Validity of single-item screening for limited health literacy in english and Spanish speakers

Wendy Pechero Bishop, Simon J. Craddock Lee, Celette Sugg Skinner, Tiffany M. Jones, Katharine McCallister, Jasmin A. Tiro

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Objectives. To evaluate 3 single-item screening measures for limited health literacy in a community-based population of English and Spanish speakers. Methods. We recruited 324 English and 314 Spanish speakers from a community research registry in Dallas, Texas, enrolled between 2009 and 2012.We used 3 screening measures: (1) How would you rate your ability to read?; (2) How confident are you filling out medical forms by yourself?; and (3) How often do you have someone help you read hospital materials? In analyses stratified by language, we used area under the receiver operating characteristic (AUROC) curves to compare each item with the validated 40-item Short Test of Functional Health Literacy in Adults. Results. For English speakers, no difference was seen among the items. For Spanish speakers, "ability to read" identified inadequate literacy better than "help reading hospital materials" (AUROC curve = 0.76 vs 0.65; P = .019). Conclusions. The "ability to read" item performed the best, supporting use as a screening tool in safety-net systems caring for diverse populations. Future studies should investigate how to implement brief measures in safety-net settings and whether highlighting health literacy level influences providers' communication practices and patient outcomes.

Original languageEnglish (US)
Pages (from-to)889-892
Number of pages4
JournalAmerican journal of public health
Issue number5
StatePublished - May 2016

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'Validity of single-item screening for limited health literacy in english and Spanish speakers'. Together they form a unique fingerprint.

Cite this