Research ArticleOriginal Research

Health Literacy Instrument in Family Medicine: The “Newest Vital Sign” Ease of Use and Correlates

Lisa Ciccarelli Shah, Patricia West, Katazryna Bremmeyr and Ruth T. Savoy-Moore
The Journal of the American Board of Family Medicine March 2010, 23 (2) 195-203; DOI: https://doi.org/10.3122/jabfm.2010.02.070278

Article Figures & Data

Figures

  • Figure 1.
    Figure 1.

    Tester verbally administers the questions on the left. The patient holds and uses the ice cream nutrition label on right to answer 6 questions. (NVS screening tool originally printed by Weiss, et al16 in 2005.) Reprinted with permission from “Quick Assessment of Literacy in Primary Care: The Newest Vital Sign, ” November/December 2005, Annals of Family Medicine. Copyright © 2005 American Academy of Family Physicians. All Rights Reserved.

  • Figure 2.
    Figure 2.

    Health literacy decreases with age. Age by decades is plotted against adequate health literacy. The youngest participant was 13; the oldest was 91. There was a significant effect of age category on health literacy (χ2 P < .0005). Total number of patients in each age bracket is shown within each bar.

  • Figure 3.
    Figure 3.

    A higher percentage (55%) of adults having adequate health literacy had taken a health class in school (left; n = 800; χ2 P < .0005), but this relationship was not true for teens still in school (right; n = 206; P = .485). Having taken a health class in school was a predictor in the logistic regression analysis for adults but not for teens. NVS, Newest Vital Sign.

  • Figure 4.
    Figure 4.

    Body mass index, categorized using World Health Organization criteria, is depicted against adequate health literacy for adults (solid bars) and teens (dotted bars). There was no association of BMI with health literacy level among either group when evaluated by analysis of variance (P > .05) or BMI category (χ2 P > .05). However, BMI category was the fourth of 5 predictors in the logistic regression analysis for adult participants (odds ratio, 1.040; 95% CI, 1.016–1.065) and second of 2 predictors among teen athletes (odds ratio, 1.087; 95% CI, 0.999–1.182). The number within each bar represents the number of patients with adequate literacy per group. No teen athlete fell in the Obesity II or Extreme Obesity BMI categories.

Tables

  • Table 1.

    Proportion of Patients with Adequate Health Literacy*

    VariableAdequate Literacy (%)
    Adult (n = 808)Athletes‡ (n = 206)
    Gender × race†
        White female63.2 (222/351)65.5 (57/87)
        White male47.5 (95/200)61.0 (61/100)
        Non-white female30.1 (53/176)44.4 (4/9)
        Non-white male23.0 (17/74)10.0 (1/16)
    Smoking status
        Current smoker or quit <5 years ago44.862.5 (5/8)
        Never smoked or quit >5 years ago50.459.6 (118/198)
    Education level
        ≤11th grade16.7100
        High school graduate or GED34.4
        Some college54.9
        College graduate; may have done postgraduate work77.5
    Self-reported health status
        Fair or poor32.30.0
        Good58.165.6
        Excellent or very good57.059.3
    Taken a health class55.057.3

    • * Adequate refers to an Newest Vital Sign score of 3 to 6.

    • † Includes African American (23.4%), American Indian (1%), Asian (0.3%), and multiracial (0.5%)

    • ‡ Includes middle-school and high-school students who were approached at preparticipation sports physicals.

  • Table 2.

    Variables Predicting Adequate Health Literacy in Logistic Regression Analysis

    Predictor VariableAdult (n = 778)MS and HS Athletes (n = 206)
    Gender × race*
        White female11
        White male0.497 (0.328–0.753)0.713 (0.384–1.324)
        Non-white female0.177 (0.111–0.282)0.295 (0.068–1.269)
        Non-white male0.210 (0.110–0.398)0.045 (0.005–0.381)
    Age0.953 (0.941- 0.965)—
    Education level
        11th grade or less1—
        High school graduate or GED1.80 (0.909–3.565)
        Some college3.667 (1.869–7.195)
        College graduate; may have postgraduate work12.019 (5.650–25.570)
    BMI1.040 (1.016–1.065)1.087 (0.999–1.182)
    Taken a health class1.536 (1.056-.235)—

    • Values provided as odds ratio (95% CI). MS, middle school; HS, high school; BMI, body mass index.

    • * Includes African American (23.4%), American Indian (1%), Asian (0.3%), and multiracial (0.5%).

  • Table 3.

    Correct Response Percentage for Adults and Young Athletes

    Question No.Abbreviated QuestionPercent Answering Correctly
    Adults (n = 778)Young Athletes (n = 206)
    1Calories in entire ice cream carton?54.552.9
    2How much ice cream has 60 g carbohydrates?56.966.0
    3Grams saturated fat in 1 serving?30.754.9
    4What % of 2500 calorie daily intake is in this ice cream pint?39.748.5
    5If allergic to peanuts, can you eat this ice cream?71.882.0
    6If not, why not?61.477.7
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