Article Text

  1. A. Sweeney1,
  2. P. F. Bass1,
  3. C. Z. Rodrigue1,
  4. C. Y. Osborn2,
  5. M. S. Wolf2,
  6. K. Davis1,
  7. M. Bocchini1,
  8. S. Jain1,
  9. T. C. Davis1
  1. 1Louisiana State University Health Sciences Center, Shreveport, LA
  2. 2Northwestern University, Chicago, IL


Background The Newest Vital Sign (NVS) is a new rapid screening instrument for low literacy in medical settings. No studies currently compare the NVS with the Short Test of Functional Health Literacy in Adults (S-TOFHLA).

Purpose Compare the performance of the NVS to the S-TOFHLA and assess the operating characteristics of the NVS.

Methods A convenience sample of patients at two federally qualified health centers (FQHCs) were interviewed and given two literacy assessments, the S-TOFHLA and the NVS. The S-TOFHLA is a reading comprehension and numeracy assessment with well-studied internal consistency, reliability, and validity. Scores range from 0 to 100, with scores less than 53 identifying poor health literacy. The NVS is a nutrition label that tests patients' general literacy and numeracy skills with six questions. A score of 4 to 6 indicates adequate literacy.

Results Of the 119 patients tested, the average age was 55 years old (35-55), 70% were female, 61% were African American, and 39% had not graduated from high school. Administration time was approximately 7 minutes for the S-TOFHLA and 5 to 7 minutes for the NVS. The internal consistency of the NVS was good (α = 0.81). The correlation between scores on the NVS and scores on the S-TOFHLA was 0.61 (p < .001). The area under the ROC curve for predicting inadequate health literacy according to the S-TOFHLA was 0.73 (95% CI 0.70-0.78). NVS scores of 0 to 1 had a sensitivity of 94.6% and a specificity of 63.4% for predicting inadequate health literacy according to the S-TOFHLA. The Table presents scores and percentages for each test.

Conclusion The NVS showed a moderate correlation with the highly validated S-TOFHLA and did well as a screen predicting low literacy as defined by the S-TOFHLA in two FQHCs.

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