Development and Validation of the Numeracy Understanding in Medicine Instrument Short Form

Schapira, Marilyn M.; Walker, Cindy M.; Miller, Tamara; Fletcher, Kathlyn E.; Ganschow, Pamela; Jacobs, Elizabeth A.; Imbert, Diana; O’Connell, Maria; Neuner, Joan

doi:10.1080/10810730.2014.933916

Cited by 32 publications

(33 citation statements)

References 48 publications

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“…Both include tests of several skills including ability to use numeric scales, interpret probabilities, and use information provided on a food label and ask respondents to provide a correct answer for each survey item. [7,24]…”

Section: Methodsmentioning

confidence: 99%

Should Health Numeracy Be Assessed Objectively or Subjectively?

Dolan

Cherkasky

et al. 2016

Med Decis Making

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Introduction Because current evidence suggests that numeracy affects how people make decisions, it is an important factor to account for in studies assessing the effectiveness of medical decision support interventions. Subjective and objective numeracy assessment methods are available that vary in theoretical background, skills assessed, known relationship with decision making skills, and ease of implementation. The best way to use these tools to assess numeracy when conducting medical decision-making research is currently unknown. Methods We conducted Internet surveys comparing numeracy assessments obtained using the subjective numeracy scale (SNS) and five objective numeracy scales. Each study participant completed the SNS and one objective numeracy measure. Following each assessment, participants indicated willingness to repeat the assessment and rated its user acceptability. Results The overall response rate was 78% resulting in a total sample size of 673. Spearman correlations between the SNS and the objective numeracy measures ranged from 0.19 to 0.44. Acceptability assessments for the short form of the Numeracy Understanding in Medicine Instrument (NUMI) and the SNS did not differ significantly. The other objective scales all had lower acceptability ratings than the SNS. Conclusions These findings are consistent with prior research suggesting that objective and subjective numeracy scales measure related but distinct constructs. Due to current uncertainty regarding which construct is more likely to influence the effectiveness of decision support interventions, these findings warrant further investigation to determine the proper use of objective vs subjective numeracy assessments in medical decision-making research. Pending additional information, a reasonable approach is to measure both objective and subjective numeracy so that the full range of actual and perceived numeracy skills can be taken into account.

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Section: Methodsmentioning

confidence: 99%

Should Health Numeracy Be Assessed Objectively or Subjectively?

Dolan

Cherkasky

et al. 2016

Med Decis Making

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“…There are multiple CRC screening test modalities and these tests often include oral and written instructions for test preparation and test result explanations. CRC information requires a wide range of literacy skills that cover basic concepts of health to more advanced concepts of risk probability and statistics (Schapira et al, 2014). Low health literacy has been found to be a barrier to CRC screening in prior research (Kobayashi, Wardle, & von Wagner, 2014; Shelton, Jandorf, Ellison, Villagra, & DuHamel, 2011) and is associated with less CRC awareness, CRC test knowledge, CRC screening test efficacy, and negative attitudes toward fecal occult blood test [FOBT] (Arnold et al, 2012; Dolan et al, 2004).…”

mentioning

confidence: 99%

Health Literacy among Medically Underserved: The Role of Demographic Factors, Social Influence, and Religious Beliefs

Christy

Gwede

Sutton

et al. 2017

Journal of Health Communication

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The current study examined the sociodemographic and psychosocial variables that predicted being at risk for low health literacy among a population of racially and ethnically diverse patients accessing primary care services at community-based clinics. Participants (N=416) were aged 50–75, currently not up-to-date with colorectal cancer (CRC) screening, at average CRC risk, and enrolled in a randomized controlled trial aimed at promoting CRC screening. Participants completed a baseline interview that assessed health literacy as measured by Rapid Estimate of Adult Literacy in Medicine-Revised, sociodemographic factors, and psychosocial variables (e.g., health beliefs) prior to randomization and receipt of an intervention. Thirty-six percent of participants were found to be at risk for low health literacy. Sociodemographic and psychosocial variables were assessed as predictors of being at risk for low health literacy using logistic regression. In the final model, predictors were male gender, being from a racial/ethnic minority group, being unable to work, having higher social influence scores, and having higher religious belief scores. These findings suggest several patient characteristics that may be associated with low health literacy, and highlight the importance of supporting all patients through simplified and clear communications and information to improve understanding of CRC screening information.

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“…Subjects also indicated their preferred pill and rated how much they liked the format on a 7-point Likert scale. Subjects then completed an objective numeracy assessment (Numeracy Understanding in Medicine Instrument Short Form (12)) and demographic questionnaire. ANOVA and chi-squared analyses were used to compare groups, and multivariate linear and logistic regression were used to assess adjusted differences between groups.…”

Section: Methodsmentioning

confidence: 99%

Utilization of Continuous “Spinners” to Communicate Risk

et al. 2017

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As patients become more involved in their medical care, they must consider the specific probabilities of both positive and negative outcomes associated with different treatments. Patients who are low in numeracy may be at a disadvantage when making these decisions. This study examines the use of a “spinner” to present probabilistic information compared to a numerical format and icon array. Subjects were asked to imagine they suffered from chronic back pain. Two equally effective medications, each with a different incidence of rare and common side effects were described. One hundred fifty-one subjects were randomized to one of three risk presentation formats: numeric only, numeric with icon arrays or numeric with spinners, and answered questions regarding their risk knowledge, medication preference, and how much they liked the presentation format. Compared to the numeric only format, both the spinner and icon array increased risk knowledge and were rated more likeable by subjects. Subjects viewing the spinner format were also more likely to prefer the pill with the lowest side effect burden.

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Development and Validation of the Numeracy Understanding in Medicine Instrument Short Form

Cited by 32 publications

References 48 publications

Should Health Numeracy Be Assessed Objectively or Subjectively?

Should Health Numeracy Be Assessed Objectively or Subjectively?

Health Literacy among Medically Underserved: The Role of Demographic Factors, Social Influence, and Religious Beliefs

Utilization of Continuous “Spinners” to Communicate Risk

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