A Comparison of Health Literacy Measurement Tools for a Sample of College Students

Oyenike Ilaka, University at Albany, State University of New York


PURPOSE: Different measurement tools can be used to measure the health literacy of college students, and each measure different aspects of health literacy. The purpose of this thesis is to understand how health literacy assessments vary. Identifying strengths and weaknesses of the different tools may lead to improved studies of the predictors and outcomes of health literacy in college students. METHOD: The data were collected from college students attending a public university in the Northeast region of the United States. A total of 249 participants were recruited by class survey administration and flyer recruitments. With the exception of the Single Item Health Literacy Screening (SILS) completed by all 249 participants, 122 participants completed the other three health literacy assessments. These assessments included: Rapid Estimate of Adolescent Literacy in Medicine (REALM-Teen), Newest Vital Sign (NVS), Short Test of Functional Health Literacy in Adults (S-TOFHLA). RESULTS: There were variations across the measurement tool scores. All students had high literacy scores for the S-TOFHLA. However, some had low health literacy scores for the SILS (20%), REALM-Teen (17%) and NVS (13%). After multivariate analysis, race (white vs non-white (OR= .09, 95% CI = .02, .49), language spoken at home (English vs. other; OR= .07, 95% CI = .02, .35), and father’s level of education (OR =5.44, 95% CI = 1.19, 24.79) were significant predictors of low health literacy with either NVS or REALM. CONCLUSION: The four measurement tools (NVS, S-TOFHLA, REALM-Teen & SILS) have varying levels of sensitivity. Some students who had high literacy scores using some measurement tools were identified as having low health literacy with other tools. Researchers and practitioners should consider which tool is the most appropriate depending on the particular circumstance.