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Health Literacy -> Measuring Health Literacy

Measuring Health Literacy

Health literacy measurement tools have generally focused on individual capacity rather than the skills that promote improved self-care and health outcomes. Most are focused on to reading and the ability assess health-related materials, and evaluate word recognition and reading comprehension.

Best known and most commonly used measures include the Rapid Estimate of Adult Literacy in Medicine (REALM) and the Test of Functional Health Literacy in Adults (TOFHLA).

The REALM is a recognition and pronunciation test of medical terms (66-items) with scores indicating four categories of grade-level-equivalent reading levels.


TOFHLA is focused on numeracy and reading comprehension (67 items, Spanish and short-form versions), measuring abilities to use real-life health care materials (prescription labels, health forms, and diagnostic test instructions).

Newest Vital Sign (developed by Pfizer, Inc., 2011—also available in Spanish) measures the ability to understand numbers, words, and concepts in a specially designed ice cream nutrition label—if you eat the entire carton, how many calories will you eat?

CAMIMH (2007) Few tools exist for measuring behavioral health literacy and vignette-based methodologies are commonly used to test the recognition of and attitudes toward mental illnesses.

Davis et al. (2008) developed a measurement tool to assess the mental health literacy of caregivers of children with SED and their care givers.

Some mental health literacy studies have used the common set of general health literacy measurement tools.