[NIFL-HEALTH:3470] likert scales for low-literacy readers

From: Holly Avey (havey@emory.edu)
Date: Thu Nov 29 2001 - 09:17:48 EST


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From: Holly Avey <havey@emory.edu>
To: Multiple recipients of list <nifl-health@literacy.nifl.gov>
Subject: [NIFL-HEALTH:3470] likert scales for low-literacy readers
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I recently tried to analyze some data I have been collecting from a low-literacy
population, and I ran across an issue I suspect others already know about and
have researched.  I attempted to write the survey questions for my pre-test at
an appropriate readability level, based on general assessments of our patient
population a few years ago.  Many of the questions featured likert scales for
answer options.  When I began to analyze the data, I discovered that it violated
normal distribution assumptions.  Specifically, the data seemed to cluster at
the extreme answer options.  My suspicion is that people with low literacy may
be more likely to choose extreme options on likert scales, possibly because the
subtle variations between the choices get a little confusing.  Does anyone know
if this phenomena has been tested empirically?  If so, could you provide me with
some references?  Any suggestions on how to address this problem?  (Maybe only
offer three choices instead of five, or throw out all likert scales
completely?)  It does pose quite a problem when trying to use standardized
instruments and compare results to other population groups. . .

Thank you for your help.

-- Holly
Holly Avey, MPH
Health Educator, Office of Health Promotion
Grady Health System, Atlanta, GA
Ph: 404-616-7561, Fax: 404-880-9464, E-mail: havey@emory.edu



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