Development and Validation of a Short-Form, Rapid Estimate of Adult Literacy in Medicine

Arozullah, Ahsan M.; Yarnold, Paul R.; Bennett, Charles L.; Soltysik, Robert C.; Wolf, Michael S.; Ferreira, Rosario M.; Lee, Shoou Yih D.; Costello, S.; Shakir, Adil; Denwood, Caroline; Bryant, Fred B.; Davis, Terry C.

doi:10.1097/mlr.0b013e3180616c1b

Cited by 360 publications

(276 citation statements)

References 23 publications

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“…In order to characterize the patient population, we created a patient survey comprised of validated and adapted measures. Validated measures included the Patient Health Questionnaire-2 (PHQ-2) 22 to screen for depression as well as the Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF) 23,24 and Short Assessment of Health Literacy for Spanish Adults (SAHLSA-50) 25 to assess health literacy in English and Spanish, respectively. Individual items were adapted from the Medical Outcomes Study 36-Item Short-Form Health Survey (MOS-SF-36) 26 to measure health-related quality of life and from the National Health Interview Survey 27 to examine primary care access.…”

Section: Methodsmentioning

confidence: 99%

Factors Influencing Hospital Admission of Non-critically Ill Patients Presenting to the Emergency Department: a Cross-sectional Study

et al. 2015

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BACKGROUND:Little is known about the factors that influence physicians' admission decisions, especially among lower acuity patients. For the purpose of our study, non-medical refers to all of the factors-other than the patient's clinical condition-that could potentially influence admission decisions. OBJECTIVE: To describe the influence of non-medical factors on physicians' decisions to admit non-critically ill patients presenting to the ED. DESIGN: Cross-sectional study of hospital admissions at a single academic medical center. PARTICIPANTS: Non-critically ill adult patients admitted to the hospital (n=297) and the admitting emergency medicine physicians (n=34). MAIN MEASURES: A patient survey assessed nonmedical factors, including primary care access and utilization. A physician survey assessed clinical and nonmedical factors influencing the decision to admit. Based on physician responses, admissions were characterized as Bstrongly acuity-driven,^Bmoderately acuity-driven,ô r Bweakly acuity-driven.^Among these admission types, we compared length of stay, cost, and readmission within 30 days to the hospital or ED. KEY RESULTS: Based on the admitting physician's assessment, we categorized the motivation for admission as strongly acuity-driven in 185 (62 %) admissions, moderately acuity-driven in 92 (31 %), and weakly acuity-driven in 20 (7 %). Per the physician surveys, 51 % of hospitalizations were strongly or moderately influenced by one or more non-medical factors, including lack of information about baseline conditions (23 %); inadequate access to outpatient specialty care (14 %); need for a diagnostic testing or procedure (12 %); a recent ED visit (11 %); and inadequate access to primary care (10 %). Compared with strongly-acuity driven admissions, admissions that were moderately or weakly acuity-driven were shorter and less costly but were associated with similar rates of ED (35 %) and hospital (27 %) readmission. CONCLUSIONS: Non-medical factors are influential in the admission decisions for many patients presenting to the emergency department. Moderately and weakly acuity-driven admissions may represent a feasible target for alternative care pathways.KEY WORDS: non-medical factors; hospital admission decision; access to care; care transitions; decision making; emergency medicine; health care delivery; medical decision making; severity of illness; socioeconomic factors; utilization.

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Section: Methodsmentioning

confidence: 99%

Factors Influencing Hospital Admission of Non-critically Ill Patients Presenting to the Emergency Department: a Cross-sectional Study

et al. 2015

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“…$95.00 [26] . initially tested in African American and Caucasian populations [20] . Being the most common method used in the health care context, the REALM is time efficient, and contains only health words [4,22] .…”

Section: Rapid Estimate Of Adult Literacy In Medicine (Realm-sf)mentioning

confidence: 99%

“…the health literacy screening questions [1] , The Functional Health Literacy in Adults (TOFHLA) [19] , Rapid Estimate of Adult Literacy in Medicine (REALM) [16,18,[20][21][22] , The Medical Achievement Reading Test (MART) [23] , the Newest Vital Sign (NVS) [24] , a single item health literacy screening question [25] , the Slosson Oral Reading Test (SORT) [26,27] , and the Wide Range Achievement Test (WRAT) [28,29] .…”

