Quantifying Word Use to Study Health Literacy in Doctor–Patient Communication

Abstract

Most health literacy research to date has assessed health literacy using either general reading tests or text-based appraisals of reading and numeracy skills, yet the definition of health literacy includes domains beyond reading ability. Effective oral communication between doctor and patient is an important component of health literacy, but only recently have efforts been made to develop measures that tap into domains beyond those that can be assessed with text-based measures. Focusing on oral exchange, this article describes computer-assisted approaches to quantifying word use and the development of three word-use measures that can be used to study health literacy in transcripts of clinical encounters. The measures can be used to assess either the expressed literacy level of patients or the aural literacy demands made by doctors. Importantly, the computer-assisted quantitative measures described here make it possible for word use to be analyzed at a level of detail that human raters would be hard pressed to attain.

This research was conducted as part of Susan Koch-Weser's doctoral dissertation. Dr. Lawren Daltroy was Dr. Koch-Weser's academic and research advisor during the formative stages of the project. His insights improved the work immeasurably, while his kindness and humor never failed to lift our spirits. Sadly, he died before the completion of the project and is terribly missed.

Notes

*Mild = self-limiting (acute) connective tissue diseases such as tendonitis. Moderate = chronic inflammatory rheumatic diseases such as osteoarthritis. Severe = systemic inflammatory diseases such as lupus.

*p < .10; **p < .05; ***p < .01.