Does Numeracy Correlate With Measures of Health Literacy in the Emergency Department?

Objectives The objective was to quantify the correlation between general numeracy and health literacy in an emergency department (ED) setting. Methods This was a prospective cross‐sectional convenience sample study of adult patients in an urban, academic ED with 97,000 annual visits. General numerac...

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Veröffentlicht in:Academic emergency medicine 2014-02, Vol.21 (2), p.147-153
Hauptverfasser: Griffey, Richard T., Melson, Andrew T., Lin, Margaret J., Carpenter, Christopher R., Goodman, Melody S., Kaphingst, Kimberly A., Wilber, Scott T.
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Sprache:eng
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Zusammenfassung:Objectives The objective was to quantify the correlation between general numeracy and health literacy in an emergency department (ED) setting. Methods This was a prospective cross‐sectional convenience sample study of adult patients in an urban, academic ED with 97,000 annual visits. General numeracy was evaluated using four validated questions and health literacy using three commonly used validated screening tools (Short Test of Functional Health Literacy in Adults [S‐TOFHLA], Rapid Estimate of Adult Literacy in Medicine‐Revised [REALM‐R], and the Newest Vital Sign [NVS]). Scores were dichotomized for health literacy tests to limited (low or marginal) versus adequate health literacy, and the proportion of patients answering all numeracy questions correctly was calculated with the mean proportion of correct responses in these groups. The correlation between numeracy scores and scores on the health literacy screening tools was evaluated using Spearman's correlation. Results A total of 446 patients were enrolled. Performance on questions evaluating general numeracy was universally poor. Only 18 patients (4%) answered all numeracy questions correctly, 88 patients (20%) answered zero questions correctly, and overall the median number of correct answers was one (interquartile range [IQR] = 1 to 2). Among patients with limited health literacy (LHL) by any of the three screening tools used, the mean number of correct numeracy answers was approximately half that of patients with adequate health literacy. However, even among those with adequate health literacy, the average number of correct answers to numeracy questions ranged from 1.6 to 2.4 depending on the screening test used. When dichotomized into those who answered ≤50% versus >50% of numeracy questions correctly, there was a significant difference between those with LHL and those who scored ≤50% on numeracy. Health literacy screening results were correlated with general numeracy in the low to moderate range: S‐TOFHLA rs = 0.428 (p 
ISSN:1069-6563
1553-2712
DOI:10.1111/acem.12310