% (21, 40) and specificity for >1, 54% (45, 63), for >2, 86% (79, 92), area under the ROC of 0.66 (0.59-0.73). Conclusion: SILS and TILS had similar test characteristics in predicting S-TOFHLA. Practice implications: While a positive result on either test increases the likelihood that a patient has low health literacy, the SILS is easier to administer and score.
AB - Objective: We compared single-item (SILS) and two-item (TILS) literacy screeners in predicting Short Test of Functional Health Literacy in Adults (S-TOFHLA) scores. Methods: Adult hemodialysis patients completed SILS, which determines need for assistance when reading written medical information; TILS (last grade completed and self-reported reading ability); and S-TOFHLA. Receiver operator characteristic curves (ROC) and stratum specific likelihoods were calculated. Results: Of 227 participants, median S-TOFHLA was 24 (IQR 15-34). 129 (55%) participants had adequate, 70 (30%) inadequate, and 37 (16%) marginal health literacy. SILS and TILS predicted S-TOFHLA scores equivalently. Test characteristics predicting inadequate health literacy were: SILS sensitivity for threshold >1, 54% (95%CI: 44, 64), for >2, 39% (29, 49) and specificity for >1, 73% (64, 80), for >2, 93% (87, 97), area under the ROC of 0.67 (0.60-0.74); TILS sensitivity for threshold >1, 72% (62, 80), for >2, 30% (21, 40) and specificity for >1, 54% (45, 63), for >2, 86% (79, 92), area under the ROC of 0.66 (0.59-0.73). Conclusion: SILS and TILS had similar test characteristics in predicting S-TOFHLA. Practice implications: While a positive result on either test increases the likelihood that a patient has low health literacy, the SILS is easier to administer and score.
KW - Health literacy
KW - Renal dialysis
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U2 - 10.1016/j.pec.2013.09.020
DO - 10.1016/j.pec.2013.09.020
M3 - Article
C2 - 24169024
AN - SCOPUS:84890244931
VL - 94
SP - 71
EP - 75
JO - Patient Education and Counseling
JF - Patient Education and Counseling
SN - 0738-3991
IS - 1
ER -