{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:23:25Z","timestamp":1793330605874,"version":"4.5.0"},"reference-count":61,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T00:00:00Z","timestamp":1712793600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Health Care Trust of Anne Constance and Carl Robert Anderson","award":["9189191"],"award-info":[{"award-number":["9189191"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Clinicians need a tool to gauge patients\u2019 ability to understand health conditions and treatment options. The Short-form Test of Functional Health Literacy in Adults (S-TOFHLA) is the gold standard for this, but its length is prohibitive for use in clinical settings. This study seeks to validate a novel three-item question set for predicting health literacy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This cross-sectional study utilized an in-person questionnaire alongside the S-TOFHLA. The sample included 2027 English- and Spanish-speaking adults (\u226518\u00a0years) recruited from primary care practices serving a low-income eastern Pennsylvania community. Most patients (57.7%) identified as Hispanic. Diagnostic accuracy of each question and aggregated scores were assessed against the validated survey by calculating the area under the receiver operating characteristic (AUROC) curve.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Questions in the \u2018Problems Learning\u2019 and \u2018Help Reading\u2019 domains (AUROC 0.66 for each) performed better than the \u2018Confident Forms\u2019 question (AUROC 0.64). Summing all three scores resulted in an even higher AUROC curve (0.71). Cronbach\u2019s alpha of the combined items was 0.696.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Study results suggest that any of the three questions are viable options for screening health literacy levels of diverse patients in primary care clinical settings. However, they perform better as a summed score than when used individually.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pubmed\/fdae035","type":"journal-article","created":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T01:14:21Z","timestamp":1712970861000},"page":"383-391","source":"Crossref","is-referenced-by-count":3,"title":["Validation of three health literacy screening questions compared with S-TOFHLA in a low-income diverse English- and Spanish-Speaking population"],"prefix":"10.1093","volume":"46","author":[{"given":"Hope","family":"Kincaid","sequence":"first","affiliation":[{"name":"Network Office of Research and Innovation, Lehigh Valley Health Network , Allentown, PA 18103 , USA"},{"name":"Morsani College of Medicine, University of South Florida , Tampa, FL 33620 \u00a0 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9924-398X","authenticated-orcid":false,"given":"Cathy A","family":"Coyne","sequence":"additional","affiliation":[{"name":"Department of Nursing and Public Health, Moravian University , Bethlehem, PA 18018 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roya","family":"Hamadani","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Lehigh Valley Health Network , Allentown, PA 18101 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Friel","sequence":"additional","affiliation":[{"name":"Morsani College of Medicine, University of South Florida , Tampa, FL 33620 \u00a0 USA"},{"name":"Department of Medicine, Lehigh Valley Health Network , Allentown, PA 18102 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,4,11]]},"reference":[{"key":"2024082908072846600_ref1","volume-title":"\u201cWhat did the doctor say?\u201d Improving health literacy to protect patient safety","author":"The Joint 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