Validation of screening questions for limited health literacy in a large VA outpatient population
Validation of screening questions for limited health literacy in a large VA outpatient population
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DOI：
10.1007/s11606-008-0520-5
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发表时间：
2008-05-01
影响因子：
5.7
通讯作者：
VanRyn, Michelle
中科院分区：
文献类型：
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作者：
Chew, Lisa D.;Griffin, Joan M.;VanRyn, Michelle
提示：以前的研究表明，一个单一的问题可能会识别出健康素养不足的个人。我们评估和比较了3个健康素养筛选问题的性能检测患者的不足或边缘健康素养在一个大型VA population.METHODS：我们进行了随机抽样的患者从4 VA医疗中心，其中包括3个健康素养筛选问题和2个验证的健康素养措施的人进行了访谈。根据成人功能性健康素养短期测试（S-TOFHLA）和成人医学素养快速评估（REALM），将患者分类为健康素养不足、边缘或充分。我们评估了3个问题中的每一个检测的能力：1）基于S-TOFHLA的健康素养不足和“不足或边缘”的组合，以及2）基于REALM.MEASUREMENTS和主要结果的健康素养不足和“不足或边缘”的组合：在4，384例患者中，1，796（41%）完成了访谈。根据S-TOHFLA和REALM，健康知识普及率分别为6.8%和4.2%。边缘健康素养的可比患病率分别为7.4%和17%。对于发现健康素养不足，“你对自己填写医疗表格有多自信？基于S-TOFHLA和REALM，“的受试者工作特征曲线下面积（AUROC）最大，分别为0.74（95%CI：0.69-0.79）和0.84（95%CI：0.79-0.89）。AUROC检测“不足或边缘”的健康素养低于检测不足的健康素养为3个questions.CONCLUSIONS：一个单一的问题可能是有用的检测患者健康素养不足的VA人口。
OBJECTIVES: Previous studies have shown that a single question may identify individuals with inadequate health literacy. We evaluated and compared the performance of 3 health literacy screening questions for detecting patients with inadequate or marginal health literacy in a large VA population.METHODS: We conducted in-person interviews among a random sample of patients from 4 VA medical centers that included 3 health literacy screening questions and 2 validated health literacy measures. Patients were classified as having inadequate, marginal, or adequate health literacy based on the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Rapid Estimate of Adult Literacy in Medicine (REALM). We evaluated the ability of each of 3 questions to detect: 1) inadequate and the combination of "inadequate or marginal" health literacy based on the S-TOFHLA and 2) inadequate and the combination of "inadequate or marginal" health literacy based on the REALM.MEASUREMENTS AND MAIN RESULTS: Of 4,384 patients, 1,796 (41%) completed interviews. The prevalences of inadequate health literacy were 6.8% and 4.2%, based on the S-TOHFLA and REALM, respectively. Comparable prevalences for marginal health literacy were 7.4% and 17%, respectively. For detecting inadequate health literacy, "How confident are you filling out medical forms by yourself?" had the largest area under the Receiver Operating Characteristic Curve (AUROC) of 0.74 (95% CI: 0.69-0.79) and 0.84 (95% CI: 0.79-0.89) based on the S-TOFHLA and REALM, respectively. AUROCs were lower for detecting "inadequate or marginal" health literacy than for detecting inadequate health literacy for each of the 3 questions.CONCLUSIONS: A single question may be useful for detecting patients with inadequate health literacy in a VA population.