[NIFL-HEALTH:3757] RE: Interpreting TOFHLA scores

From: Walter F. Wallace (Walter.F.Wallace@Hitchcock.ORG)
Date: Wed Aug 07 2002 - 17:08:57 EDT


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From: Walter.F.Wallace@Hitchcock.ORG (Walter F. Wallace)
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Subject: [NIFL-HEALTH:3757] RE: Interpreting TOFHLA scores
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This is a very interesting area of concern.  I'm a little suspicious of crosswalking any reading assessment according to grade level when working with adults.  Might it not make more sense to validate the reading levels against the ABE/ESL standards associated with WIA?  Has anyone looked at STOFHLA or REALM in relation to EFF standards?

Walter

Walter Wallace
GME Office
Dartmouth-Hitchcock Medical Center
walter.f.wallace@hitchcock.org

--- You wrote:
The STOFHLA was not validated relative to reading grade levels (probably
purposefully to maintain a focus on functional health literacy). The
TOFHLA manual reports Spearman correlation of .81 with REALM (Rapid
Estimate of Adult Literacy in Medicine)which was set up to give ranges
of reading level scores. I believe that this is for raw scores rather
than for the literacy levels (3 for TOFHLA and 4 for REALM)making
practical comparisons a little tricky. In my experience working with
both there is a good correspondence between individuals who score in the
lowest category of either test (reading level <= 3rd grade for REALM and
inadequate functional health literacy for the TOFHLA) but then there is
less overlap in the 4-6th grade category of REALM and the marginal
health literacy category of TOFHLA.  I would love to hear from some of
the developers of these instruments on this (regular contributers to the
list).
Ian 

-----Original Message-----
From: nifl-health@nifl.gov [mailto:nifl-health@nifl.gov] On Behalf Of
Debbie Yoho
Sent: Wednesday, August 07, 2002 2:48 PM
To: Multiple recipients of list
Subject: [NIFL-HEALTH:3751] Interpreting TOFHLA scores



In a JAMA article from July 24/31, 2002 (Vol 288, No 4) on the
"Association of Health Literacy with Diabetes Outcomes",  the short-form
Test of Functional Health Literacy in Adults (s-TOFHLA) was the
instrument used to assess literacy.  The article states, "The mean
abbreviated s-TOFHLA score was 21...38% of patients had inadequate
health literacy (s-TOFHLA score 0-16), and 13% had marginal health
literacy (s-TOFHLA score 17-22)".  Does anyone know if these scores will
translate to grade levels to get a clearer picture of what "inadeqate"
and "marginal" health literacy mean in terms of reading abililty?


Deborah W. Yoho
Co-moderator, NIFL-Health  and
Executive Director
Greater Columbia Literacy Council
2728 Devine Street,  Columbia, SC  29205
803-765-2555   Fax  803-779-8417   dwyoho@earthlink.net
--- end of quote ---



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