Risk Estimate of Inadequate Health Literacy (REIHL): development and validation of a practitioner-friendly health literacy screening tool for older adults

Abstract

This study aimed to develop and validate a brief practitioner-friendly health literacy screening tool, called Rapid Estimate of Inadequate Health Literacy (REIHL), that estimates patients' health literacy inadequacy in demanding clinical settings. Methods: This is a methodological study of 304 community-dwelling older adults recruited from one community health centre and five district elderly community centres. Logistic regression models were used to identify the coefficients of the REIHL score's significant factors. Receiver operating characteristic (ROC) curve analysis was then used to assess the REIHL's sensitivity and specificity. Path analysis was employed to examine the REIHL's criterion validity with the Chinese Health Literacy Scale for Chronic Care and concurrent validity with self-rated health scale and the Geriatric Depression Scale-15. Results: The REIHL has scores ranging from 0 to 23. It had 76.9% agreement with the Chinese Health Literacy Scale for Chronic Care. The area under the ROC curve for predicting health literacy inadequacy was 0.82 (95% confidence interval=0.78-0.87, P<0.001). The ROC curve of the REIHL showed that scores ≥11 had a sensitivity of 77.8% and specificity of 75.6% for predicting health literacy inadequacy. The path analysis model showed excellent fit (Chi squared [2, 304] 0.16, P=0.92, comparative fit index 1.00, root mean square error of approximation <0.001, 90% confidence interval=0.00-0.04), indicating that the

Association between multiple chronic conditions and insufficient health literacy: cross-sectional evidence from a population-based sample of older adults living in Switzerland

“…In this context, measuring health literacy in hospital or primary care settings could be a key lever to personalizing health information and disease management in daily clinical practice. Recent publications developed and validated brief scales to rapidly detect inadequate health literacy in order to better tailor communication to healthcare users' skills and needs [57][58][59]. As communication and information exchange constitute a central part of disease management, continued efforts should also be made to support the learning of communication skills throughout the career of health professionals [60].…”

Development and validation of a comprehensive health literacy tool for adults in Hong Kong

“…Additionally, there is no rigorously validated HL scale for the general population in Hong Kong. Although several studies explored HL in the local community, the scales they used were either disease-specific or population-specific ( 36 – 40 ) or directly translated from existing ones without psychometric testing ( 41 , 42 ). Hong Kong is facing the challenges posed by the increasing disease burden from chronic diseases and has a dual-track healthcare system encompassing public and private sectors.…”

Developing a Health Literacy Scale for adults in Hong Kong: A modified e‐Delphi study with healthcare consumers and providers

“…In addition, there is no rigorously validated HL scale for the general population in Hong Kong. Although several studies explored the HL levels in Hong Kong, the scales they used were either condition‐specific (i.e., disease‐specific and population‐specific) 37 , 38 , 39 , 40 , 41 or directly translated from existing scales without psychometric testing. 42 , 43 Hong Kong has a dual‐track healthcare system encompassing the public and private sectors.…”