Test-retest reliability of the Newest Vital Sign health literacy instrument: In-person and remote administration.
Andrea M Russell, Deesha A Patel, Laura M Curtis and 4 others
PMID 30503639WHAT IT FOUND
Phone administration of the Newest Vital Sign health literacy screening produced scores similar to in-person testing.
Score consistency dropped when the second test was delayed, so a remote score may change over time.
Key findings
01Retest scores were similar by phone and in person (ICC 0.70 versus 0.81), and category agreement was moderate (kappa 0.52 versus 0.58).
02Score consistency dropped when the second test was 10 to 24 days after baseline rather than 4 to 9 days (in-person ICC 0.88 to 0.70; phone 0.73 to 0.68).
03Most participants contacted by phone completed the screening (85%), but 26 could not because they lost the label materials.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample came from a single emergency department and was mostly female with relatively high literacy, so it may not apply to more diverse patients. The phone test was not supervised, so participants may have used aids such as calculators. Some participants could not be retested because they lost the nutrition label. Reliability decreased when the second test was delayed, so a remote score may not be stable over weeks. The study was exploratory and preliminary, and it analyzed existing trial data rather than testing the screening in routine care. Pain was associated with scores in some comparisons but not consistently across the study.
Declared interests
Michael S Wolf has served as a consultant on health literacy measurement with Merck, Sharp & Dohme Corp.
The easy way to misread this
Do not conclude that remote health literacy screening is interchangeable with in-person screening at any interval. The study was preliminary, and score consistency dropped when retesting occurred later.