Measuring health literacy is a tricky and complicated process. In part, this
is because there are so many aspects to potentially include in an evaluation methodology. The challenge of measuring health literacy is also compounded by the many contexts in which health literacy can be evaluated – from different diseases to different stages of life to different health system contexts. Further, there is the two-sided nature of health literacy: We can focus on measuring the health literacy of individuals as patients, but we should also focus on measuring the health literacy of health professionals and health systems as it relates to their ability to serve their patient population.
There are several existing screeners of health literacy at the moment, and more are under development. But the field as a whole is still working on coming to a consensus on what should be measured, how it should be measured, and who should be evaluated.
In this discussion we will collectively explore the existing screeners and measures of health literacy and discuss their uses and limitations. We will also discuss the elements of what a rigorous measure of health literacy might focus on and what kinds of conceptual work and rigorous testing are needed to in order to continue to collectively advance the field of health literacy.
- What kinds of measures or screeners do you need in your work,
- Who and what do we need to measure? (Just patients' abilities or
those of providers? How about systems?)
- Do we focus on specific skills - and if so which ones? Or, do we
focus on the predicted outcomes of health literacy? (In both cases, are
they the same for measuring patients vs. providers?)
- What components would you include in an ideal measurement or
screening tool - and why - and how?
- How can we create tools that work equally well across different
- How can we best continue to advance the field of health literacy
given the disparate screening and measurement tools that exist?
Together, we will discuss the responses to these questions, but also
address any or all of the following possible topics as interest and
- Overview and discussion of current screening/measurement tools
- Uses and limitations of each (include why it's not appropriate
to screen in waiting rooms)
- What they used in the National Adult Literacy Survey
- Given the existing measures, how can we evaluate a specifically
targeted intervention in a way that is comparable across projects? Do we
care to do so? (For example, a curricula taught in and adult lit class,
OR a training of health center personnel?)
- Building a dream tool: What does it need / what do we need to do
Andrew Pleasant is the director of health literacy and communication at Canyon Ranch Institute. See Andrew’s bio here.
Measuring health literacy: A challenge to curriculum design and evaluation
This article explores the challenges to developing measures of health literacy and evaluations of health literacy curricula and other interventions.
A perspective piece on health literacy put out by Canyon Ranch Institute
and more resource and publication links are available at http://www.canyonranchinstitute.org/perspectives/healthlit
A presentation by Andrew Pleasant to the Institute of Medicine (IOM)
Roundtable on health literacy sponsored Workshop on measures of health
literacy is available at
Other presentations at that workshop are available at
The workshop summary is available at
Andrew Pleasant's article on the National Adult Literacy Survey's health
literacy results and analysis published in Focus on Basics is available
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