The Development of a Health Numeracy Measure

描述(由申请者提供)：一般健康素养可以被定义为一个人获得、处理和理解做出适当医疗保健决策所需的基本健康信息的能力。医学研究所提出了一个健康素养模式，它包括四个结构：1)文化和概念知识，2)口头素养(听和说)，3)印刷素养(写作和阅读)和4)算术。每一种结构都反映了在保健系统中发挥作用所需的一套技能，而且每一种结构都需要一种有效的措施来推动我们对扫盲与健康之间关系的理解。我们建议在健康计算结构的概念框架基础上开发一种新的健康素养测量方法。我们开发了一个健康计算的概念框架，它包括初级计算技能、应用健康计算和解释性健康计算领域。一种全面和有效的计算方法将通过以下方式推动传播和决策科学的发展：a)提供一种工具来描述特定个人或人群中存在的计算水平和组成部分；b)指导制定量身定制的交流和患者教育材料；c)支持制定干预措施，以提高卫生计算技能。本申请的具体目的是：1.开发一种测量健康计算能力的工具，称为医学数字理解工具(NUMI)。Numi将是一种基于经验得出的健康计算框架。B.跨种族(黑人和白人)和族裔(西班牙裔和非西班牙裔)群体的跨文化平等。使用项目反应理论开发，以确保项目的估计特征相对于用于评估测量的样本是不变的。2.为确定NUMI的信度和效度，将进行内部信度和平行测验信度。B.内容有效性将得到专家小组对算术结构的审查、对确定的反映算术结构的技能的审查以及对为NUMI工具生成的项目的审查的支持。C.将通过评估NUMI的分数与教育水平以及现有的成就和健康素养衡量标准之间的关联来检验结构效度。D.标准的有效性将通过评估NUMI上的分数与医学数据解释测试、采取健康保护行为和感知健康之间的关联性来测试。

DESCRIPTION (provided by applicant): General health literacy can be defined as a person's ability to obtain, process, and understand the basic health information needed to make appropriate health care decisions. The Institute of Medicine has put forth a model of health literacy that includes four constructs: 1) cultural and conceptual knowledge, 2) oral literacy (listening and speaking), 3) print literacy (writing and reading) and 4) numeracy. Each construct reflects a set of skills required to function in the health care system and each requires a valid measure to move forward our understanding of the relationship between literacy and health. We propose to develop a new measure of health literacy based upon a conceptual framework of the health numeracy construct. We have developed a conceptual framework of health numeracy that includes the domains of primary numeric skills, applied health numeracy, and interpretive health numeracy. A comprehensive and valid numeracy measure will advance the science of communication and decision-making by: a) providing a tool to describe the level and components of numeracy present in a given individual or population, b) guiding the development of tailored communication and patient educational materials, and c) supporting the development of interventions to improve health numeracy skills. The specific aims in this application are: 1. To develop a measure of health numeracy named the Numeracy Understanding in Medicine Instrument (NUMi). The NUMi will be a. Based upon an empirically derived framework of health numeracy. b. Cross-culturally equivalent across race (black and white) and ethnic (Hispanic and Non-Hispanic) groups. c. Developed using Item Response Theory to ensure that the estimated characteristics of the items are invariant with respect to the sample that is used to evaluate the measure. 2. To establish the reliability and validity of the NUMi a. Internal reliability and parallel-testing reliability will be conducted. b. Content validity will be supported by expert panel review of the numeracy construct, review of the skills identified to reflect the numeracy construct, and review of the items generated for the NUMi instrument. c. Construct validity will tested by evaluating the association of scores on the NUMi with levels of education and existing measures of achievement and health literacy. d. Criterion validity will be tested by evaluating the association of scores on the NUMi with the Medical Data Interpretation Test, the adoption of health protective behaviors, and perceived health.