The Health Literacy Skills Instrument: A 10-Item Short Form

Figures & data

Table 1. Mean health literacy scores, by participant characteristics

			Health Literacy–Long Form			Health Literacy–Short Form
Characteristic	N	%	M (95% CI)	B (SE)	p	M (95% CI)	B (SE)	p
Gender
Male	458	48	70 (68–73)	1.57 (2.18)	.469	67 (64–70)	0.77 (2.26)	.734
Female	431	52	69 (66–72)	REF		67 (63–70)	REF
Age (years)
18–29	180	22	69 (65–73)	1.54 (3.08)	.617	67 (62–72)	3.60 (3.32)	.279
30–44	205	25	71 (66–76)	3.53 (3.21)	.271	69 (64–73)	5.14 (3.10)	.098
45–59	255	27	71 (68–75)	4.11 (2.80)	.143	69 (65–72)	5.25 (2.82)	.063
60+	249	26	67 (64–70)	REF		63 (60–66)	REF
Education
More than high school	316	36	80 (78–83)	21.49 (2.49)	<.001	78 (75–80)	20.75 (2.63)	<.001
High school graduate	295	33	68 (65–72)	12.13 (2.21)	<.001	65 (61–69)	12.83 (2.38)	<.001
Less than high school	278	31	59 (55–62)	REF		57 (53–61)	REF
Race
White	664	64	74 (72–76)	REF		70 (68–73)	REF
Black	83	13	56 (50–62)	−17.97 (3.47)	<.001	53 (46–60)	−17.37 (3.74)	<.001
Hispanic	80	17	65 (59–71)	−8.73 (3.51)	.013	64 (59–70)	−6.07 (3.42)	.076
Other	62	6	65 (57–72)	−9.06 (4.37)	.038	66 (58–73)	−4.74 (4.40)	.281
Marital status
Married	489	46	73 (71–76)	7.34 (2.12)	<.001	71 (68–73)	6.81 (2.17)	.002
Not married	400	54	66 (63–69)	REF		64 (60–67)	REF
Employment status
Employed	470	51	74 (71–77)	REF		70 (67–74)	REF
Retired	161	15	68 (64–71)	−6.00 (2.54)	.018	64 (61–66)	−6.90 (2.64)	.009
Disabled	81	11	55 (50–59)	−19.23 (4.03)	<.001	52 (47–56)	−18.86 (4.15)	<.001
Unemployed	177	23	68 (64–72)	−5.40 (2.73)	.048	69 (65–72)	−1.79 (2.64)	.499
Geographic region
Northeast	161	18	67 (62–72)	−3.79 (3.38)	.263	66 (61–70)	−3.43 (3.36)	.308
Midwest	206	22	70 (64–75)	−1.13 (3.44)	.742	66 (60–71)	−3.29 (3.65)	.368
South	338	38	70 (67–73)	−0.57 (2.80)	.838	67 (64–71)	−1.75 (2.87)	.542
West	184	22	71 (66–75)	REF		69 (64–73)	REF

Figure 1 Item characteristic curves. (Color figure available online.).

Table 2. Psychometric properties of the Health Literacy Scale–Short Form

			IRT Parameters
Item	Percentage correct	Factor loading	Slope	Threshold
PRINT-PROSE
1. Which set of low density lipoprotein (LDL) and high density lipoprotein (HDL) levels is best?	66	0.57	1.20	−0.88
2. Which of the following is not a sign of a stroke?	90	0.71	1.84	−1.88
PRINT-DOCUMENT
3. Which of the following entrance is closest to the elevator?	80	0.63	1.40	−1.36
4. In the example listed in the first row of the table, when should the medicine be taken?	59	0.56	1.15	−0.47
5. A person is cooking dinner for himself and he wants to include one serving from the meat and beans group. What should he choose?	75	0.68	1.59	−1.09
PRINT-QUANTITATIVE
6. If a person is on a 2,500 calorie diet, what percent of the daily value of saturated fat would he get from one serving?	24	0.36	0.67	2.06
7. More men die from prostate cancer than from other causes. Based on the chart above, would you say this is true, false, or are you not sure?	80	0.64	1.62	−1.42
INTERNET
8. Kate weighs 150 pounds. Which activity would burn the most calories?	54	0.61	1.36	−0.24
ORAL
9. If a person was worried about his cough, what number should he press?	58	0.49	0.91	−0.43
10. What part of the body do lunge exercises work?	89	0.86	2.46	−1.77

Table 3. Mean health literacy scores, by self-reported skills

			Health Literacy—Long Form			Health Literacy—Short Form
Skill	n	%	M (95% CI)	B (SE)	p	M (95% CI)	B (SE)	p
I am good at math
Agree	429	46	77 (74–79)	12.59 (2.07)	<.001	74 (71–77)	12.35 (2.16)	<.001
Disagree	450	54	64 (61–67)	REF		62 (58–65)	REF
Remembering information I read
Easy	565	65	73 (71–76)	9.93 (2.28)	<.001	71 (68–73)	9.50 (2.32)	<.001
Difficult	317	35	63 (60–67)	REF		61 (58–64)	REF
Remembering information I hear
Easy	584	66	72 (70–75)	8.00 (2.42)	.001	70 (67–72)	7.48 (2.40)	.002
Difficult	295	34	64 (61–68)	REF		62 (59–66)	REF
Understanding information I read
Easy	665	73	75 (73–77)	18.42 (2.59)	<.001	72 (70–74)	17.08 (2.69)	<.001
Difficult	211	27	57 (52–61)	REF		55 (51–59)	REF
Understanding information I hear
Easy	691	77	73 (71–75)	14.89 (2.87)	<.001	71 (69–73)	15.22 (2.94)	<.001
Difficult	189	23	58 (54–63)	REF		56 (51–60)	REF
Explaining a health issue to my doctor
Easy	682	74	72 (70–74)	8.87 (2.77)	.001	70 (67–72)	9.62 (2.85)	<.001
Difficult	196	26	63 (59–68)	REF		60 (56–65)	REF
Locating health information on the Internet
Easy	654	72	74 (71–76)	13.01 (2.57)	<.001	71 (69–73)	13.33 (2.73)	<.001
Difficult	222	28	61 (56–65)	REF		58 (53–62)	REF
Finding health information I need
Easy	645	72	73 (71–75)	11.53 (2.67)	<.001	71 (69–73)	11.78 (2.78)	<.001
Difficult	231	28	62 (57–67)	REF		59 (54–64)	REF