Arcia A, Pho AT, Lor M, Bakken S, et al.
Patient education and counseling. Date of publication 2023 Apr 1;volume 109():107628.
1. Patient Educ Couns. 2023 Apr;109:107628. doi: 10.1016/j.pec.2023.107628. Epub
2023 Jan 10.
Comparison of Newest Vital Sign and Brief Health Literacy Screen scores in a
large, urban Hispanic cohort.
Arcia A(1), Pho AT(2), Lor M(3), Bakken S(4).
Author information:
(1)School of Nursing, Columbia University, 560 West 168th Street, MC6, New York,
NY 10032, USA. Electronic address: adrianaxarcia@gmail.com.
(2)School of Nursing, Columbia University, 560 West 168th Street, MC6, New York,
NY 10032, USA. Electronic address: apho@stanford.edu.
(3)School of Nursing, Columbia University, 560 West 168th Street, MC6, New York,
NY 10032, USA. Electronic address: mlor2@wisc.edu.
(4)School of Nursing, Columbia University, 560 West 168th Street, MC6, New York,
NY 10032, USA; Department of Biomedical Informatics, Columbia University, 622 W.
168th Street, PH20 3720, New York, NY 10032, USA. Electronic address:
sbh22@columbia.edu.
OBJECTIVE: Prior studies comparing subjective and objective health literacy
measures have yielded inconsistent results. Our aim was to examine the
concordance between Newest Vital Sign (NVS) and Brief Health Literacy Screen
(BHLS) scores in a large cohort of English- and Spanish-speaking urban Hispanic
adults.
METHODS: Item means, standard deviations, corrected-item total correlations,
Cronbach's alpha, and Spearman correlations and area under receiver operating
characteristic (AUROC) curve analysis were used to compare NVS and BHLS items
and total scores.
RESULTS: N = 2988 (n = 1259 English; n = 1729 Spanish). Scores on both measures
demonstrated good internal consistency (NVS: α = .843 English, .846 Spanish;
BHLS: α = .797 English, .846 Spanish) but NVS items had high difficulty; more
than half of respondents scored 0. Measures were only weakly correlated (rs
= .21, p < .001, English; rs = .19, p < .001, Spanish). The AUROC curves
were .606 (English) and .605 (Spanish) for discriminating the lowest NVS scoring
category.
CONCLUSION: Subjective health literacy scores were poor predictors of objective
scores. Objective scores demonstrated floor effects, precluding discrimination
at low levels of the trait continuum.
PRACTICE IMPLICATIONS: Subjective health literacy scores may fail to identify
individuals with limited health literacy.
Copyright © 2023 Elsevier B.V. All rights reserved.
DOI: 10.1016/j.pec.2023.107628
PMCID: PMC9931673
PMID: 36646018 [Indexed for MEDLINE]
Conflict of interest statement: We have no known conflicts of interest to
disclose.
