Health Literacy INDEX: Development, Reliability, and Validity of a New Tool for Evaluating the Health Literacy Demands of Health Information Materials

Abstract

There is no consensus on how best to assess the health literacy demands of health information materials. Comprehensive, reliable, and valid assessment tools are needed. The authors report on the development, refinement, and testing of Health Literacy INDEX, a new tool reflecting empirical evidence and best practices. INDEX is comprised of 63 indicators organized into 10 criteria: plain language, clear purpose, supporting graphics, user involvement, skill-based learning, audience appropriateness, user instruction, development details, evaluation methods, and strength of evidence. In a sample of 100 materials, intercoder agreement was high: 90% or better for 52% of indicators, and above 80% for nearly all others. Overall scores generated by INDEX were highly correlated with average ratings from 12 health literacy experts (r = 0.89, p < .0001). Additional research is warranted to examine the association between evaluation ratings generated by INDEX and individual understanding, behaviors, and improved health. Health Literacy INDEX is a comprehensive tool with evidence for reliability and validity that can be used to evaluate the health literacy demands of health information materials. Although improvement in health information materials is just one aspect of mitigating the effects of limited health literacy on health outcomes, it is an essential step toward a more health literate public.

The Emergence of Environmental Health Literacy—From Its Roots to Its Future Potential

“…Academic endeavors to date have focused primarily on elucidating the attributes of EHL and on the stages of becoming literate about environmental health concepts and issues (Kaphingst et al 2012; Sørensen et al 2012). These academic efforts have built upon conceptual frameworks from the fields of health literacy and risk communication to define the progression of understanding from basic knowledge to comprehension and application (Colucci-Gray et al 2006; Guidotti 2013; Nutbeam 2008).…”

Designing persuasive health materials using processing fluency: a literature review

“…The implications of this cast new light on the importance of designing readable health materials. Traditionally, health materials have been difficult to process because of excessive jargon [45, 46], excessively high reading levels [4], and dense presentation of information [47, 48]. In recent years, low health literacy has been recognized as one of the barriers to understanding and using health information in making appropriate decisions about one’s health and health care [3].…”

“…Accordingly, when patients or caregivers are overwhelmed with too much health information, their ability to comprehend, recall, and use this information can decline [63]. Nevertheless, written health materials tend to be information dense [47, 48]. Kaphingst et al [48] reviewed health materials and found that only half limited the number of key points to five or fewer per section.…”

Design and Implementation of a Randomized Controlled Trial of Genomic Counseling for Patients with Chronic Disease

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