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Development of an easy-to-use Spanish Health Literacy test.
Shoou-Yih D Lee1, Deborah E Bender, Rafael E Ruiz
1Department of Health Policy and Administration, School of Public Health, University of North Carolina at Chapel Hill, 1101 McGavran-Greenberg Hall (CB# 7411), Chapel Hill, NC 27599-7411, USA.
Health Services Research
|August 11, 2006
Summary
A new health literacy test, SAHLSA-50, effectively screens Spanish speakers. This validated tool improves upon existing methods for assessing health literacy in diverse populations.
Area of Science:
- Health Literacy Research
- Medical Education
- Sociomedical Sciences
Background:
- Assessing health literacy is crucial for effective patient communication and care.
- Existing tools like REALM may not adequately assess health literacy in Spanish-speaking populations.
- A culturally and linguistically appropriate tool is needed to identify low health literacy among Spanish adults.
Purpose of the Study:
- To develop and validate the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA).
- To create a reliable and valid instrument for screening health literacy in Spanish speakers.
- To adapt and improve upon existing health literacy assessment methods.
Main Methods:
- SAHLSA was developed based on the Rapid Estimate of Adult Literacy in Medicine (REALM), incorporating word recognition and a novel comprehension test.
- The instrument was validated by comparing it with other health literacy tools in a sample of Spanish-speaking and English-speaking adults.
- Item response theory analysis was used to refine SAHLSA into a 50-item instrument (SAHLSA-50).
Main Results:
- SAHLSA significantly improved the differentiation of health literacy levels compared to REALM alone in Spanish speakers.
- SAHLSA-50 demonstrated strong correlations with the Test of Functional Health Literacy in Adults (r=0.65).
- SAHLSA-50 showed good reliability (Cronbach's alpha=0.92, Pearson's r=0.86) and was associated with better physical health status.
Conclusions:
- The SAHLSA-50 is a reliable and valid instrument for assessing health literacy in Spanish-speaking adults.
- This tool can be effectively used in clinical and community settings for screening low health literacy.
- SAHLSA-50 addresses a critical need for culturally appropriate health literacy assessment.