Measuring patients' ability to read and comprehend: a first step in patient education

Recent reports released by the U.S. Department of Education indicate that approximately 90 million adults have poor reading and comprehension skills. This information highlights the importance of considering the literacy level of clients when planning patient education programs. The purpose of this investigation was to measure, in urban public clinics, the discrepancy between a self-report of the highest grade completed in school and the actual reading and comprehension levels of patients, measured by the WRAT and CLOZE. Twenty-five subjects, 22 African Americans and 3 Caucasians, participated in this study. The findings indicated that, even though the self-reported highest grade completed showed a mean of twelfth grade, the actual mean reading level was below eighth grade. The results on comprehension showed that 52% (N = 13) of the subjects needed additional instructions after reading materials and 24% were unable to comprehend what they read. The demographics of people with poor literacy skills suggests that they represent a significant proportion of health care consumers who visit health departments, primary care facilities, and community-based health centers (Baker, Newton, & Bergerstresser, 1988).