Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 6:4:100262.
doi: 10.1016/j.pecinn.2024.100262. eCollection 2024 Dec.

Adaptation of a health literacy screener for computerized, self-administered use by U.S. adults

Olivia J Lindly  1 , Taylor A Wahl  1 , Noa M Stotts  2 , Amy M Shui  3
Affiliations

Adaptation of a health literacy screener for computerized, self-administered use by U.S. adults

Olivia J Lindly et al. PEC Innov. .

Abstract

Objective: Health literacy is a critical health determinant, for which few computerized, self-administered assessments exist. This study adapted and tested the reliability of the Newest Vital Sign© (NVS) as a computerized, self-administered health literacy screener.

Methods: Phase one involved 33 participants to create response options for a computerized, self-administered NVS (C-NVS). Phase two was a randomized crossover trial to test the consistency of C-NVS and original, interviewer-administered NVS (I-NVS) scores in 89 participants.

Results: Linear mixed-effects regression model results showed a significant carryover effect (p < .001). Crossover trial data from time 1 showed that participants who initially received the C-NVS had significantly higher average scores (M = 5.7, SD = 0.6) than participants who received the I-NVS (M = 4.5, SD = 1.5; t(87) = 5.25, p < .001). Exploratory analysis results showed that when the washout period was longer than 33 days (75th percentile) the carryover effect was not statistically significant (p = .077).

Conclusion and innovation: Findings suggest learning can occur when health literacy screeners are administered more than once in less than a month's time and computerized, self-administered health literacy screeners may produce ceiling effects. A universal precautions approach to health literacy therefore remains germane.

Keywords: Adults; Crossover trial; Health literacy; Rural; Safety net.

PubMed Disclaimer

Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Olivia Lindly reports financial support was provided by Southwest Health Equity Research Collaborative at 10.13039/100008883Northern Arizona University (U54MD012388), which is sponsored by the 10.13039/100006545National Institute on Minority Health and Health Disparities.

Figures

Fig. 1
Fig. 1
Newest vital sign ice cream nutrition label. This is the ice cream label used as part of the Newest Vital Sign.
Fig. 2
Fig. 2
Example of computerized newest vital sign item with response options and pre-recorded narration as text. Voice Over Provided: “This Nutrition Facts label is on the back of the pint of ice cream. If you eat the entire container of ice cream how many calories will you eat? 250 cal? 500 cal? 750 cal? 1000 cal? I don't know?” This figure displays the first item of the computerized, self-administered Newest Vital Sign and the voice over provided with the item.
See this image and copyright information in PMC

References

    1. Berkman N., Davis T., McCormack L. Health literacy: what is it? J Health Commun. 2010;15(sup2):9–19. doi: 10.1080/10810730.2010.499985. - DOI - PubMed
    1. K. Sørensen et al., “Health literacy and public health: a systematic review and integration of definitions and models,” BMC Public Health, vol. 12, p. 80, Jan. 2012, doi: 10.1186/1471-2458-12-80. - DOI - PMC - PubMed
    1. Nutbeam D. Defining, measuring and improving health literacy. Health Eval Promot. 2015;42(4):450–456. doi: 10.7143/jhep.42.450. - DOI
    1. Nutbeam D. The evolving concept of health literacy. Soc Sci Med. 2008;67(12):2072–2078. doi: 10.1016/j.socscimed.2008.09.050. - DOI - PubMed
    1. Nutbeam D., Lloyd J.E. Understanding and responding to health literacy as a social determinant of health. Annu Rev Public Health. 2021;42(1):159–173. doi: 10.1146/annurev-publhealth-090419-102529. - DOI - PubMed