Generic Health Literacy Measurements for Adults: A Scoping Review

Abstract

Background: Generic health literacy measurement (GHLM) is an important tool to identify individuals with limited health literacy and can assist the design of tailored interventions for improving public health literacy. However, there is no consensus on measuring generic health literacy. The present study aims to review current GHLM used for adults in the literature. Methods: A scoping review was undertaken to map the available measurements designed to assess generic health literacy. Results: The review identified 19 GHLM for adults. Most of them applied a multidimensional definition of health literacy with a focus on individuals’ abilities to access, appraise, understand, and apply health information and services. Nutbeam’s conceptual model and Sørensen’s integrated model were widely used among the identified measures as the theoretical foundation. While the social determinants of health (SDH) were acknowledged in the two models, it remains unmentioned in many of the identified measures based on the Nutbeam’s model and needs further development in the measure based on the Sørensen’s model. A total of 39 different domains were assessed in the 19 measurements: prose was identified in 8 measurements and was the most prominent domain; followed by numeracy (n = 7) and interactive (n = 7). SDH related domains such as social support (n = 3), social capital (n = 1) were seldom included in the identified measurements. Conclusions: Although current GHLM adopted a multidimensional construct, they mainly focused on individuals’ abilities and SDH has not been well-developed in the assessment. Further research is required to advance the measuring of the interaction between SDH and health literacy.

Satisfaction With Patient Engagement and Self-Reported Depression Among Hospitalized Patients: A Propensity-Score Matching Analysis

“…The difference in satisfaction with PE interventions between urban and rural patients has not been studied in China or worldwide. Poor health literacy, widely associated with poor health, low quality of life, and impaired wellbeing (39,46) could explain this difference, given that, in this study, 26.2% of urban patients had a university degree, compared with only 4.6% of rural patients. However, rural patients, limited by insurance reimbursement rates, geographical barriers, and social stigma (47,48), reported a low possibility of developing depression when they were satisfied with their involvement in designing their discharge plan, which could minimize the likelihood of hospital readmission.…”

Validation of an Arabic Version of the Adherence to Refills and Medications Scale (ARMS)

“…Even though patients with limited health literacy were leaning toward being non-adherent (e.g., ARMS score ≥ 16), the association between health literacy and Arabic-ARMS score was not significant. This can be due to the study's small sample or the fact that health literacy was assessed using the SILS which is not as reliable as other longer scales, such as Test of Functional Health Literacy (TOFHL) and Rapid Estimate of Adult Literacy in Medicine (REALM) [51]. However, adequate health literacy was negatively associated with the total ARMS score, which means that patients with adequate health literacy were more likely to adhere to their prescription medications.…”

Validation of an Arabic Version of the Self-Efficacy for Appropriate Medication Use Scale

“…Moreover, health literacy was assessed using the single item literacy screener (SILS). Though SILS is a valid tool to assess health literacy, it is not as reliable as other scales [19], such as the 67-item Test of Functional Health Literacy (TOFHL), which was not used due to the time constraint associated with administering such a lengthy questionnaire [39]. Additionally, this was a single center study and the majority of patients were Saudi (98%) which may limit the generalizability of the study findings.…”