Addressing the “Other” Health Literacy Competencies—Knowledge, Dispositions, and Oral/Aural Communication: Development of TALKDOC, an Intervention Assessment Tool

Abstract

Most health literacy assessments evaluate literacy skills including reading, writing; numeracy and interpretation of tables, graphs, diagrams and charts. Some assess understanding of health systems, and the ability to adequately apply one's skills to specific health-related tasks or demands in health situations. However, to achieve functional health literacy, the ability to “obtain, process, and understand basic health information and services needed to make appropriate health decisions,” other health literacy dimensions should be assessed: a person's knowledge and attitudes about a health issue affects his or her ability to and interest in participating in his or her own care. In patient care settings, the abilities to listen, ask questions and check one's understanding are crucial to making appropriate decisions and carrying out instructions. Although literacy is a skill associated with educational attainment and therefore difficult to change in a short time, health education interventions can address health literacy domains such as knowledge, attitudes and oral communication skills. For this reason, an instrument that can assess these constructs is a valuable part of a health educator's toolbox. The authors describe the development and process and outcomes of testing a novel instrument targeted to assess HPV and cervical cancer health literacy competencies, TALKDOC, including its validation with the Health Activities Literacy Scale.

Acknowledgments

The work described in this manuscript was generously supported by the Eunice Kennedy Shriver National Institute of Child Health and Development (1 RO3 HD050402-01). We wish to thank the staff and student interns who participated in developing and implementing this assessment tool; the members of the Advisory Board who provided the content and ensured the scientific validity of the information in the instrument; and the members of the community who participated in the testing of the instrument. Also, the authors' sincere thanks go to Irwin Kirsch of the Center for Global Assessment Educational Testing Service, Princeton, NJ and to Rima Rudd of the Department of Society, Human Development and Health at Harvard University School of Public Health, Boston MA for their guidance, consultation and moral support and, in particular, for providing access to the Health Activities Literacy Scale.

Notes

*For example, I have had abnormal Pap test results in the past; it was time and I asked for it; school physical; to get birth control pills renewed; heavy bleeding and painful cramps; new sex partners.