Urmimala Sarkar|Dean Schillinger|Andrea López|Rebecca L. Sudore
Validation of Self-Reported Health Literacy Questions Among Diverse English and Spanish-Speaking Populations
San Francisco General Hospital|University of California, San Francisco|San Francisco General Hospital|University of California, San Francisco|San Francisco VA Medical Center
limited health literacy hl contributes poor health outcomes disparities direct measurement often timeintensive selfreported hl questions validated among spanishspeaking diverse englishspeaking populationsto evaluate three selfreported questions 1 confident filling medical forms 2 often problems learning medical condition difficulty understanding written information 3 often someone help read hospital materials answers based 5point likert scalethis validation study nested within trial diabetes selfmanagement support san francisco department public healthenglish spanishspeaking adults type 2 diabetes receiving primary careusing test functional health literacy adults stofhla english spanish reference classified hl inadequate marginal adequate calculated cindex test characteristics three questions summative scale compared stofhla assessed variations performance language raceethnicity age educationof 296 participants 48 spanishspeaking 9 white nonhispanic 47 inadequate hl 12 marginal hl overall 57 reported confident forms somewhat less confident forms question performed best detecting inadequate cindex 082 077087 inadequate plus marginal hl c index 081 076086 p001 differences questions performed comparably summative scale confident forms question scale also performed best across language raceethnicity educational attainment agea single selfreported hl question confidence forms summative scale three questions discriminated spanish english speakers adequate hl inadequate andor inadequate plus marginal hl confident forms question summative scale may useful estimating hl clinical research involving spanishspeaking englishspeaking chronicallyill diverse populations