Development and validation of a measure of health literacy in the UK: the newest vital sign

Persistent Link:
http://hdl.handle.net/10150/610094
Title:
Development and validation of a measure of health literacy in the UK: the newest vital sign
Author:
Rowlands, Gill; Khazaezadeh, Nina; Oteng-Ntim, Eugene; Seed, Paul; Barr, Suzanne; Weiss, Barry
Affiliation:
London South Bank University, London, UK; Guy’s and St Thomas’ NHS Foundation Trust, London, UK; Kings College London, London, UK; University of Arizona, Tucson, AZ, USA
Issue Date:
2013
Publisher:
BioMed Central
Citation:
Rowlands et al. BMC Public Health 2013, 13:116 http://www.biomedcentral.com/1471-2458/13/116
Journal:
BMC Public Health
Rights:
© 2013 Rowlands et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)
Collection Information:
This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.
Abstract:
BACKGROUND:Health literacy (HL) is an important public health issue. Current measures have drawbacks in length and/or acceptability. The US-developed Newest Vital Sign (NVS) health literacy instrument measures both reading comprehension and numeracy skills using a nutrition label, takes 3 minutes to administer, and has proven to be acceptable to research subjects. This study aimed to amend and validate it for the UK population.METHODS:We used a three-stage process; (1) a Delphi study with academic and clinical experts to amend the NVS label to reflect UK nutrition labeling (2) community-based cognitive testing to assess and improve ease of understanding and acceptability of the test (3) validation of the NVS-UK against an accepted standard test of health literacy, the Test of Functional Health Literacy in Adults (TOFHLA) (Pearson's r and the area under the Receiver Operating Characteristic (ROC) curve) and participant educational level. A sample size calculation indicated that 250 participants would be required. Inclusion criteria were age 18-75 years and ability to converse in English. We excluded people working in the health field and those with impaired vision or inability to undertake the interview due to cognitive impairment or inability to converse in English.RESULTS:In the Delphi study, 28 experts reached consensus (3 cycles). Cognitive testing (80 participants) yielded an instrument that needed no further refinement. Validation testing (337 participants) showed high internal consistency (Cronbach's Alpha = 0.74). Validation against the TOFHLA demonstrated a Pearson's r of 0.49 and an area under the ROC curve of 0.81.CONCLUSIONS:The NVS-UK is a valid measure of HL. Its acceptability and ease of application makes it an ideal tool for use in the UK. It has potential uses in public health research including epidemiological surveys and randomized controlled trials, and in enabling practitioners to tailor care to patient need.
EISSN:
1471-2458
DOI:
10.1186/1471-2458-13-116
Keywords:
Literacy; Health literacy; Nutrition label; Measure
Version:
Final published version
Additional Links:
http://www.biomedcentral.com/1471-2458/13/116

Full metadata record

DC FieldValue Language
dc.contributor.authorRowlands, Gillen
dc.contributor.authorKhazaezadeh, Ninaen
dc.contributor.authorOteng-Ntim, Eugeneen
dc.contributor.authorSeed, Paulen
dc.contributor.authorBarr, Suzanneen
dc.contributor.authorWeiss, Barryen
dc.date.accessioned2016-05-20T08:58:25Z-
dc.date.available2016-05-20T08:58:25Z-
dc.date.issued2013en
dc.identifier.citationRowlands et al. BMC Public Health 2013, 13:116 http://www.biomedcentral.com/1471-2458/13/116en
dc.identifier.doi10.1186/1471-2458-13-116en
dc.identifier.urihttp://hdl.handle.net/10150/610094-
dc.description.abstractBACKGROUND:Health literacy (HL) is an important public health issue. Current measures have drawbacks in length and/or acceptability. The US-developed Newest Vital Sign (NVS) health literacy instrument measures both reading comprehension and numeracy skills using a nutrition label, takes 3 minutes to administer, and has proven to be acceptable to research subjects. This study aimed to amend and validate it for the UK population.METHODS:We used a three-stage processen
dc.description.abstract(1) a Delphi study with academic and clinical experts to amend the NVS label to reflect UK nutrition labeling (2) community-based cognitive testing to assess and improve ease of understanding and acceptability of the test (3) validation of the NVS-UK against an accepted standard test of health literacy, the Test of Functional Health Literacy in Adults (TOFHLA) (Pearson's r and the area under the Receiver Operating Characteristic (ROC) curve) and participant educational level. A sample size calculation indicated that 250 participants would be required. Inclusion criteria were age 18-75 years and ability to converse in English. We excluded people working in the health field and those with impaired vision or inability to undertake the interview due to cognitive impairment or inability to converse in English.RESULTS:In the Delphi study, 28 experts reached consensus (3 cycles). Cognitive testing (80 participants) yielded an instrument that needed no further refinement. Validation testing (337 participants) showed high internal consistency (Cronbach's Alpha = 0.74). Validation against the TOFHLA demonstrated a Pearson's r of 0.49 and an area under the ROC curve of 0.81.CONCLUSIONS:The NVS-UK is a valid measure of HL. Its acceptability and ease of application makes it an ideal tool for use in the UK. It has potential uses in public health research including epidemiological surveys and randomized controlled trials, and in enabling practitioners to tailor care to patient need.en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.biomedcentral.com/1471-2458/13/116en
dc.rights© 2013 Rowlands et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)en
dc.subjectLiteracyen
dc.subjectHealth literacyen
dc.subjectNutrition labelen
dc.subjectMeasureen
dc.titleDevelopment and validation of a measure of health literacy in the UK: the newest vital signen
dc.typeArticleen
dc.identifier.eissn1471-2458en
dc.contributor.departmentLondon South Bank University, London, UKen
dc.contributor.departmentGuy’s and St Thomas’ NHS Foundation Trust, London, UKen
dc.contributor.departmentKings College London, London, UKen
dc.contributor.departmentUniversity of Arizona, Tucson, AZ, USAen
dc.identifier.journalBMC Public Healthen
dc.description.collectioninformationThis item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
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