Is the cloze procedure appropriate to evaluate health literacy in older individuals? Age effects in the test of functional health literacy in adults.
Is the cloze procedure appropriate to evaluate health literacy in older individuals? Age effects in the test of functional health literacy in adults.
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DOI：
10.1155/2014/194635
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发表时间：
2014
影响因子：
4.7
通讯作者：
Jacobs RJ
中科院分区：
文献类型：
--
作者：
Ownby RL;Acevedo A;Waldrop-Valverde D;Jacobs RJ
健康素养由于其对老年人健康的重要性而受到越来越多的关注，因为研究表明，老年人的健康素养与他们的健康密切相关。研究还表明，老年人的健康素养水平较低，但这一发现是可变的，可能取决于使用哪种健康素养测试。功能性健康素养测试（TOFHLA）评估的老年人得分低于年轻人，但以前的研究表明，这可能是由于TOFHLA上与年龄相关的差异项目功能（DIF）。这里报告的研究评估了社区居民志愿者样本中与年龄相关的DIF。22%的项目对于年龄较大的人来说难度更大，与他们的整体能力无关，当这些项目从总分中剔除时，年龄差异就不再存在了。工作记忆任务的表现预测了年龄较大的人在与年龄相关的项目上的表现，而不是年轻人。至少有一部分老年人在健康素养方面的明显缺陷，在TOFHLA评估时，可能与DIF项目有关。TOFHLA和任何采用完形填空程序来评估阅读理解的方法，在老年人中应谨慎使用。
Health literacy has received increasing attention because of its importance for older individuals' health, as studies have shown a close relation between older individuals' health literacy and their health. Research also suggests that older individuals have low levels of health literacy, but this finding is variable and may depend on which health literacy test is used. Older individuals assessed with the Test of Functional Health Literacy (TOFHLA) score lower than younger individuals, but a previous study suggested that this may result from age-related differential item functioning (DIF) on the TOFHLA. The study reported here assessed age-related DIF in a sample of community-dwelling volunteers. Twenty-two percent of items were differentially more difficult for older individuals independent of their overall ability, and when these items were eliminated from the total score, age differences were no longer found. Performance on a working memory task predicted older but not younger individuals' performance on the age-related items. At least part of older individuals' apparent deficits in health literacy when assessed by the TOFHLA may be related to DIF on its items. The TOFHLA, and any measure that employs the cloze procedure to evaluate reading comprehension, should be used cautiously in older individuals.