Section: Literature Reviewmentioning

confidence: 99%

Measuring health literacy in emergency departments

Alqudah

Johnson

Cowin

et al. 2013

JNEP

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Background: Literacy and health literacy are important concepts that are related to how important health care messages are understood by patients. Emergency nurses are engaged in health promotion and require an understanding of the patient's health literacy. To assist emergency nurses in assessing a patient's level of health literacy a series of valid and reliable health literacy measurement tools have been presented. The aim of this paper is to nominate one of these tools to be used by emergency nurses in testing individual and group levels of health literacy. Methods:Databases searched included Scopus, Science direct, PubMed, PsycINFO and Educational Resources Information Center (ERIC). Included articles were published between 1990 and 2011, English language only, and articles that discussed word recognition tools and tools that take five minutes or less to administer resulting in sixteen articles. Results:The Rapid Estimate of Adult Literacy in Medicine-Short Format (REALM-SF) has been used successfully within an emergency setting to identify patients' level of health literacy and to supply appropriate health information. This tool was found by nursing staff to be easily administered, and more acceptable when used in private areas. However, further research within varying age groups is recommended. Conclusion:Most of the available tools are related to each other and have the ability to measure varying levels of health literacy. The REALM-SF is a simple quick approach to measuring health literacy in busy clinical settings. Emergency nurses require training in administering these tests in a non-threatening and accurate manner.

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“…Similar to the Rapid Estimate of Adult Literacy in Medicine-Short Form, a health literacy assessment tool, 17 we asked participants to read eight specific words from the brochure aloud to assess readability of words used in the brochure. These words were bone, activity (two simple words for practice), osteoporosis, supplements, density, calcium, dairy, and strengthening.…”

Section: Items From the Semistructured Interview Guidementioning

confidence: 99%

Understanding Preferences for Osteoporosis Information to Develop an Osteoporosis Patient Education Brochure

Edmonds

Solimeo

Nguyen

et al. 2017

TPJ

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Context: Patient education materials can provide important information related to osteoporosis prevention and treatment. However, available osteoporosis education materials fail to follow best-practice guidelines for patient education.Objective: To develop an educational brochure on bone health for adults aged 50 years and older using mixed-method, semistructured interviews.Design: This project consisted of 3 phases. In Phase 1, we developed written content that included information about osteoporosis. Additionally, we designed 2 graphic-rich brochures, Brochure A (photographs) and Brochure B (illustrations). In Phase 2, interviewers presented the text-only document and both brochure designs to 53 participants from an academic Medical Center in the Midwest and an outpatient clinic in the Southeastern region of the US. Interviewers used open-and closed-ended questions to elicit opinions regarding the brochures. In Phase 3, using feedback from Phase 2, we revised the brochure and presented it to 11 participants at a third site in the Southeastern US.Main Outcome Measures: Participants' comprehension of brochure text and acceptability of brochure design.Results: We enrolled 64 participants. Most were women, white, and college-educated, with an average age of 66.1 years. Participants were able to restate the basic content of the brochure and preferred Brochure A's use of photographs.Conclusions: Using feedback from older adults, we developed and refined a brochure for communicating bone health information to older adults at risk of osteoporosis and fragility fractures. The methods outlined in this article may serve to guide others in developing health educational brochures for chronic medical conditions.

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Development and Validation of a Short-Form, Rapid Estimate of Adult Literacy in Medicine

Abstract: The REALM-SF provides researchers a brief, validated instrument for assessing patient literacy in diverse research settings.

Cited by 360 publications

References 23 publications

Factors Influencing Hospital Admission of Non-critically Ill Patients Presenting to the Emergency Department: a Cross-sectional Study

Factors Influencing Hospital Admission of Non-critically Ill Patients Presenting to the Emergency Department: a Cross-sectional Study

Measuring health literacy in emergency departments

Understanding Preferences for Osteoporosis Information to Develop an Osteoporosis Patient Education Brochure

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